Mastitis, gut health and probiotics, is there a relationship?
- Did you know lactational mastitis affects 1 in 3 breastfeeding mothers?
- It is the #1 reason why mothers stop breastfeeding
- In 25-30% of those affected will experience recurrent episodes
STANDARD MANAGEMENT APPROACH & SYMPTOM MANAGEMENT
● Support continued breastfeeding
● Warm compress before feeding
● Cold compress after feeding
● Massage any breast lumps towards nipple when feeding or expressing
● Maintain hydration
● Simple analgesia Paracetamol or ibuprofen (short-term: only)
● ANTIBIOTIC THERAPY Flucloxacillin or dicloxacillin Cephalexin or clindamycin (if penicillin allergy)
CAUSATIVE & CONTRIBUTING FACTORS
● Infection (bacterial, fungal, viral)
● Poor attachment
● Cracked nipples
● Blocked milk ducts
● Incomplete breast emptying
● Ceasing breastfeeding too quickly
● Likely infectious agents: Staphylococcus aureusStaphylococcus epidermidis, Streptococcus mitis, Candida albicans, Herpes simple
Dysbiosis may be a primary cause of lactational infectious mastitis
Staphylococci seem to be the main aetiological agents of human lactational mastitis.
Staphylococci are the most predominant bacteria found in breast milk.
Women experiencing lactational mastitis appear to have an outgrowth of Staphylococci, particularly S. epidermidis.
Commensal bacteria found to be helpful in lactational mastitis:
● Lactobacillus salivarius
anti-inflammatory, antimicrobial, immunoregulatory
● Lactobacillus gasseri
antimicrobial, inhibits S. aureus growth
● Lactobacillus fermentum
● Lactobacillus rhamnosus
antimicrobial, acts against S. aureu
BACTERIA IN HUMAN BREAST MILK
Orally administered probiotics have proven to be an effective alternative to antibiotics in the treatment of mastitis.
Specific probiotic species are able to modulate the human milk microbiome by decreasing total bacterial count and replacing mastitis-causing bacteria with Lactobacillus spp.
Some probiotics have been shown to impact both innate and acquired immunity, and induce pro- and anti-inflammatory cytokines and chemokines.
In particular, L. salivarius, L. fermentum, L. gasseri and L. rhamnosus have demonstrated an ability to competitively inhibit S. aureus
Additional tips to prevent mastitis
After feeding your baby, put some of your breast milk onto your nipple and sit in the sun until the milk has dried! Your milk contains antimicrobial properties that can help reduce the occurrence of mastitis and by sitting in the sun you help dry the area which in turn further reduced the occurrence for mastitis!
Feel free to comment on any of your own successful remedies x
Jimenez E, Fernandez L, Maldonado A, et al. Oral administration of Lactobacillus strains isolated from breast milk as an alternative for the treatment of infectious mastitis during lactation. Appl Environ Microbiol 2008;74(15):4650-4655.
2. Scott JA, Robertson M, Fitzpatrick J, et al. Occurence of lactational mastitis and medical management: a prospective cohort study in Glasgow. Int Breastfeed J 2008;3:21.
3. Fernandez L, Langa S, Martin V, et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacolog Res 2013;69:1-10
4. Fernandez L, Arroyo R, Espinosa I, et al. Probiotics for human lactational mastitis. Beneficial Microbes 2014;5(2):169-183.
5. Arroyo R, Martin V, Maldonado A, etal. Treatment of infectious mastitis during lactation: antibiotics versus oral administration of lactobacilli isolated from breast milk. Clin Infect Dis 2010;50(12):1551-1558.
6. Heikkila MP, Sais PEJ. Inhibition of Staphylococcus aureus by the commensal bacteria of human milk. J App Microbiology 2003;95:471-478.
7. Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev 2013;2:CD005458.
8. Martin V. Interactions between the microbiota of human milk and human immunodeficiency virus type-1 (HIV-1). PhD Thesis, Complutense University of Madrid, Madrid, Spain, 2012.