Mastitis and the microbiome

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By Sherrie Miller

Mastitis is a common condition for many breastfeeding mothers, and for many this means the end of breastfeeding their baby. Some women suffer with excruciating pain in their breasts, driving a deep fear into them with the thought of their baby latching on, for yet another painful feed. For some, this may cause sadness, a feeling of failure and of course lessens the chance of baby getting the best they can receive from mother’s breast milk.

I recently had a coffee catch up with another local Peninsula Nutritionist, Emma Park, who is a clinical educator of a brand of probiotics that specifically targets the mastitis infection. Emma educates hospitals, doctors, nurses and pharmacists on a particular probiotic strain called Lactobacillus Fermentum CECT5716. This strain of probiotic is isolated from healthy human breast milk. Lucky for me, Emma also educated me on this amazing strain of ‘good bacteria’ helping many mothers recover from mastitis and continuing to breastfeed their babies.

What causes Mastitis?

According to the Australian Breast Feeding Association’s website;

“Mastitis is usually the result of a blocked milk duct that hasn’t cleared. Some of the milk banked up behind the blocked duct can be forced into nearby breast tissue, causing the tissue to become inflamed. The inflammation is called mastitis. Infection may or may not be present.”

Inflammation is the body’s natural immune response to incite healing to the affected area. Signs of mastitis can include breast pain, redness, swelling and heat. This is the work of your body trying to clear away the banked up milk from where it shouldn’t be. When infection kicks in, it means pathogenic bacteria have now got involved. This is not ideal and because of this, your body’s immune response is increased, and the signs and symptoms generally become worse. Breasts may show shiny skin and red streaks throughout and the systemic symptoms of infection such as flu-like symptoms, headaches and temperature will have kicked in.

The general protocol is to prescribe antibiotics and be advised to continue to feed baby, to drain the milk from the breast, as well as applying massage and using alternate cold/heat packs. If left untreated, further complications can occur, potentially resulting in hospitalisation.

The Microbiome

One of our best protective measures we have is our microbiome. The microbiome is a term used describing our ‘community’ of bacteria and microbes. The microbiome needs to be in a healthy balance, with more ‘good’ protective bacteria (also known as probiotics), and less pathogens (‘bad’ bacteria).

The greatest concentration of bacteria and microbes live in our gut, but breast milk and breast tissue has its own microbiome that supports the immune system, reduces local inflammation and acts as a protective army against the pathogenic bacteria that create infection.

If you have healthy and robust levels of good bacteria in your breast milk, you are less likely to get mastitis. This is where specific probiotics can be extremely helpful. When you take specific strains of probiotics it can increase the beneficial flora in you breast milk, reduce local inflammation and kill the ‘bad bugs’ that can cause the pain and infection. As effective as antibiotics are, they do not discern between the good guys and the nasty guys – they just wipe them all out. That’s OK in the short term, but without restoring the protective, beneficial bacteria, you leave yourself open for re-infection and side effects such as thrush, digestive issues and long term immune issues. These side effects are often treated with more antibiotics or medications, forcing you onto the rollercoaster ride of mastitis-antibiotics-mastitis-antibiotics, and so on. This long term rollercoaster ride can potentially become damaging to both yours and bubs immune system.

Other potential pathways to Mastitis

Our daily diet, lifestyle and environment can also impact our gut and breastmilk microbiome, even from far back as pre-conception.

The following may contribute to compromised gut and breast milk flora, from pre-conception to feeding:

  • Poor diet
  • Moderate to high levels of stress
  • Environmental toxins
  • Regular use of medications, such as ibuprofen, steroids, contraceptive pill, and antibiotics (one course of antibiotics can impact your beneficial flora levels for two years – and some strains never recover)

So then;

  • You don’t have the good bacteria to reduce local inflammation
  • Your systemic immune system is compromised as it relies on a robust microbiome to fight infection
  • Pathogenic bacteria can easily overgrow causing infection

Lactobacillus Fermentum CECT5716

The thing about probiotics is you need the right one for the job. They’re all essentially beneficial but not always effective to treat a specific condition. The single strain probiotic, Lactobacillus Fermentum CECT5716, originally isolated from healthy human breastmilk, has been specifically researched for pregnancy, breastfeeding and infants.

Clinical research has shown that this strain of probiotic directly inhibits the growth of the infective bacteria that can cause breast pain and mastitis. In another trial it has also been shown to effectively reduce the occurrence of mastitis (by 51%) in mothers that had antibiotics at delivery. Remembering that antibiotics at delivery can wipe out the protective flora in the breast milk, leaving them open to increased chance of inflammation and infection. The group that took the therapeutic dose of Lactobacillus Fermentum CECT5716 were able to restore their protective flora and reduce their chances of getting mastitis.

The particular probiotic product that Emma Park educated me on, contains exactly the same quantity and strain of Lactobacillus Fermentum, used in the clinical trials. Taking this strain of probiotic from third trimester, you boost your beneficial microbiome levels, protect against the negative effects of antibiotics, support your immune system and reduce your chances of getting breast pain or mastitis, with the ultimate goal of successful continuation of breast feeding.

If you would like to find out more about the probiotic Lactobacillus Fermentum and its effect in mastitis, you can contact Emma Park, emmaparknutritionist@gmail.com to get the right product for you.


Sherrie Miller is a qualified Nutritionist with a special interest in gut health. She is passionate about the way in which our digestive health can influence our mental health, skin health and immunity.  Sherrie takes the concept of ‘Food is Medicine’ very seriously.

You can find out more on Instagram @sherriemillernutrition

First published in Peninsula Kids – Spring 2018

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