Mastitis typically feels, as my midwife so nicely put it, like being run over by a Mack truck…multiple times.  It’s a lot like a very bad flu – aching, fever and intense fatigue.  But in addition to typical flu symptoms, the breasts are inflamed.  One or both may be red, hot, swollen, and/or tender.  It does not have to visibly affect the whole breast; usually there is only a section of the breast that visibly looks or feels inflamed. Often the fever accompanying mastitis is quite high – 101°F or 38.5°C or higher (1).

Note that you may be predisposed to mastitis if you are having a lot of pain with breastfeeding and have cracked nipples.  The intense pain during breastfeeding can be due to a brewing infection in the cracked nipples that may lead to mastitis in the future.  The pain during breastfeeding may spread through the whole body or feel like it is in the chest wall or sternum.  Women with abundant milk supply are also more likely to develop mastitis, as the baby is less likely to empty the breast completely when feeding (2). HOWEVER!  Homeopathy helps in all of these situations.  It may help if the pain from breastfeeding is particularly acute, thereby potentially preventing mastitis, and it may help bring your milk supply into balance and prevent mastitis that way.  And if you develop mastitis, it will help treat it quickly and help you avoid antibiotics.

Some lifestyle notes:

Lactation Support: If you are struggling with breastfeeding, know that you are not alone.  There are lactation consultants, La Leche League groups and similar in many places now, and many do virtual consults if you can’t find someone in your area.  Poor latches, tongue ties, and other “mechanical” issues can interfere with the baby fully draining the breast during feeding and can lead to cracked nipples, two things that will make mastitis more likely.  I highly recommend finding some help and not to just “put up” with pain.  I know I would not have been able to continue breastfeeding without getting lots of support early on in the process.  I suspect my need for support is not remotely unusual – even though 83% of new moms tried to breastfeed in the U.S. in 2019, only 24% had been able to exclusively breastfeed through 6 months (3).  This is not to make it seem like adding formula is a “failure”, but rather to show that if a woman wants to breastfeed, her will-power may not be enough; she also may need lots of community support in one way or another, and not enough women are getting that. 

Diet: Assuming you are in the early postpartum period, your body has just been through a massive physical effort during labor (regardless of how the baby was delivered).  Your hormones are also still surging and changing as you breastfeed, or wean if you aren’t breastfeeding.  Both mean that your body needs a little TLC right now.  From a diet perspective, I recommend eating lots of protein and antioxidants, specifically vitamin C (4).  The drop in progesterone and estrogen after delivery increase your protein requirements (5).  You can actually think of the first few months of breastfeeding as similar to menopause; in both, levels of hormones that build muscle (estrogen and testosterone) are quite low (6, 7).  Clinically, Dr. Stacy Sims reports that low protein intake often first manifests as fatigue and depression, two very common feelings during the early postpartum period (8 ).  Low iron has the same symptoms, so make sure to supplement if you are low (9).  Not to mention protein intake will help with healing all the tissues that are going through the ringer with breastfeeding and during labor.  Not to mention, keeping protein high (1.5-2g/lb of bodyweight) will help you maintain, if not increase, your muscle mass and strength – necessary for carrying your new 10lb weight around all day (10, 11, 12, 13)! Protein can be hard to get into your diet (I found that especially true when I didn’t usually have two hands at a meal to cut a steak) so don’t be afraid to supplement with protein powders, collagen supplements and/or make lots of bone broth to drink throughout the day.  From an antioxidant and vitamin C perspective, stick to colorful fruits and veggies and lots of greens– sweet potatoes, beets, peppers, tomatoes, cabbages, kale, spinach, cilantro, parsley… you get the idea.

Supplements: I generally don’t love supplements, but early postpartum is particularly stressful emotionally and physically.  Trying to have a diet that is perfect and able to give you every little micronutrient is exhausting at the best of times.  In the early postpartum, it can feel an absolute impossible task.  So since we live in an age with a plethora of supplements, I think leaning on them to help you stay as healthy as possible during this period is a great way to lower the burden of having to eat really well.  If you are having trouble getting enough fruits and veggies into your diet, consider adding a vitamin C supplement to your diet.  Vitamin C also helps with wound healing for you and baby, and there is some evidence that it helps prevent jaundice in the infant (14, 15).  Make sure you are getting enough vitamin D as it helps with your mood, and if you are breastfeeding, I recommend taking at least 6400IU to make sure enough vitamin D is present in the breastmilk for your babe (16). As stated above, if eating lots of protein at each meal is difficult for you, consider supplementing with protein powders and/or collagen powders.

Remedies:

As always, homeopathy is individualized to the patient.  If you find yourself with mastitis, the remedy you need may not be here.  But if your mastitis is relatively typical, these are the three remedies I think of most often.

Belladonna.

Meaning “beautiful woman” in Italian.  It’s nice to be called beautiful when you are only a few weeks postpartum, isn’t?

Belladonna is known for its “inflammatory” type symptoms, which often fit mastitis.  Things are red, hot, throbbing and achy.  The breast may have these symptoms, but Belladonna patients also often present with a red face and/or aching, congestive, throbbing headaches. Patients are often thirsty with a dry throat, although they may or may not want to drink.  You may also have prolapse with or without urging or pressing downwards towards the vagina; it may even feel like everything is just going to fall out.  Your lochia (the bloody discharge after labor) may smell bad and be lumpy (which indicates an infection – you need to go see your healthcare provider if that happens).  During the mastitis, you may have an intense, “anxious” desire to sleep.

The breast will often have hardened lumps, tender to touch.  The whole body can even be incredibly sensitive to touch.  You may feel incredibly tired and weary, not wanting to move at all.  You may feel better when you pull the head backwards (think of fish pose in yoga) or resting the head on something.  Your pulse will be fast and beat hard against your fingers when you feel it.

Sources: Boenninghausen’s Characteristics, Hahnemann’s Materia Medica Pura.

Pulsatilla:

Unlike Belladonna, after pains in Pulsatilla patients are very intense, without the expected amount of lochia. This doesn’t necessarily mean you have no lochia, but perhaps less lochia than expected.  The milk supply may be increased, and there may be pain and swelling at the nipple.  Usually pulsatilla patients, while in pain, are chilly and are not thirsty.  The pains can feel like the parts “were dashed with cold water”.  Pulsatilla patients are generally worse in a warm or stuffy room and are better with open air.  So you may want to keep the windows open or put a fan on.  Gentle motion, not heavy exercise, often makes Pulsatilla patients better as does lying on their back. 

Emotionally, Pulsatilla patients are usually gentle, possibly weepy, and mild.

In contrast to Belladonna, the pulse of Pulsatilla patients is often weak, maybe hardly perceptible.

Pulsatilla should be considered in cases of deeply cracked and bleeding nipples, if the other symptoms fit.  I could not find direct evidence that Pulsatilla has been used in cases of painful nursing with cracked nipples, but Pulsatilla is indicated for cases of deeply fissured or bleeding cracks in the skin.  Based on the idea of symptom recombination (used by Boenninghausen, Hahnemann and others), Pulsatilla should be considered for nipple cracks when other symptoms indicate Pulsatilla as well.

Sources: Boenninghausen’s characteristics, Allen’s Encyclopedia

Phytolacca:

This remedy is sometimes called a “specific” for mastitis, but I think other remedies fit mastitis beautifully too, so I’m not convinced Phytolacca is what everyone should try.  Allen wrote in his Handbook that it’s most useful after the acute phase of mastitis has passed, but to me it sounds like the state that is often a precursor to mastitis - the painful breastfeeding with damaged nipples.

Phytolacca has intense pain while breastfeeding and incredibly sensitive, cracked and fissured nipples.  The pain during breastfeeding may start at the nipple and shoot through to the back or through the whole body.  The pain may linger after breastfeeding, and be worse at night (so late-night feedings may feel worse than those during the day). The breastmilk may be thick, stringy or lumpy.  There also may be intense pain with the let-down that’s better by putting your hand on the breast. There may be lumps in the breast (think clogged ducts, which are also often precursors to mastitis).

Like Belladonna, there can be bearing down pains in the pelvis.  But unlike Belladonna, the breast may have a purplish color (or just red), whereas Belladonna will likely be just red.  Like Belladonna and Pulsatilla, Phytolacca patients likely have an abundant milk supply.

Sources: Boenninghausen’s characteristics, Allen’s Handbook, Clarke’s Dictionary