Mastitis and The Rule of 5

Learn how to identify and treat mastitis with the rule of 5.

Mastitis is the inflammation of breast tissue with or without an infection. It is most commonly found in breastfeeding mothers. If left untreated it can develop into a serious abscess requiring surgical drainage.

Mastitis can be caused from a blocked milk duct in the nipple called a milk blister or further back in the ductal system.  It usually comes on gradually and affects only one breast. Women will usually notice a hard lump of engorgement that feels tender, hot, swollen, or looks red. Some also report a low-grade fever. The area usually feels tender or painful before a feeding and less so afterward.

It can also be caused by an obstruction or a bacterial infection. Bacteria can enter the breast from a sore cracked nipple, or by something structural, such as a poor latch, a tongue tie, or a poor-fitting bra.

Mastitis usually comes on quickly and can occur at any point in lactation. Symptoms are similar to those of a plugged duct but more significant. Including a fever with or without chills with flu-like aching.

With mastitis, the expressed milk may look lumpy, stringy, or gelatinous.   Despite its appearance the milk is safe for the baby. The milk may also include mucus, pus, or blood which can also change the taste of the milk temporarily.

However early identification of the symptoms can help with prevention.

Heat, massage, empty breast, and rest.

Do not stop or decrease feedings when you have a plugged duct or mastitis. In fact, aim for nursing every two hours and keep the affected breast as empty as possible. Always nurse on the infected breast first, completely empty it before switching sides. Express the breast completely if unable to nurse.

Before nursing, use a warm compress, shower, or basin soak the breast to soften the tissue. Once the tissue is softer, massage the sore area towards the nipple. Watch this video clip for more instructions.

Perfect your nursing latch and learn a variety of nursing positions to see which works best. One option includes nursing while leaning over the baby so that the breast dangles and your baby can use gravity to help to draw out the blockage.

After feeding, pump out any remaining milk, and treat the breast with cold compresses and ibuprofen as needed.

Do not forget about reducing daily stress, focusing on sleep, and healing. Intake adequate fluids and nutritious foods to support healing and breastfeeding.



Rule of 5 for mastitis

5 days of rest!

5+ liters of water/day

Every 5 hours take ibuprofen 600-800 mg

5 hot showers/bath with downward massage towards nipple

5 days of homeopathic phytolaca 30c (follow the dosing on the bottle)

4-5 doses of Lecithin (1200mg) daily if plugged (1 x day to avoid plugged ducts)

*talk to your provider about if antibiotics are needed while you continue to nurse and drain the breasts.