As a Certified Breastfeeding Counselor, you do not diagnose or treat anything, including mastitis. However, it is within your scope of practice to provide general education. This includes providing evidence-based information about how to prevent mastitis.

It was once thought that bacterial infections were the most common reason for mastitis. However, we now know that inflammation is not typically bacterial. In fact, it is now treated similarly to a sprain in that it is irritated and strained tissue. A bacterial infection is possible, of course, but is less common than we once thought.

Here are quick reminders to prevent mastitis:

Prevent Mastitis by Feeding On Demand

As breast milk is a supply demand process, the best way to maintain a healthy supply is by feeding on demand. If someone skips feeds or tries to go to a strict schedule, it can interfere with a natural supply. In some cases, it is necessary to feed with a schedule (e.g. a preterm infant), then it is important to not skip feeds.

By feeding on demand, one maintains the right volume of milk for the baby. This reduces the risk of an oversupply which can lead to irritation. It can also reduce the risk of a low milk supply which may not trigger mastitis, but it can cause other feeding challenges.

Do Not Stretch Feeding Times Too Much

At times, it is necessary to adjust how and when someone feeds baby. Perhaps they have a work or social event, and they might be unable to easily pump or feed baby. Maybe they are trying to adjust to a nap or overnight sleep schedule and think stretching feeds could help.

Anytime there is an unexpected change to feeding routine with less milk removal, there is an increased risk of engorgement and thus an increased risk of mastitis.

If a client needs to or desires to increase the time between feeds, encourage them to do so gradually so that their body has time to adjust.

A Proper Deep Latch is Important For Preventing Mastitis

As a CBC, you know how important a proper latch is. When baby has a proper latch, they ensure effective milk transfer and are less likely to cause nipple damage.

When there is insufficient milk transfer, there is an increased risk of engorgement and clogged ducts. That alone can increase the risk of mastitis. However, when you add in nipple damage, there is also the risk of broken skin leading to bacterial mastitis which can be even more painful.

Again, as a CBC, you do not diagnose or treat anything. However, you can remind clients that if they have symptoms of mastitis and a fever they should touch based with their medical provider.

Remind Parents to Use Both Breasts

Many find one of their breasts tends to produce a bit more milk than the other. When that happens, it is common for the parent and the baby to fall into a preference of using one side more. Skipping one breast at some feeds can increase engorgement.

Encourage parents to use both breasts by rotating which breast they begin each feed with. For example, at the first feed, they start with the right breast then go to the left. The second feed of the day, they start with the left breast and then go to the right. Doing that as often as they remember, can help reduce going too long between efficient milk removal in any one breast.

Avoid Extra Pumping – An Oversupply is NOT Fun

For some people, an oversupply is initially unavoidable. However, for most people, an oversupply is the result of frequent and extra milk removal. As we know, milk is a supply demand process. So, if we demand extra milk, the body makes it. The greater an oversupply, the great the risk of engorgement.

When someone has an oversupply, it means they produce more milk than their baby consumes. This means that they typically needing to remove the milk to avoid discomfort. However, by constantly demanding extra they continue to make extra. This can mean being tied to a pumping schedule in between feeds.

Clients should avoid creating an oversupply by pumping too much extra in the early weeks. Only pumping when a feed is missed or one additional pumping session per day for a freezer stash is typically all that is needed. Any extra can lead to an oversupply.

In addition to the above, little things like avoiding restrictive and tight clothing or bras, focusing on rest, and managing stress can all aid in reducing the risk of mastitis.