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When a breastfeeding mother gets mastitis: How to treat infected milk ducts and build up supply after

Just nine days after first-time mum Jolene Neo gave birth to her daughter, she was hit by a painful bout of mastitis, a breast infection caused by blocked milk ducts.

Being inexperienced at breastfeeding, Jolene had bought a compact breast pump for the convenience. However, the weak motor, coupled with her naturally “very, very fatty milk quality”, meant she was unable to clear her breasts effectively. It resulted in blocked milk ducts that caused her first round of mastitis.

Trying to cope with the pain of the inflammation, on top of the lack of sleep while finding her footing as a new mum, took a heavy toll on the 36-year-old. Her breast milk supply was affected – her yield plummeted by “a good 50 per cent”, she said. 

Aside from taking antibiotics, Neo engaged a breast masseuse to clear the blockages in her milk ducts. To ease the pain, she placed chilled or frozen cabbage leaves on her breasts – a popular home remedy – but that also lowered her yield. To rebuild her milk supply, she invested in a hospital-grade breast pump.

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Neo isn’t the only mum who has experienced mastitis. One of her friends had multiple bouts of mastitis within months, which caused an abscess; she realised that something was wrong when she found herself expressing fresh blood. The abscess needed to be drained and the poor mum came close to weaning her baby because of what she went through. 

Like Neo and her friend, other mums too, may face traumatising experiences with mastitis. How can mothers better understand and manage this breast infection – or better yet, avoid it? CNA Women asked the experts.

WHAT IS MASTITIS AND WHAT CAUSES IT?

Mastitis refers to the inflammation of the milk ducts and surrounding breast tissue with swelling, causing a narrowing of the ducts.

“When the narrowing of the ducts persists or worsens, this may lead to symptoms such as fever, chills and body aches,” said Cynthia Pang, a senior lactation consultant and Assistant Director of Nursing, Lactation Service, at KK Women’s and Children’s Hospital (KKH). “It can progress to bacterial mastitis requiring antibiotics to resolve the condition.”

If the fever, pain, swelling and redness persist for more than 24 hours, you should see a doctor.

WHAT ARE SOME SEVERE CASES OF MASTITIS YOU’VE ENCOUNTERED?

“We have had cases of repeated occurrences of mastitis or abscesses (build-up of pus). In those severe cases of mastitis, regular on-demand feeding and cold compresses can help to regulate the mother’s supply,” said Pang.

A follow-up consultation with a lactation consultant may be needed to address issues such as improper latching, incorrect pumping techniques or using a breast pump shield that’s the wrong size.

CHOOSING THE RIGHT BREAST PUMP FOR YOU

Here are two things to consider when shopping for a breast pump.

MANUAL OR ELECTRIC BREAST PUMP?

It really depends on one’s comfort level and needs. A colleague who breastfed both her kids swore by her trusty manual single pump. She found the electric pump painful to use. Pumping by hand allowed her to control the pressure more intuitively, even though it gave her quite a workout.

On the rare occasion that she had blocked ducts, she managed by latching her baby and using the manual pump regularly until the blockage cleared.  

An electric pump will do all the hard work for you but tends to be more expensive than a manual pump. Mums who prefer an electric pump feel it does a more thorough and faster job, which may help to prevent plugged milk ducts.

For some who have fattier milk and are more susceptible to mastitis, a hospital-grade pump – though more expensive – is the best way to unblock those painful milk ducts.

Of course, using an electric pump means you need an electric plug or batteries. A manual pump eliminates all that and is lighter to pack. Some mums thus use an electric breast pump on a daily basis but switch to a manual one when they have to be on the run or on business trips.   

SINGLE OR DOUBLE PUMP?

Using a single pump on one breast, then the other, will naturally take more time compared to using a double pump. If a mum is rushed for time, she may sometimes cut short or even skip expressing milk from the second breast. If that happens frequently enough, it may lead to blocked milk ducts and mastitis.

There are ways to work around this. Breast pump maker Medela recommends that “if you’re single pumping, alternate and switch breasts every five minutes until your milk flow stops”. Think of it as how you’d alternate breasts when you latch your baby.

Whatever your preference for breast pumps, the key thing is to clear both breasts adequately – although not completely – when you express milk. Emptying both breasts may lead to an oversupply of milk. While having plenty of milk may sound like a good problem, it may backfire on you and increase your risk of mastitis.

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DOES MASTITIS IMPACT THE MILK DUCTS PERMANENTLY?

Associate Professor Lim Geok Hoon, head of the KK Breast Department at KKH, said mastitis usually does not have any permanent consequences. However, it is more likely for a woman who has had mastitis to develop another episode of mastitis later, which could affect her breastfeeding.

WILL IT REDUCE THE MUM’S BREAST MILK SUPPLY FOR GOOD? IS THERE ANY WAY TO REVERSE THIS?

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