🔥 Changes in Mastitis Treatment 🔥
🔥 Changes in Mastitis Treatment 🔥
I thought I’d do a little post on managing mastitis……I suppose not everyone is aware that our understating of mastitis and the guidelines for treating it have fairly recently changed a little. The Academy of Breastfeeding Medicine has updated its Mastitis Spectrum Protocol last year, and I’m actually a little late the the party with this post, even though I have implemented the changes into practice 😬
The changes are both significant and interesting:
🔴 Previous understanding of mastitis was that milk is not emptied from the breast effectively/or bacteria enters the breast via nipple trauma.
✅ Now it’s thought that an overproduction of milk, an imbalance in the microbiome of the breast and swelling due to inflammation are what causes mastitis symptoms.
🔴 Previously, treatment consisted of FREQUENT emptying of the breast, possibly by pump, hot compresses, massage (perhaps even with vibrating devices)
✅ Now we recommend avoiding overstimulation and excessive pumping (only until relative comfort is achieved), cold instead of heat, especially after milk removal, no deep massage but gentle lymphatic drainage, which is gentle massage of the lymph nodes in the axilla, and massage away from the nipple towards the axilla or into the centre and top of the chest. Avoid vibrating massagers but do access therapeutic ultrasound if available (quite tricky in the UK)
🔴 Treatment/symptom relief has always been ibuprofen and paracetamol, and antibiotics were usually prescribed as first line of treatment.
✅ Ibuprofen and paracetamol are still fab for treating mastitis, but lecithin supplements can help emulsify milk and reduce inflammation.
Antibiotics should be reserved for bacterial mastitis (perhaps confirmed by milk culture)…..antibiotics may make recurrent mastitis more likely AND many (most?) cases of mastitis clear up by themselves.
Probiotics MAY help prevent certain types of mastitis, particularly Limosilactobacillus fermentum and ligilactobacillus salivarius.
🔥 So yeah, fairly big changes, and lots more interesting stuff. If you want to read more, here is the ABM protocol: https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf