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  • Cleo Marchese, IBCLC, RLC

COVID-19 or Mastitis? How can I tell the difference?

In a post COVID world, some mothers are rushing to the hospital or their doctors office because they believe they have COVID-19. Only to find out they have mastitis. COVID-19 is a virus and mastitis is breast infection.


Mastitis in Latin for masto- "female breast" + -itis "inflammation."

It is a common lactation complication of breast tissue that may or may not lead to infection.


If you have COVID-19 you may experience:

  • cough

  • fever

  • fatigue

  • difficulty breathing in advanced cases




What are the symptoms of mastitis?

  • Chills, headache, flu-like symptoms or a fever over 100.4°F.

  • A painful swelling or hard area in your breast that is not going down after a feeding or pumping.

  • A red, tender or painful area(s) on your breast that is hot to the touch.

  • Red streaks that radiate over your entire breast or large parts of it.

  • Your baby is reluctant or refuses to nurse on the affected side.


What causes mastitis?

Mastitis can happen a few weeks postpartum, when you wean abruptly or during a sudden decrease in breastfeeding. Stress is a major cause of mastitis which is why we are seeing a lot of it the last few weeks. Moms are spending more than the usually post partum period at home with the whole family. Mothers are fixing meals several times day, trying to care for school age children and getting no down time. They are also stressed and worried about their family and the unknown affects of the new Corona virus. It can take anywhere from a 7-10 days for mastitis to resolve in most situations.


How can I tell the difference between COVID-19 and mastitis?

It is true, most women experience flu-like symptoms in the beginning when you have mastitis but if you are nursing. Take a moment to take stock of your breasts. Does one or both feel achy and painful? Is redness beginning to show? Are you developing hard, painful areas that aren't draining after breastfeeding or pumping. Is one of your breasts hot to the touch? Has your baby started getting fussy when nursing one side?



What should I do and when should I call the doctor?

Most mastitis is not infective. It can be treated with common sense measures such as rest, and frequently emptying your breasts. You should call your doctor if you feel worse after 24 hours, or have a fever over 101.8° F.

You can help your mastitis quickly resolve by:


Getting plenty of rest.

Eating healthy foods to boost your immune system and staying hydrated.

Sleep without a bra. During the day wear lose fitting bras or skip wearing one entirely.

Massage your breasts before a feeding and during feeding feedings to promote better drainage

Alternate between cool compresses to help with swelling, and warm to promote better milk flow.

Tip: Massaging your breasts in the shower or in a warm bath works best for most mothers to help with slowly draining breasts.

Use OTC analgesics such as acetaminophen and/or ibuprofen for fever and pain. They are safe to take while breastfeeding.

Most babies don't mind the saltier tastier of breast milk when their mother’s have mastitis while other will refuse to nurse. If your baby refuses to nurse on the affected side, pump or hand express to keep your breast drained. Tip: Start on the other unaffected breast first and switch to the mastitis side second.

Do not abruptly wean, this will make your mastitis much, much worse!!!


How to prevent mastitis at any time of the year

  • Nurse frequently, especially if you have a young baby.

  • Plan to pump or express milk from your breasts for long separations from your baby.

  • Watch your breasts for engorgement, feed your baby promptly if they feel too full.

  • Don’t try to prolong feeding especially with young infants. This can cause poor weight gain with “polite” babies who will not let always cry when they are hungry.

  • Remember the golden breast feeding rule: crying is a late indicator of hunger.

  • Delegate jobs and do-list, don’t let others push everything onto you at home or work.

  • Avoid sleeping on your stomach; do not wear tight, constricting clothing or bras.

  • Get plenty of sleep and try to stick to healthy diet.

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