What can dry up breast milk while having mastitis?

Management of Breast Milk Production During Mastitis

During mastitis, mothers should continue breastfeeding rather than attempting to dry up breast milk, as continued breastfeeding or milk expression is an essential part of treatment and helps resolve the condition faster. 1, 2

Understanding Mastitis and Breastfeeding

• Mastitis occurs in approximately 10% of breastfeeding women in the United States and can lead to cessation of breastfeeding if not properly managed 3
• Regular feeding or expression of milk is a crucial adjunct to other treatment measures for mastitis 1, 2
• Discontinuing breastfeeding during mastitis can actually worsen the condition 2

Recommended Approach for Mastitis Treatment

• Initial management should focus on continued breastfeeding or milk expression, not drying up milk supply 1, 2
• Apply conservative measures first for 1-2 days:
  • Use nonsteroidal anti-inflammatory drugs for pain and inflammation 4
  • Apply ice to reduce inflammation 4
  • Feed the infant directly from the affected breast to ensure complete emptying 4
  • Minimize excessive pumping which can worsen inflammation 4
• If symptoms don't improve after conservative measures, antibiotics effective against Staphylococcus aureus (e.g., dicloxacillin, cephalexin) may be prescribed 3, 4

Why Drying Up Milk Is Not Recommended During Mastitis

• Milk stasis is often a primary contributor to mastitis, and reducing milk removal can worsen the condition 5
• Effective milk removal is essential to treatment and may make antibiotics unnecessary in some cases 5
• Attempting to dry up milk during active mastitis increases the risk of abscess formation, which occurs in approximately 10% of mastitis cases 1, 3

If Weaning Is Absolutely Necessary

If a mother must stop breastfeeding for other reasons while having mastitis:

• Complete the full course of mastitis treatment first before attempting to reduce milk supply 2
• After mastitis has resolved, gradual weaning is safer than abrupt cessation 3
• Cabergoline (Dostinex) is contraindicated for suppression of lactation in breastfeeding women according to FDA labeling 6

Complications of Improper Management

• Delaying treatment or attempting to dry up milk during mastitis can lead to:
  • Progression to breast abscess requiring drainage (occurs in 10% of mastitis cases) 1, 3
  • Premature cessation of breastfeeding, depriving both mother and infant of health benefits 7
  • Increased maternal discomfort and prolonged recovery 7

Prevention of Recurrent Mastitis

• Proper lactation technique, including good infant latch, is the best prevention 4
• Encourage physiologic breastfeeding rather than pumping when possible 4
• Avoid practices that overstimulate milk production or cause tissue trauma:
  • Excessive pumping to completely empty breasts 4
  • Aggressive breast massage 4
  • Overfeeding that creates oversupply issues 4

Remember that continued breastfeeding during mastitis generally does not pose a risk to the infant, and the benefits of breastfeeding outweigh the risks in most cases of mastitis 3.