On one side is the red, swollen and painful breast, on the other side is the baby waiting to be fed, what to do? If you have mastitis while breastfeeding, you can continue to breastfeed for fear that your baby will eat the milk containing bacteria or drugs, which will affect your health; if you don’t breastfeed, you won’t want to. How do I weigh the trade-offs?
Mastitis generally goes through three stages: milk stagnation, early pus formation, and abscess maturation, and whether you can still breastfeed depends on which stage the inflammation is in.
For the first three days, most women can breastfeed
When Xie Dan squeezed her hand, milk spurted out from the woman’s nipples, the milk ducts were opened and the inflammation receded. This is mastitis in the lactation phase. The lactation phase, usually within three days of onset, is when there is a confined lump in the breast that is painful on pressure, and the patient may have chills and fever.
The cause of mastitis during breastfeeding is simple. The main cause is blockage of the milk ducts, which leads to milk stagnation and rapid multiplication of bacteria in the stagnant area, causing inflammation. In women who have given birth to their first child, the skin of the nipple-areola area is delicate, and the baby’s hard sucking can lead to skin breakdown and pain. Mastitis comes unexpectedly when the mother is afraid to breastfeed because of the pain and does not know how to empty the milk. At this stage, if the milk is emptied in time, the symptoms can be eliminated and no medication is needed. You can safely breastfeed on the affected side. The milk is mainly thick milk with little bacterial content, especially within 4-5 hours after the bruising occurs, and the milk has not yet deteriorated. The baby can also do a good job of unblocking the milk ducts for you by exerting its “milking strength”.
If the blockage is prolonged, the milk will become thicker and thicker, and the color will change to yellowish or yellowish slightly green, which means that the milk contains a small amount of pus. But don’t worry, such milk still won’t affect your baby’s health. If your baby is weak or has an immunodeficiency disease, you can also breastfeed after the milk is drained.
Can you still breastfeed if you take medicine?
When the milk has been stagnant for more than three days, the mastitis basically enters the pus stage. At this time, breast lumps increase in size, pain increases, skin flushing or edema becomes apparent, and a high fever may develop. At this point, breastfeeding may become more than necessary. Because the ducts in the inflamed area are broken and blocked, milk production on the affected side is significantly reduced. “You can breastfeed on the healthy side. If you insist on nursing on the affected side, not only does it exacerbate the pain and not help the improvement of the condition, but the baby does not get the milk, so it is not recommended.” At this stage, the pus cannot be drained through the nipple, either by squeezing or pumping, so medication is needed to relieve the symptoms.
But then comes the question: do the medications get into the breast milk? Can the child still eat them?
There are three main types of medications used to treat mastitis: antibiotics, antipyretics and herbal medicines, which cannot be generalized.
1. Antibiotics. The antibiotics used for acute mastitis are generally penicillins, cephalosporins and macrolides (such as erythromycin). Most penicillin and cephalosporin antibiotics do not cause adverse effects on the baby, so you can breastfeed during the medication, but if the baby has diarrhea after eating milk, you should suspend breastfeeding. There are also some antibiotics for which breastfeeding must be suspended during use. Therefore, you must consult your doctor about breastfeeding before using antibiotics, and you can’t do it on your own.
2, antipyretic and analgesic drugs, such as acetaminophen, ibuprofen. They will enter the lotion in small amounts, but they do not affect the baby much. But looking through the drug instructions, it clearly states, “Use with caution (or prohibit) for breastfeeding women.” Because these drugs have not been tested on lactating mothers for safety (no way, can not recruit volunteers!). . Therefore, prudent doctors will also recommend suspending breastfeeding, stopping the drug for two days before breastfeeding.
3. Herbal treatment varies from evidence to evidence. Some people want to clear heat, some want to reduce milk secretion, some want to unblock the milk channels. There are fewer studies on whether Chinese herbs can affect the health of the breast child, and not many adverse reactions have been observed clinically, so it is generally safe. However, if the mother has diarrhea in the baby after taking the medicine, breastfeeding should also be suspended.
Don’t breastfeed if it’s more than five days old and you’ve had a drainage procedure
After the appearance of a breast lump, if it is not effectively treated, about five days or so, you will find that the lump shrinks and becomes soft, the pain and skin flushing are reduced or disappear, and the fever subsides. This is a sign that the breast abscess has matured.
In the mature stage of an abscess, the small abscesses at the site of inflammation merge into one large abscess, and in most cases, the ducts leading from the abscess to the nipple have been destroyed and occluded, and the pus cannot be drained through the nipple. If the pus is not drained out, the disease will not heal. If the abscess is small, the doctor will use a syringe to aspirate the pus, and once it is clean, you can continue breastfeeding. If the abscess is larger, it can be treated with the fire-needle treatment in Chinese medicine, which involves heating a thick needle and sticking it into the breast to allow the pus to drain out of the body through the needle hole.
For larger or complicated abscesses, an incision and drainage procedure has to be done, where an incision is made in the breast to release the pus. After draining the abscess, some mothers may want to breastfeed on the healthy breast, but it is actually difficult to stick to it. This is because the affected side is also producing milk and needs to be emptied in time. The gauze and cotton pads on the wound surface often occupy a large area and even cover the nipple, which affects the use of the breast pump; if you express milk, you will touch the wound and cause discomfort. In addition, when breastfeeding, active babies often tear off the wound dressing and contaminate the wound, making it difficult for the wound to heal. Therefore, most people decide to return to breastfeeding.
Preventing mastitis: from the beginning of pregnancy
During the second trimester, pregnant women should frequently scrub the areola with warm water to strengthen the resistance of the nipple-areola skin. Women with inverted nipples, which can increase the difficulty of breastfeeding, should have them corrected before pregnancy. After a failed breastfeeding attempt, you should return to breastfeeding in time and not hard.
Recurrence prevention: Don’t forget to “milk”
It is important to send mastitis away and prevent recurrence. It is important to make sure that milk is emptied regularly and that too much milk is not stored in the breast. Whenever you feel swelling or hardness in your breasts, or white dots appear on your nipples (milk plugs in the milk ducts), squeeze them out immediately or ask your doctor for treatment.
Drink plenty of water to dilute the milk. Eat a light diet, less fish soup, chicken soup, pig’s foot soup and other high-protein foods, and more green vegetables and fruits. If the nipple skin is broken, apply sesame oil after cleaning to promote wound healing.
Do not wean suddenly, you should take back milk medicine and let the milk decrease slowly. Sudden weaning leads to milk stagnation, which can also lead to mastitis.