How can I prevent frequent breast infections?

Ask Anne…

Question: I had plugged ducts and breast infections 5 times when I was nursing my first baby I lived on antibiotics and ultrasounds.  Nothing I tried worked, and the pain was excruciating.  How can I reduce the chance of this happening again with my second child?

Answer: I hate that you had so many problems with soreness and breast infections (mastitis) when you were nursing your first baby.  There is something very wrong anytime that you experience round after round of mastitis. Nobody should have to go through that!

If you do develop mastitis with this new baby, you need to find out why this is happening and treat the cause of the breast infection effectively, once and for all.

In many cases, the infection reoccurs after treatment with antibiotics because the original infection wasn’t ever completely cleared up in the first place. This can happen when you are sick and don’t take the complete course of medication (you feel better after a few days and stop taking the drug – it usually takes at least 7-10 days of antibiotic treatment in order for it to be effective), or when the wrong antibiotic was prescribed for the particular strain of bacteria causing the infection.

Recurrent yeast can be caused by other, less common reasons as well: chronic bacterial infection, cyst or tumor in the breast, maternal anemia (this causes a lower resistance to infection), and a secondary fungal infection.

Dr. Ruth Lawrence (Breastfeeding: A Guide for the Medical Profession) suggests that after the first recurrence of mastitis, mothers should have their milk cultured (be sure to get a “clean catch” – midstream, into a sterile container). The baby’s mouth and throat should be cultured at the same time. That is the only way to know for sure what is really going on.

If the infection reoccurs, then you will need to find a “breastfeeding friendly” doctor who has both the willingness to work with you on this, as well as the expertise and the capacity to perform the tests that are indicated (not all doctor’s offices or labs are set up to perform the necessary cultures, and even if your OB-GYN’s office is, he may not be willing or able to culture the baby as well as the breast milk).

It is possible that you had a secondary fungal infection, also called “fungal” or “candidal” mastitis. If that was the case, then simply taking antibiotics might not have cleared up the infection completely, unless antifungal treatment to address the underlying problem with yeast was administered at the same time.

Best of luck with nursing this time around. I hope everything goes smoothly for you.

Anne Smith, IBCLC
Breastfeeding Basics