Mastitis is an inflammation of the breast tissue, often involving an infection, which causes significant discomfort and pain. While the physical act of pumping does not directly cause mastitis, improper use or poor equipment maintenance can create the necessary conditions for it to develop. These conditions typically involve milk stasis, where milk is trapped, or tissue damage that allows bacteria to enter the breast.
Understanding Mastitis
Mastitis most commonly affects lactating individuals. Symptoms often appear suddenly, including a localized red, warm, and painful area on the breast, sometimes accompanied by systemic symptoms like a fever of 101°F (38.3°C) or higher, chills, and flu-like body aches. The two primary pathways leading to mastitis are milk stasis and bacterial entry. Milk stasis occurs when a duct is clogged or the breast is not fully emptied, causing milk to back up and create inflammation, which provides an ideal environment for bacteria to multiply. Bacteria, often from the skin, can also enter the breast through a tiny crack or sore on the nipple, leading to infection.
Pumping Techniques That Increase Risk
Incorrect Flange Size
Using an incorrect breast shield (flange) size is a common issue that increases mastitis risk. A flange that is too small compresses the milk ducts, impeding flow and resulting in incomplete emptying and milk stasis. Conversely, a flange that is too large pulls excessive areolar tissue into the tunnel, causing swelling, blocking ducts, and leading to ineffective milk removal. Both situations leave milk behind, which precedes inflammation and potential infection.
Excessive Suction
Using excessive vacuum or high suction settings is another significant risk factor. High suction does not necessarily increase milk output but can cause trauma to the delicate nipple and areola tissue. This damage leads to swelling and inflammation, restricting milk flow, and creates micro-abrasions that serve as entry points for bacteria. Keeping the suction level comfortable is more effective than maximizing the setting.
Poor Pumping Habits
Infrequent or rushed pumping sessions directly contribute to risk by causing milk stasis. Skipping a scheduled session or cutting one short prevents the full removal of milk, allowing pressure to build within the ducts. This prolonged fullness increases inflammation and the likelihood of a blockage forming. Additionally, neglecting to clean and sterilize pump parts thoroughly can introduce pathogenic bacteria directly into the milk collection system.
Essential Pumping Practices for Prevention
Preventing mastitis requires ensuring all equipment is appropriately sized and used gently. The flange size must be correct, drawing only the nipple into the tunnel without excessive pulling of the areola or rubbing against the sides. Since nipple size can change, periodic re-measurement is necessary to confirm proper fit.
Key Preventative Measures
- Maintain a consistent and regular pumping schedule to avoid feeling overly full and prevent milk stasis.
- Gently massage the breast during the session, moving from the outer areas toward the nipple, to promote complete emptying.
- Set the pump to a comfortable suction level that stimulates flow but never causes pain or discomfort, thereby avoiding tissue trauma.
- Practice meticulous hygiene by properly washing and sanitizing all pump parts that contact milk after each use.
Managing Mastitis While Continuing to Pump
Upon noticing symptoms like a painful lump, redness, or fever, contact a healthcare provider immediately. A medical professional can diagnose the condition and determine if antibiotics are necessary to treat a bacterial infection, preventing progression to complications like a breast abscess. Continuing to remove milk from the affected breast is a primary component of management, as stopping expression worsens symptoms and increases inflammation. Frequent, gentle milk removal is recommended to relieve pressure and clear blockages. Over-the-counter anti-inflammatory medications, such as ibuprofen, and applying a cool compress after pumping can help reduce pain and swelling.