Breastfeeding problems and solutions: Mastitis

What is mastitis?

Mastitis is a condition that causes your breasts to become inflamed. The inflammation can quickly progress to an infection. If you have it, you may notice that areas of your breasts are:

• red
• hard
• sore
• hot
• swollen

You may also feel a lump, which is often referred to as a blocked duct. However, this isn’t caused by a blockage, but by milk getting into your breast tissue instead of your milk ducts.

You may also have flu-like symptoms, such as:

• chills
• headache
• a temperature of over 38.5 degrees C (101 degrees F)
• exhaustion.

If you find yourself with mastitis, you're not alone. Some research indicates that about one in 10 breastfeeding mothers get it and some bottle-feeding mothers do too.

Having mastitis can be a painful experience while it lasts. Rest assured that with the right treatment, mastitis can be cleared up quickly. Unfortunately, you can get mastitis more than once, but it's unlikely that you'll get it in both breasts at the same time. We hope that's some consolation!

What causes mastitis?

Mastitis is most often caused by milk stasis. This is when milk builds up in your breast because it’s being made faster than it’s removed.

Milk stasis can happen when your baby isn’t emptying your breasts well when he feeds. This may be because he isn’t latched on properly.

The following conditions can also cause milk stasis and lead to mastitis:

• engorgement that doesn't return to normal
• feeding to a strict routine
• an injury to your breast
• wearing poorly fitted bras, often with underwire, that are too tight

Sometimes, milk stasis can become worse and develop into infective mastitis. This may happen if you’ve had cracked nipples. An infection can pass through the crack or fissure in your nipple into the lymphatic system of your breast.

You're more likely to develop mastitis if you are a first-time mum but more experienced breastfeeding mothers aren't immune. Mastitis can occur at any time while you're breastfeeding. However, it's most common in the first month after giving birth when you are learning about breastfeeding.

How can I treat mastitis?

Don't stop feeding, as that will make your mastitis much worse. Get help and advice straight away from your doctor. If you’ve had mastitis for a few days and it’s become infected, your doctor may prescribe antibiotics.

You may also like to try these self-help methods, whether or not you’re taking antibiotics:

• Make sure your baby is latched on properly to your breast and is feeding well.
• Try different breastfeeding positions if they help your baby to latch on better.
• To keep your affected breast well drained of milk, breastfeed as often as your baby wants to. The more often you feed, the better.
• Express milk by hand or with a breast pump, after feeds, if you feel your baby has not fed well. Some mums find a breast pump removes milk better than their baby, particularly if they also have sore nipples.
• If you feel ill, rest as much as you can. It may be a good idea to let your husband or a relative look after your baby when you take a break.
• You may find that it helps to apply warmth to your breast. Put a wash cloth or compress on your skin, or have a warm bath or shower. However, some mums find that cold compresses work better.
• If it helps to massage your breasts, do so very gently while your baby is feeding to help the milk to flow from them. Vigorous massage can actually make mastitis worse. It pushes the leaked milk further into your breast tissue.
• You can also take painkillers, prescribed by your doctor, to help with the pain.
• Some mums find homeopathic medications effective in treating mastitis. Do consult a licensed and practising homeopath.

You may prefer to try these self-help measures before seeing your doctor and taking antibiotics. However, take good care of yourself, because if your mastitis does not start to improve, it can develop into a breast abscess. An abscess will require immediate medical attention, and sometimes surgery, to drain it.

If you are finding it hard to help your baby latch on and feed well, it's important to get help. Ask your doctor to recommend a breastfeeding specialist. Also look at our A-Z list of breastfeeding organisations for further sources of help.

How long will mastitis last?

If it is diagnosed early, mastitis is easy and quick to treat. It won't be long before you feel better. If you start a course of antibiotics, be sure to take all of it. If your breast remains tender and you still have a temperature after a few days of taking antibiotics, go back to your doctor.

Should I stop breastfeeding if I have mastitis?

No, it's important that you continue to breastfeed through mastitis. It'll help you to get better. Although it may be extremely painful at times, you need to let your baby feed as often as possible.

Removing plenty of milk will help to heal your mastitis. Try putting warm wash cloths on your breasts for several minutes before each feed. This should help your let-down reflex and make feeding more bearable for you.

If your baby doesn't empty your inflamed breast during each feed, use a breast pump to empty it. And if you find it too painful to breastfeed, try expressing your milk and giving the milk to your baby in a paladai, cup or expressing bottle.

Will mastitis affect my baby?

Even though you may be feeling unwell and uncomfortable, mastitis will not affect your baby. It’s perfectly safe for her to feed from your affected breast. Even if you have infective mastitis and your baby swallows bacteria in the milk, it will be killed off by the acid in her stomach.