Mastitis and Thrush

P atient Information Women’s Health Service

What is ?  Have plenty of rest. Stay in bed and feed Mastitis is inflammation of the breast. It can be your baby frequently caused by a blocked duct or by an infection in the  Make sure you have a good fluid intake and breast. eat a variety of healthy foods including nutritious snacks How to recognise mastitis  Your supply usually reduces with  Red inflamed area on your breast mastitis. It will increase again once the  Your breast feels sore inflammation / infection has resolved. It  You have flu-like symptoms - aching, may take up to two weeks to build up your shivery, raised temperature, tired and milk supply tearful  Correct position of baby at the breast.  You have a fever – temperature over 38ºc Position your baby so that their chin is pointing towards the affected area. Make What are the causes of mastitis? sure baby is latched well onto the  Missed feeds and  Blocked ducts  If you have cracked or sore , ask for  Damaged nipples help to check baby is latched correctly  Oversupply of milk  If after 6-12 hours these self-help  Poor drainage of the breast due to a poor techniques have not helped antibiotic treatment may be necessary. Please contact  Fatigue (tiredness) your own doctor or midwife  Poor health or anaemia  Pain relief may be helpful. Take  Wearing a tight bra or restrictive top paracetamol and an anti-inflammatory pain relief (as long as you are not allergic to What is the management of mastitis? these medications) This should start immediately any symptoms You do not need to stop with appear. mastitis. Most antibiotics are safe when you are breastfeeding although the may taste a  Carry on with breastfeeding. It is important little salty at this time, ask the person prescribing to keep emptying your breast your antibiotics if you are concerned.  Feed from the side which is sore first  If your baby has not drained the affected Your baby may also be unsettled, have diarrhoea breast, you will need to express. and want to feed more frequently. The most  Gently massage the breast before and common antibiotic used is flucloxacillin 1g 3 times during feeding and expressing a day for 10 days. It does not need to be taken on  Alternate warmth and cold. Warmth before an empty stomach. If you are allergic to penicillin a and during feeding to help your ‘let-down’ different antibiotic will be prescribed. and for comfort. Cold after the feed to help It is very important to complete the prescribed reduce the swelling and inflammation course of antibiotics. Mastitis can re-occur if the  Make sure there is no pressure on your course is not completed. breast from your bra, clothing or the way your breast is held

Page 1 of 2 [continued] Probiotics  Take a probiotic , e.g. acidophilus, Taking a probiotic that contains Lactobacillus to help restore your protective gut flora salivarius or Lactobacillus fermentum may assist with symptoms of mastitis. Take it as soon as you What are the options for treating my get symptoms, it can be taken alongside antibiotic thrush? treatments. Non-medical Thrush  Alternatively you can use1 tablespoon of Sometimes thrush can occur after taking white vinegar in a glass of water and use antibiotics. the solution to bathe your nipples  Eat natural “live” yoghurt. This has bacteria What is Thrush? in it that acts against thrush. You can also put some live yoghurt on your nipples How to recognise Thrush  with thrush should not freeze milk  Sudden onset of nipple and or until they are symptom free  You may have red/deep pink, sore nipples Medical that do not improve. Shiny, itchy or flaky Your doctor may prescribe you and your baby the skin. White spots on your nipple medicines listed below.  Sometimes deep burning breast pain radiating through to the back :  Throbbing between feeds, or Antifungal cream – Miconazole cream. Apply to extreme pain during feeds that is not your nipples after each feed. You will also need to improved with better latch or positioning watch for vulva or vaginal thrush and treat this if it  A cracked nipple that will not heal is present.  Pain while correctly using a Baby under 6 months of age:  A white coating on your baby's or Nystatin drops. Treat baby’s mouth by smearing white spots in their mouth which do not rub 1ml of the medication thinly over the whole inside off mouth (oral mucosa) using a clean finger.  Baby may be fussy at the breast, refusing Baby 6 months of age and over: breast, clicking or gassy Miconazole gel, smeared thinly over the whole  Your baby has a sore red nappy rash inside mouth (oral mucosa) using a clean finger.

It can take two to five days for symptoms to What is the management of thrush? improve. Continue the treatments for 7 days after For you symptoms have resolved.  Get the best latch possible. Improving the If symptoms have not improved within 7 days, ask latch can decrease the pain your doctor or midwife for further advice.  Wash your hands frequently, especially after changing baby’s nappy Remember  Hot wash and dry towels at home daily, or When using Antifungal creams, gels or drops – use paper towels nystatin or miconazole treat your nipples and your baby’s mouth at the same time.  Avoid using soap on your nipples

 Boil your expressing equipment and feeding equipment for 20 minutes each day  Air dry nipples after feeding and change your breast pads frequently  Reduce the amount of sugary food you eat

CapDocs ID: 1.100711 | Issue date: November 2018 | Review date: November 2021 Page 2 of 2