My Thoughts on Mastitis Treatment

Welcome to my Clinical Lactation Support blog. I like to tuck away some of my thoughts and treatments Ideas here.

Mastitis is associated with a fever over 100.4 and a red area on the breast that is very painful. Because of the associated fever keep replacing fluids and supporting immune system health. You can treat a fever with either Ibuprofen or Tylenol safely while breastfeeding.

Start dose of ibuprofen at 800, then once fever is down, can alternate Tylenol and ibuprofen at much lower doses until pain and infection is resolved.

Ibuprofen every 8 hours (400 mg- 800 mg). Good to keep the max dose over 24 hours at or under 3000mg
Tylenol every 4-6 (325 mg-650 mg). Good to keep the max dose over 24 hours at or under 3000mg

If your fever is still high when using one of these, you can take both types of medications at once if needed. Watch your top maximum dose over 24 hours with Tylenol in particular since it is metabolized in the liver. A single dose should not go over 650 every 4-5 hours at the highest. Do not take the ibuprofen on an empty stomach.
 
Please contact your primary healthcare provider if you have a sustained temp over 100.4 it is likely time to add in one of these antibiotics. All are compatable with breastfeeding. 
There is a fantastic evidence based article available that says this: 
Nursing mothersOutpatient treatment
Outpatient options includes the following:

• Dicloxacillin 500 mg PO QID for 10-14 days or
• Cephalexin 500 mg PO QID for 10-14 days or
• Amoxicillin-clavulanate 500 mg PO TID or 875 mg PO BID for 10-14 days

If beta-lactam allergy:

• Clarithromycin 500 mg PO BID for 10-14 days (or see following section)

If suspected community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection:

• Clindamycin 300 mg PO TID for 10-14 days or
• Trimethoprim-sulfamethoxazole 1 DS tablet PO BID for 10-14 days [4] (caution if nursing preterm infant or child with known or suspected glucose-6-phosphate dehydrogenase [G6PD] deficiency) or 
• Doxycycline 100 mg PO BID for 10-14 days (pregnancy Category D and secreted in breast milk; do not use in pregnancy or if breastfeeding)  "

Full Article here: http://emedicine.medscape.com/article/2028354-overview

For a more holistic treatment of mastitis you will want to use vigorous massage prior to breastfeeding with a oil carrier of at least I teaspoon to one drop of essential lavender oil, and a breast poultice of sliced or grated potato placed directly on the breast. Heat the breast before breastfeeding and cool it down afterwards. 

There is good evidence cited here:  http://cid.oxfordjournals.org/content/50/12/1551.full that says treatment with probiotics L. fermentum CECT5716 or L. salivarius CECT5713 will help resolve mastitis.

The key probiotic strains are sold, but not together. I looked for a bottle that had both but I could not find one. http://www.swansonvitamins.com/swanson-ultra-femflora-feminine-probiotic-formula-60-caps and this one: http://www.swansonvitamins.com/swanson-probiotics-dr-stephen-langers-ultimate-16-strain-probioticwith-fos-60-veg-caps
Take both of these each day along with 4800mg of sunflower lecithin to prevent any future blocked ducts.
So lets start with those, add garlic into your diet for immune system support, make sure you are eating enough iron rich foods, and also consider a dilute amount of oil of Oregano. Be sure that you never offer an Essential oil to a baby.

Consider reading over my article on mastitis: http://nativemothering.com/2011/10/what-are-some-of-the-predictors-and-solutions-for-mastitis/

-Serena Meyer RN IBCLC