The Academy of Breastfeeding Medicine recently updated the protocol for mastitis. Moving forward, I will be implementing these protocols into my practice. Myself and many other lactation professionals have been advising techniques and tips that now contradict the new standard of care. Let’s get into it.

What is mastitis? Mastitis is now defined as inflammation of the mammary gland.

How do I know if it’s Mastitis?

  • a swollen area on your breast that may feel hot and painful to touch – the area may become red but this can be harder to see if you have darker skin
  • a visible lump or hard spot on your breast
  • a burning pain in your breast that might be constant or only when you breastfeed
  • nipple discharge, which may be white or contain streaks of blood
  • flu-like symptoms, such as aches, a high temperature, chills and tiredness.

Lifestyle changes to consider:

Take a daily probiotic – Lactobacillus Genus is recommended

Eat fermented foods daily and foods rich in Choline – Kombucha, sauerkraut, eggs, organ meats,
cruciferous veggies, to name a few!

Sunflower/Soy Lecithin

Avoid tight fitting bras

What should you avoid?

  1. Deep massage. The breast is full of glandular tissue – not a muscle. Deep or intense massage will cause more inflammation and edema to the effected tissue.
  2. Use of vibration and heat therapy is no longer recommended. Although heat can bring immediate relief, it can do more damage in the long run. Instead, try to do lymphatic drainage. It was common for heated massagers, electric toothbrushes and even vibrators to be used.
  3. Have you ever heard of putting your legs up the wall? For my yogi’s, think of inverted legs or shoulder stand. We can do something similar with the breast tissue by using the edge of your hand (pinky and the outside of your hand) and sweep down towards your armpit, you can sweep from the nipple to the arm. This might not make sense, but the breast actually drains into the armpit.
  4. Ditch the Haakaa and Epsom salts or castor oil packs. This is something I recommend regularly, but not anymore! When you place the Haakaa on your breast tissue, it creates negative pressure, which could lead to engorgement or an oversupply. While Epsom salts may bring relief as you can see a clog or particles come out into the saline solution, it increases circulation to the breast, and for the case of mastitis, we need to avoid more fluid in the tissue.
  5. No more dangle nursing or pumping! This was a previous method that encouraged gravity to help the body with inflammation.
  6. Over sanitizing your products. This change puzzled me at first, but the more I read, it makes sense. If you have a real bacterial infection, the root cause is linked to gut health (or related to oversupply) and over sanitizing can throw off the microbiome.

Mastitis used to be referred to an infection, but that is not always the case. If you believe you have mastitis, please contact your medical provider, but consider all of the above for 24 hours. If nothing improves, that’s when you need an exam and possibly antibiotics. When too many antibiotics are administered for an infection that is not present, you can develop resistance for future use.

This is a lot of information, I know! If you want to nerd out with me, please refer to the ABM protocol, and you can talk to your provider about the changes if this applies to you. Above are some of the new changes. Once again, reach out to your medical provider if you have any concerns.

I want to thank you all for your continued support of my business. I am one very fulfilled and happy doula. As we move into 2023, I will be offering new childbirth education classes that focus on what you really need to know about pregnancy and your labor. These will be group classes via Zoom, and it will be 90 minutes long.

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