30% of women will develop mastitis in the first 3 weeks after delivery.
30% of those women will develop a second mastitis.
If you have developed a recurrent mastitis, find out why.
Here are the most common reasons why women get recurrent mastitis:
1. Milk left in the breast for a longer time than the breast wants it to be.
- skipping a feeding,
- sleeping longer at night,
- skipping feedings at night (someone else is feeding the baby so you can sleep)
- high milk production that the baby cannot remove,
- baby with a cold so doesn’t feed well
2. Open wound on the nipple (see Nipple Scab article)
3. Pressure on the breast
- tight bra,
- sleeping on stomach,
- baby carrier
- backpack/ heavy purse
- baby sleeping on your chest
4. Milk blister, bleb, inflamed duct. See Bleb article.
Once a duct gets inflamed, it is at higher risk for getting blocked and reblocked. If you have a “bleb” or inflamed duct, make sure you drain the breast well at every feeding.
- Massage the breast during the feeding/pumping,
- If your baby did not feed well for some reason, pump after that feeding to fully drain
5. Incomplete treatment during the first mastitis
- Incorrect type of antibiotic (dicloxacillin, cephalexin and clindamycin are all first line antibiotic choices).
- Incorrect antibiotic dosage (verify dosage with pharmacy)
- Short treatment course (a 10 to 14 day course may be needed)
Recommended antibiotic therapies for mastitis: speak with your doctor about antibiotic choices
Dicloxacillin 500mg every six hours if you don’t have a penicillin allergy.
If you are allergic to penicillin but can take cephalosposins, take cephalexin 500mg every 6 hours for 10 days.
If you are allergic to penicillin and have never taken cephalosporins, take clindamycin 300mg every six hours for 10 days.
Zithromax is not a first choice antibiotic for mastitis and may not be effective for mastitis.
**If you have recurrent mastitis in the same breast, speak with your doctor about getting a culture done to identify the bacteria causing the infection.
**If you have recurrent mastitis in the same spot each time, speak with your doctor about getting an ultrasound to evaluate the area.