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I wanted to share this episode ASAP because I actually experienced my first bout of mastitis just two weeks ago and I wanted to avoid antibiotics at all costs. I know they have a time and a place, but I knew if I took action right away, my chances of needing antibiotics were much smaller. I also had no idea how painful it was until I experienced it first hand!
So today’s episode is all about natural and holistic ways to both prevent and treat mastitis. Please remember that this is legally not considered personal medical advice, but what I am going to share is backed by science, so you can use it for educational purposes in helping you know what is going to work best for you if mastitis does come your way.
For decades, women were taught that mastitis was an infection of the breast that required antibiotics to be resolved. This is only partially true. Not every case of mastitis is caused by or accompanied by an infection, and if no infection is present, antibiotics are not going to help at all. In fact, they will make things worse.
Mastitis is inflammation in the breast. It can be caused by a clogged milk duct or an infection, but could also be a result of poor nutrition, poor breastfeeding mechanics, and unmanaged stress.
While you could get mastitis at any point in your breastfeeding journey, you’re more likely to get it during the first three months of breastfeeding while your supply is regulating. For me personally, I started showing symptoms of mastitis day four postpartum once my mature milk had come in.
Once your milk switches from colostrum to mature milk, you naturally become very very engorged with an oversupply. This is normal (and you know I don’t just throw that word around!). Your body doesn’t know how much milk your baby needs, so it airs on the side of caution and makes a ton right off the bat to make sure baby is taken care of.
Overtime, as you allow baby to only eat as much as they want (instead of fully draining the breast every single time), your body begins to learn how much milk you actually need to produce and you become less engorged.
However, this process can take a few weeks, and if baby has a poor latch, you have the wrong flange size, or you have poor nutrition habits, you could develop a clogged milk duct or an infection, which left untreated, can turn into mastitis.
Symptoms of mastitis include:
For me personally, I found that warm, hard, red spot after my shower one day. My milk had just come in the day before and I was very uncomfortable so I jumped in a quick hot shower to try and relax. Then I looked in the mirror and saw mastitis developing.
Thankfully, because I caught it early and knew what to do, I didn’t develop a fever or an infection.
Before I tell you my mastitis protocol, I want to quickly talk about each risk factor I mentioned earlier so you know how to minimize your chances of getting mastitis. Then we’ll talk about what to do if you do get it.
Like I said earlier, you’re at risk for developing mastitis just because you’re lactating (yes, this includes my pumping moms!), but there are other risk factors that you need to be aware of.
You are naturally going to have an oversupply for the first few weeks while your body figures out how much milk baby needs, but if you intentionally keep your oversupply, it could create problems down the line.
I need you to know right now that there is no magic number of ounces you need to be producing to make “enough” milk for your baby. My first baby needed an average of 4-5 ounces from one breast each feeding, my second baby only wanted about 2 ounces from each breast each feeding, and my third is TBD (he’s only two weeks old at the time of this recording).
Remember that the entire goal of lactation is to make exactly enough for your baby. That means if your baby needs 3 ounces, you’re making 3 ounces each time. If your baby needs 5 ounces, you’re making 5 ounces.
I say this because you are going to be tempted to pump the first few weeks postpartum to fully drain the breast because the engorgement is so painful, but if you do that, you’re only going to signal to your body that it needs to continue to make that much milk moving forward. This will increase your risk of not only mastitis and burnout too.
And, unfortunately, the nurses at the hospital actually told me I needed to fully drain the breast each time for the first few weeks, so I need to make an important distinction. Once your supply has regulated, you want to be fully draining the breast each feeding. That is how your body continues to make the right amount of milk for your baby. But, for the first few weeks, we don’t want to do that because you are starting with an oversupply and your body doesn’t know what the right amount is yet. I wouldn’t worry about fully draining the breast each time until about 6 weeks postpartum.
Now, if you want to build a freezer stash in those early weeks, I recommend listening to episode 70 where I talk about how and when to introduce pumping in postpartum. I give you a few ideas that are both safe and effective and I also share what has worked for me with my first two kids. I’ll link that episode for you in the shownotes.
But again, please do not intentionally create an oversupply. It’s not necessary, it’s not sustainable, and it’s not safe.
This is such a big topic that could easily be its own podcast episode, but I’m going to try and keep it pretty basic for this conversation.
If your baby or your breast pump is not efficiently removing milk, it’s going to send mixed signals to your body about how much milk to make AND it increases your risk for clogged ducts, which lead to mastitis.
To make sure you are sufficiently removing milk each time, make sure your baby has a deep latch and/or make sure you have the right flange size. How do you know if you have the right flange size? Get a special measuring tool just for measuring your nipples and the corresponding flange size.
As for baby, not only do they need to have a deep latch, but they need to have good oral mechanics too. If they have any oral restrictions like tongue/lip/cheek ties or tight muscles, it’s going to impair their ability to get the full range of motion when they need to eat, which means they’re not sufficiently removing milk.
Some signs that your baby is having problems removing milk are nursing around the clock (different from cluster feeding), fussiness at the breast, frequent unlatching during feedings, inability to get a deep latch, and lots of gas bubbles because they’re swallowing air while they nurse.
If you suspect your baby has oral restrictions or problems nursing, please see a lactation consultant.
I know this might come as a surprise, but your diet does actually play a role in your risk of developing mastitis. Now, there’s no sure-fire way to 100% prevent mastitis with diet, but it does affect your risk.
Because mastitis is inflammation, this means it is directly related to your immune system, and more than 70% of your immune system lives in your gut. This means that what you eat or don’t eat is directly linked to your overall inflammatory response.
This is especially important to understand in the early weeks postpartum. Your body is in a heightened state of inflammation during pregnancy, and then it skyrockets in early postpartum because of the trauma of childbirth and all the open and healing wounds you have. This is good, but it needs to be controlled and slowly brought down. We don’t want you to stay in chronic inflammation.
So if you’re eating high-inflammatory foods in early postpartum like tons of gluten, processed dairy, refined carbs, high-sugar foods, and processed foods like packaged snacks and fast food, you’re feeding the inflammation that’s already there and if it continues to increase, it needs to find new places to go like your breast tissue.
Focus on whole foods that are nutrient dense and incorporate lots of anti-inflammatory foods throughout the day to support your body through the inflammation without making it worse.
If you’re not sure how to do that or it sounds like too much mental load to try and plan every meal like that, just follow the recipes in my postpartum recovery cookbook! I did all the hard work for you. You can grab my cookbook at the link in the shownotes.
I also want to mention that I don’t recommend sunflower lecithin for clogged ducts or mastitis while we’re on the topic of nutrition. It’s been long recommended as a solution, but new research has come out that it has negative long term effects on your gut health, which means it’s negatively impacting your immune system, which means it’s increasing your risk of recurrent mastitis.
If you’re worried about anything else working, just keep listening for the mastitis protocol!
The last risk factor that I want to mention is unmanaged stress. Now, as always, I’m not encouraging you to lower your stress, I’m encouraging you to manage your stress. Those are two very different things.
I’m a firm believer that it’s not that we have too much stress in our lives, it’s that our capacity to handle the stress in our lives is too small. If we can increase our capacity to handle stress and our ability to handle that stress in a healthy way, it wouldn’t be such a problem.
I have a friend who developed mastitis “out of nowhere” after a really stressful weekend at 9 months postpartum. She had a great milk supply, her babies didn’t have any oral restrictions, her diet was great, but she had a really stressful weekend and she started showing signs of mastitis on Sunday into Monday.
Now, I know you’re thinking in your head, “Brooke, early postpartum is stressful. Motherhood is stressful. I can’t avoid it.” And I hear you. You’re right! But remember, we need to improve our capacity and ability to handle the stress of motherhood.
You can do this by:
And most importantly, remember to communicate with your partner regularly about your needs and your feelings. The more you bottle up, the more stressed you’ll be. Think of your stress like energy - it can’t be created or destroyed, and it always has to go somewhere. So if you bottle it up, it’s going to find places to go like your breast and you end up with mastitis.
This is obviously a very big simplification and there are lots of contributing factors to mastitis, but just wanted to give you an idea of how stress enters the picture.
Everything I’m going to share about treating mastitis holistically I learned from my friend Allegra, who is an IBCLC and naturopathic dietitian. She is absolutely incredible and you should follow her immediately on Instagram! I’ll link her profile in the shownotes.
So, if you discover that you have mastitis developing, here’s what you can do holistically to treat your symptoms:
I’m starting with this one because I’m still doing it daily just because it’s that amazing. Breast gymnastics was created by IBCLC Maya Bolman, and it’s essentially a specific type of lymphatic massage used to promote circulation and milk flow.
Using very gentle hands, all you have to do is hold your breasts in your hands and move them up and down, side to side, and in small circles for a minute or so. I prefer doing this in a warm shower, but you can do it anytime, with or without clothes on.
I’m not kidding when I say this immediately relieves the chronic pain of engorgement, clogged ducts, and/or mastitis. When I did have mastitis, I did it right before each feeding to loosen things up before baby nursed and it helped with my latch and let down, too.
“Your lymphatic system is a group of organs, vessels and tissues that protect you from infection and keep a healthy balance of fluids throughout your body” (Cleveland Clinic). It’s a part of your immune system that drains extra fluid that has passed out of your blood and into tissues and then returns it back to the blood.
You have lymph nodes at various points around your body, including your jawline, armpits, and groin. Lymph nodes are small bean-shaped structures that filter substances traveling through lymphatic fluid, and they contain lymphocytes (white blood cells) that help the body fight infection and disease.
Remember how I mentioned that breast gymnastics is kind of a special lymphatic massage? Well doing traditional lymphatic massage will greatly help your mastitis too. There’s a special technique to doing it though, and I can’t really explain it just through audio, so if you want to learn more about it, I’ve linked a demo video for you in the shownotes that you can watch to learn how to do it for mastitis.
I did my two minute lymphatic drainage routine three times a day until my mastitis went away and I always felt so good afterwards. It really does help!
Dry brushing is part of the lymphatic care routine. After doing your lymphatic drainage massage, you’ll do the routine over again but with a special kind of brush specifically used for dry brushing. I’ll link the ones I have in the shownotes.
Dry brushing is great for managing inflammation, supporting your lymphatic system, and stimulating blood flow throughout the body. I did it right after lymphatic massage and also right before I got in the shower.
This is actually just a breast bath! Fill up a giant bowl or dish with warm water and epsom salts, then dangle your breasts over the bowl and let them soak and relax for 10-15 minutes.
Gone are the days when you're using direct heat for mastitis. Because it's a local source of inflammation, you want to use cold compress to help calm it down.
You can still take a hot shower, but if you're using direct and local compress, it needs to be cold.
Normally, for a deep latch and proper breastfeeding mechanics, you want to be slightly reclined. However, to get the maximum milk flow and use gravity to help unclog any ducts, you'll want to dangle nurse.
You could do this by having baby in your lap or on a bed and literally dangling your breasts over baby while they eat.
Remember, mastitis is inflammation, so eating foods that fight inflammation and support your immune system are key. Think foods high in omega-3 fats, minerals, and protein. I also took high doses of turmeric because turmeric has been shown through scientific studies to be just as effective or more effective than Ibuprofen at managing inflammation.
What I’m about to suggest isn’t 100% necessary, but it will definitely be helpful: I also recommend minimizing your gluten, sugar, and processed food intake while following the mastitis protocol, just because these three categories of food raise inflammatory markers quickly and can make all your other efforts not as successful.
If you’re not sure where to start with an anti-inflammatory diet or it just sounds like too much work to try and make anti-inflammatory meals, just grab my postpartum recovery cookbook at start with week 1 recipes. The entire cookbook is anti-inflammatory, especially the first 2 weeks!
I'm sure you know it's important to stay hydrated while nursing, but it's even more important if you have mastitis. This is because we need more fluid to help get the milk moving around, support your immune system, and support nutrient absorption and digestion.
But remember, hydration doesn't just mean drinking more water. You also need to be increasing your vitamin C and electrolyte intake as well.
My favorite electrolyte drinks are Redmond Relyte (code "mama15") and Just Ingredients (code linked in the shownotes).
If your symptoms are not improving, it’s possible you have developed a bacterial infection and will require antibiotics [in addition to your holistic remedies] to heal your mastitis. If this is the case, I strongly recommend taking a probiotic complex along with the antibiotics to make sure you’re supporting your gut. The one I used is from Just Ingredients and I love it because it has pre/pro/postbiotics all in one to make sure your gut has everything it needs to be healthy. I’ll link it in the shownotes with my discount code.
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