Mastitis is a breast condition that some breastfeeding mothers will unfortunately experience.
Having mastitis is often both a miserable and painful experience – it usually makes you feel unwell, very tired and makes your breast hurt a lot!
Trying to breastfeed can be very uncomfortable too.
With the right treatment however, you can get on top of it quickly.
The information below will help you to understand what mastitis is, how to treat it and when to see your doctor.
What Is Mastitis?
Mastitis is inflammation of the breast. It may due to an infection (infective mastitis) or not (non-infective mastitis).
What Causes Mastitis?
Mastitis has two main causes:
- Milk stasis, where breastmilk is not flowing freely through the ducts
- The culprit organism is usually the bacteria Staphlococcus aureus
Milk stasis is usually the main cause of mastitis and it may or may not be accompanied by (or progress to) infection.
What Can Cause Milk Stasis?
Milk stasis can happen when milk is not removed well or often enough from the breast. This can cause milk to bank up in the ducts and hence result in the milk not being able to move as well through the ducts.
Milk stasis may occur if:
- Your baby doesn’t attach optimally to your breast
- Your baby doesn’t drain your breast well (e.g. due to a tongue-tie)
- Feeds are restricted (e.g. your baby is fed according to a schedule)
- You have an oversupply
Mastitis can occur at any stage during breastfeeding, but it most commonly occurs in the second or third week after giving birth. It typically occurs in one section of one breast.
Signs and symptoms of mastitis usually come on quite suddenly. If you have mastitis, you may feel/see:
- A tender hard lump in your breast
- That the lump is warm to touch
- A patch of redness on the overlying skin
- Intense pain in the affected area, especially when your let-down reflex occurs
- Very tired and run-down
- Aching muscles
- Possibly nauseous
- Often there is a fever ≥ 38.5 degrees Celsius
How Can I Tell If I Have Infective Or Non-infective Mastitis?
The signs and symptoms of both infective and non-infective mastitis are largely indistinguishable. It is up to the clinical judgement of a doctor to decide which one it is. Infective mastitis requires the use of antibiotics whereas non-infective mastitis does not.
It may be more likely for infective mastitis to be diagnosed if:
- There is nipple damage as this could be a possible way for bacteria to enter the breast
- Your symptoms do not improve within 24 hours
- You are acutely unwell
It's important to keep breastfeeding when you have mastitis. Frequent milk removal helps you get better sooner.
Here are some treatment ideas:
- Apply heat for up to a few minutes before breastfeeding (e.g. with a wheat bag or warm towel)
- Loosen your bra or remove it during breastfeeds so that part of it cannot dig into any part of your breast and hence effect how well milk gets removed
- Feed your baby first from the affected breast as a baby tends to suck most vigorously from the first side, and hence drain it most effectively
- If you find your baby isn’t feeding well, try expressing
- During the feed, gently but firmly stroke your breast, starting from behind the blockage, towards your nipple. Some mothers find it helpful to do this sort of massage, combined with some hand expressing, after breastfeeds
- Use cold packs after breastfeeds for pain relief, and to help reduce inflammation
- Changing breastfeeding positions could help drain and unblock a blockage more effectively
- Speak to your doctor about use of pain relief medication
- Rest as much as you can
For more ideas and support speak with an Australian Breastfeeding Association counsellor or see a lactation consultant.
Can Probiotics Help With Mastitis?
There is insufficient evidence about the use of probiotics for the treatment or prevention of mastitis. There is one very flawed study, which unfortunately received a lot of attention — and from which a particular product came about.
To support your immune system, you may like to take probiotics, bearing in mind that each individual strain of probiotics have their own function in the body, so you'd be best to speak to a naturopath to get the right one. Also, consider dietary measures to boost your immune system.
Drink plenty of water and make sure your diet contains a range of healthy foods, including lean protein, vegetables (in a variety of colours), green leafy salads, good fats (coconut oil, olive oil, avocado, egg, fish etc), nuts and seeds. Here are 13 delicious and healthy breakfast ideas.
Will My Supply Be Affected?
Some mothers notice a temporary supply drop in the breast that has mastitis.
A baby may also be a bit fussier with feeds from the affected breast. This may be because:
- The milk tastes saltier
- Of a supply drop
- It may be more difficult for your baby to get the milk out
Continuing to feed your baby when your baby needs to be fed helps ensure your baby will continue to get the milk he needs. While the supply may be a bit lower in the affected breast, the supply in the other breast can increase to help ensure your baby continues to get enough milk. Formula supplementation is nearly always not necessary.
Once the mastitis resolves, your baby may want to feed more frequently – this will help to boost your supply back up again.
If you find your supply is struggling to get back to where it was before the mastitis, speak with a lactation consultant for more ideas.
Is It Safe To Feed My Baby When I Have Mastitis?
Yes! It's perfectly safe (and important) to keep feeding your baby from the affected breast. Even if you have infective mastitis and need antibiotics, it is still safe and important to keep breastfeeding.
When Do I Need To See A Doctor?
It's important to see your doctor if you have any of the following symptoms:
- Flu-like symptoms (e.g. muscle aches, fever, chills, fatigue)
- A cracked nipple with signs of infection (e.g. your nipple may be red, hot to touch and thick, yellow pus may be present)
- Presence of pus or blood in your breastmilk
- Sudden and severe symptoms
- If a lump in your breast has not cleared within 24 hours