An Update on the Recognition and Management of Lactational Breast Inflammation

Christine M. Betzold, NP, CLC, MSN

Disclosures

J Midwifery Womens Health. 2007;52(6):595-605. 

In This Article

Management of Breastfeeding Cessation

When milk stasis is left unresolved, the mother has an increased risk for developing infectious mastitis. If she already has infectious mastitis her risk of getting an abscess is increased, and if she has an abscess her recovery will be delayed.[17] Thus, mothers with breast inflammation should wait until it is resolved before commencing weaning. Once resolution occurs, we recommend wearing a supportive bra, taking analgesics, and using cold compresses for comfort. Suggest a gradual tapering of milk production by skipping one or two feedings or pumpings every 2 to 3 days. Over the first week or two, she can minimize the risk of recurrent mastitis and maximize her comfort level by thoroughly draining the breast in the morning and at bedtime. Binding the breasts, a common intervention, will not hinder milk production and only adds more pressure, causing more discomfort and increasing the risk of plugs and infection.

Some mothers may still choose to abruptly wean. Midwives should warn them that abrupt breastfeeding cessation causes severe milk stasis, increases the risk of infection or abscess, and may lead to systemic symptoms, and that the resulting engorged, hard breast is painful. When the resulting engorgement is left untreated by milk removal, the discomfort and systemic symptoms will persist for approximately 3 to 4 days or the length of time it takes milk production to downgrade.

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