Breastfeeding for some seems to work perfectly from the start, or so we think.
The true picture is that for the majority of women there is a struggle with an aspect of breastfeeding resulting in some women abandoning breastfeeding altogether. The Australian Breastfeeding Association says more than 96% of women initiate breastfeeding however by 3 months just 39% of babies are exclusively breastfed. This is no judgement of the new mum, it's a full acknowledgement that for some it's hard and complicated and the pain can be unbearable. I understand the concept of watching the clock or listening to your baby cry, ready for another feed, and then perhaps having a little cry yourself in anticipation of the pain. It's heartbreaking.
As a physiotherapist with a special interest in women's health, I treat pain and inflammation in pre and post pregnant women on a daily basis. I listened to their stories about breastfeeding and was drawn to investigating how I could further support women to continue breastfeeding. I went on to train in 'The Lactating Breast for Physiotherapists' and now have effective treatment techniques that can help with inflammatory conditions of the breast, such as mastitis and blocked ducts.
The number one risk for getting mastitis is having had mastitis previously, it is also the second most common reason for women to stop breast feeding.
In the early stages of mastitis it is impossible to tell if it is infective. Both infective and non-infective mastitis present with 2 or more of these symptoms including a red or sore area of the breast, flu like symptoms such as hot & cold, achy joints and hardness/tightness of the breast. Infective mastitis requires antibiotics however non-infective can be successfully managed without. Both infective and non-infective mastitis will benefit from physiotherapy treatment.
Ideally physiotherapy treatment should begin on the day your mastitis starts but can be beneficial to reduce pain and inflammation at any stage. You should book to see your GP on the first day too in case antibiotics are required. Physiotherapy management is an adjunct therapy and must always be used together with other measures such as correct attachment, usage of different feeding positions and therapy with local agents. For best outcomes, physiotherapy works as part of a multi-disciplinary team with doctors, midwives and lactation consultants to help you get the best possible outcomes.
80% of first time mothers experience nipple pain in the early weeks post delivery and 60% have nipple trauma. Women who reported nipple trauma had a more than two-fold increased risk of developing mastitis. How to prevent nipple pain is again a multi-disciplinary approach aimed at targeting attachment for example, however physio can significantly improve the healing time with low level laser therapy.
Physiotherapy treatment for the inflammed breast may include:
Therapeutic Ultrasound which greatly assists in reducing the inflammation of the breast.
Lymphatic drainage massage
Advice on further reducing inflammation, prevention of mastitis.
Low level laser therapy to expediate nipple trauma healing
To be able to facilitate timely treatment I offer home visits. To enable this both the ultrasound and laser are portable.
Please contact reception on 5332 9940 to assist arranging the most convenient appointment options. A referral is not required but please bring along any supporting information from your GP, obstetrician, midwife or lactation consultant.
Amir L, Forster D, Lumley J, McLachlan H. (2007) A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants. BMC Public Health,7(1): 62.
Amir, L et al (2016) Low level laser for breastfeeding problems. Breastfeeding Review, 24(2), 27-31
Buck M.L, Amir, L.H, Cullinane M, Donathe S.M, & CASTLE study team (2014). Nipple pain, damage and vasospasm in the first 8 weeks postpartum. Breastfeeding Medicine, 9(2), 56-62
Cullinane M, Amir L, Donath S, Garland S, Tabrizi S, Payne M, Bennett C. Determinants of mastitis in women in the CASTLE study: a cohort study. (2015) Determinants of mastitis in women in the CASTLE study: a cohort study. BMC Family Practice, 16: 181
Chaves, M et al (2012) LED phototherapy improves healing of nipple trauma: A pilot study. Photomedicine and Laser Surgery, 30(3), 172-178
Coca KP et al (2016) Efficacy of Low-Level Laser Therapy in Relieving Nipple Pain in Breastfeeding Women: A Triple-Blind, Randomized Control Trial. Pain Management Nursing 17(4), 281-289
Posso et al (2007) Control of nipple pain during breastfeeding using low level laser therapy. Regional Anesthesia and Pain Medicine, 32(5)