Feeling 'fluey' any time when you are breastfeeding is a warning sign that you could be coming down with mastitis, an inflammation of the breast that may or may not also be infected. Symptoms of mastitis can hit suddenly and hard: one minute you feel just fine and the next you feel shattered and aching all over with chills and a fever. Sometimes flu-like symptoms come on even before you get a fever or notice breast tenderness. Mastitis can affect you emotionally too - it is common to feel 'just awful' and teary.
Another sign that mastitis may be rearing its ugly head is an intensely painful breast. Your whole breast may feel tender and 'tight' and be swollen, red and hot or you may present with a red, sore, lumpy patch on one area of your breast only. A sore, lumpy breast may also be caused by a blocked duct or, in the early days of breastfeeding can be due to engorgement (full breasts). A blocked duct or mastitis without infection will start to feel better with simple measures such as rest and emptying the breast but if you feel increasingly unwell, you will need to seek medical treatment – the sooner the better!
Often the causes behind mastitis can be attributed to lifestyle stresses such as overdoing things and becoming exhausted or stressed, missing feeds (such as when you go on a long car trip and baby sleeps through a feed or if you express to go out but don't express while you are away from your baby) or scheduling feeds too strictly and too far apart. Cracked nipples can also set you up for mastitis as infection can enter the breasts through broken skin so it is important to seek help early for nipple soreness.
Watch your baby, not the clock: avoid overly full breasts and feed long enough to drain your breasts – if you feel tender or full after a feed, express a little milk for comfort.If you feel very full (perhaps if baby has slept a long stretch), offer your baby a feed – chances are he will nurse enough to relieve your fullness even if he is sleepy. If you feel any lumpiness, massage your breast gently towards the nipple under a warm shower (or apply a warm face washer if water restrictions are an issue) and express for comfort. Avoid under-wire or tight bras that may compress milk ducts. Also take care when you are sleeping that you don't sleep in a position that may squash your breasts – such as lying on your stomach.Take care of yourself. Rest, a nutritious diet and relaxing activities that make you feel good will reduce the effects of stress and boost your immune system.
The good news is that if you start treatment early, you can get on top of mastitis before you become very ill. 'Warmth, rest and empty your breast' is a good adage to remember and if you suspect mastitis, consult your doctor early.
Mastitis is a medical illness so should be taken seriously – take sick leave from all duties except feeding your baby. Empty the affected breast. Vary feeding positions to empty all ducts.Take pain relief such as Panadol or Nurofen half an hour before feeding, have a warm shower or apply a warm face washer or warm water in a disposable nappy against your sore breast (this will stay warm longer than a face washer but test carefully that it isn't too hot). Feed on the sore side first but if your affected breast feels too sore to nurse on, start feeding on the least sore side, then switch sides when your milk lets down.Alternate hot and cold packs on your breast for comfort – hot before a feed to stimulate circulation and mobilise infection fighters in the breast and cold afterwards to relieve pain.Drink plenty of fluids – fever and infection will increase your need for fluids. Weaning isn't wise while you are treating mastitis as this will increase the chances of developing an abscess that needs to be surgically drainedIf you are prescribed antibiotics, be sure to take the full course.