Updated mastitis guidelines were released in 2022, which have recommended some changes in how we view mastitis and how we manage it.

Mastitis is now considered a spectrum of inflammatory conditions of the lactating breast. Symptoms can include redness, breast pain, swelling and flu like symptoms. Mastitis can occur with or without infection. It is impossible to determine from the signs and symptoms alone whether an infection is present. The only way to determine whether an infection is present is to take a milk culture. Mastitis is the most common reason to wean from breastfeeding within the first 12 weeks of the birth of your baby.

Other conditions which may present in a similar way are blocked ducts, breast abscess and white spot. A blocked duct can lead to mastitis if not cleared.

So what triggers the inflammation? It is thought that the pressure within the milk ducts becomes greater than the pressure of the surrounding tissue. This could occur if the volume of milk produced is much greater than the volume of milk removed from the breast, or if the duct is blocked. This increased pressure within the duct then causes milk to leak into the surrounding glandular tissue, which triggers an inflammatory response.

Risk factors for developing mastitis include interrupted or erratic feeding patters, a sudden change in the number of feeds, skipped feeds, positioning and attachment problems, wearing tight bras or garments, rough handling of breasts, trauma, and previous episodes of mastitis.

New management protocols include:

• ice (instead of heat)
• feed on demand (don’t try and empty your breasts)
• gentle massage (lymphatic drainage)
• pain relief/anti inflammatories
• Rest
• therapeutic ultrasound

How can Physiotherapy help?

• Treatment modalities such as therapeutic ultrasound
• Advice regarding positioning of the baby while feeding
• Gentle massage techniques to aid lymphatic drainage

Mastitis is a condition that can come on very quickly. It is best to seek help as soon as you notice any symptoms, i.e pain, redness, swelling of the breast. If treated early mastitis can resolve quickly.

For more information please contact Shanee, your physiotherapist at Caulfield Natural Health Clinic on 95283994, or book an appointment via our website.

To view the new mastitis protocols visit https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf