What is it?
Mastitis occurs when breast tissue becomes inflamed most commonly as a result of a blocked milk duct. Mastitis can be infective in nature (full body fevers / chills) or non-infective.

The two primary causes of mastitis are:

  • Milk stasis – when the breast isn’t emptied effectively and completely. 
    • Most cases of milk stasis occur when baby’s sleep patterns are altered i.e. if baby sleeps longer than usual or baby is unwell and feeding is disturbed which leads to the breast not being emptied as frequently or fully as usual 
  • Nipple trauma – when there is damage to the nipple creating cracks which can harbour bacteria and lead to infection
    • Nipple trauma can occur in the first couple of weeks when breast feeding is becoming established or when baby starts teething and may bite or clamp down on the nipple 

mastitis picSymptoms

  • Reddened, hard, hot or shiny area on the breast  
  • Marked tenderness or pain 
  • Full body fevers, chills, aches and pains

Physiotherapy treatment options

  • Gentle breast massage 
  • Breast massage techniques stimulate and gently facilitate the drainage of the inflamed and affected area 
  • Therapeutic Ultrasound 
    • There is no conclusive evidence to show the exact therapeutic effect of ultrasound however, there is substantial evidence to show no harm and strong correlations between reduced inflammation and less pain post use of therapeutic ultrasound. 
    • There are also reports that ultrasound can break down biofilms and improve cell permeability which can improve the effectiveness of antibiotics when indicated 
  • Lymphatic massage & drainage
    • Stimulating the lymphatic system in the axilla, neck and breast facilities the drainage of the inflamed affected area 
  • Musculoskeletal treatment (neck, shoulders, thoracic spine)
    • Helps to free up the entire surrounding area which is typically very tight, sore and stiff. We utilise massage, trigger point release and joint mobilisaiton to effectively improve general range and comfort 
  • Parasympathetic stimulation techniques
    • Relaxation exercises (mediation, mindfulness, self care)
    • Breathing exercises
    • Sleep strategies 
  • Kinesio Taping
    • Kinesio Tape can be applied along lymphatic lines which acts as a gentle pump to assist with the drainage of the affected area 
  • Breastfeeding positioning and attachment alteration as indicated 
    • We ensure that attachment is effective and positioning is comfortable
  • Additional breast emptying strategies – to assist in additional emptying if required. Sometimes, hand or pump expressing is indicated prior to or post feed to assist in the comfortable and effective emptying of the breast. 
    • Hand expressing – we can show you how to hand express your breast comfortably 
    • Electric pump use – we can discuss different ways to use your pump to empty your breast furthermore 
  • Home Exercises typically include:
    • Self breast massage 
    • Vibration therapy 
    • Gentle compression and advice regarding appropriate and supportive clothing and bras
    • Hot / Cold Therapy

Other treatment options

  • Antibiotics – prescribed by your doctor 
    • The two primary pathogens in infective mastitis are staphylococcus and streptococcus which typically inhabit the skin and nasopharynx
    • These pathogens are penicillin resistant – so it is very important that the right antibiotic is prescribed so that the involved pathogen is managed 
    • The most common antibiotics prescribed are flucloxacillin and dicloxacillin
  • Lactation Consultant 
    • It is highly recommended that you see a lactation consultant so that they can do a thorough examination of your baby’s latch, tongue, mouth and other possible factors which could be contributing to nipple trauma or recurrent mastitis.