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Home Breastfeeding

Mastitis – 9 Painful Signs, Symptoms And Treatment

Rene Sandeman, RM, IBCLC
by Rene Sandeman, RM, IBCLC
Last updated by Emily Brittingham, IBCLC, BHSc on October 4, 2024
Reading Time: 7 min
mastitis

mastitis

Mastitis is the word no breastfeeding mother wants to hear. Anyone who has suffered this, will know it’s an awful experience that can leave a mother in pain, feeling unwell and very tired.

If you develop mastitis, breastfeeding can become extremely painful. Many mothers find it hard to continue. Fortunately, with the right guidance and support, mastitis can be quickly overcome and you can be back on your breastfeeding journey in no time.

Let’s dive in and discover more: the facts about what causes it; the difference between inflammatory and bacterial mastitis; and tips to treat and prevent it occurring.

What is Mastitis?

Mastitis is inflammation of the mammary glands in the breasts and surrounding tissue. The symptoms causing the inflammation might or might not be due to an infection.

Inflammatory mastitis is when the inflammation is caused by stress on the breast tissue, commonly caused by a clogged milk duct.

If left long enough without immediate management, it can lead to bacterial mastitis, where inflammation causes a breast infection.

Mastitis symptoms

Symptoms of a breast infection can appear in one or both breasts, and can occur at any stage during a mother’s breastfeeding journey. Research shows that an infection in the breast is most common in the first six weeks of breastfeeding, with the highest incidence in the first two or three weeks postpartum.

Signs and symptoms of breast inflammation usually appear quite suddenly. If you have one or more blocked ducts, you might feel, or see:

  1. A tender hard lump in your breast tissue
  2. That the lump is warm to touch
  3. A patch of redness on the overlying skin
  4. Pain or a burning sensation while breastfeeding
  5. Very tired and run-down
  6. Breast engorgement
  7. Aching muscles
  8. Possible nausea
  9. Fever, with a temperature of 38.5C or more.

What is the cause of Mastitis?

There are two main causes of mastitis:

  1. Milk stasis, or stagnant milk. This happens when breastmilk is not moving freely through the milk ducts and causes a blocked duct
  2. Bacteria, most commonly Staphylococcus aureus.

Milk stasis most commonly causes mastitis, as the clogged milk duct begins to develop inflammation.

These are the risk factors that can cause blockages:

  • Your baby doesn’t attach optimally to your breast
  • Your baby doesn’t drain your breast well (e.g. due to a tongue-tie)
  • Breastfeeds are restricted (e.g. you feed according to a schedule)
  • You have an oversupply of breast milk
  • You have a milk blister on your nipple at the milk duct opening.

If mastitis is reoccurring, your breastfeeding technique might need to be checked by someone who specializes in breastfeeding, such as a lactation consultant.

Can I keep breastfeeding if I have mastitis diagnosed?

Mothers are often told to stop breastfeeding straight away until they feel better. This advice is very unhelpful and can make mastitis even worse.

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’s still safe, and important, to keep feeding from the breast.

Reach out for help from a breastfeeding support service such as The Australian Breastfeeding Association or La Leche League.

For more information about how often you should breastfeed your baby, you can read BellyBelly’s article Breastfeeding Times | Important Guide To What To Expect.

How do you unclog a milk duct fast?

Blockages occur in your milk ducts for different reasons and, if they are dealt with quickly, they can be resolved before infection kicks in.

As soon as you feel any symptoms of mastitis – such as a blockage, a red spot on your breast, or feeling unwell, try the following:

  • Cancel plans and rest as much as possible, focusing on you and your little one
  • Stay calm and relaxed to help your milk flow easily
  • Use a warm compress on the affected side for a short time before the feed to help the milk flow
  • Feed your baby or express milk using a breast pump, according to your usual routine
  • Make sure your little one is well latched so he can remove milk effectively
  • Use cold compresses or ice packs after feeding, to help reduce inflammation.

For more information, speak with your healthcare provider or an Australian Breastfeeding Association (ABA) counsellor or see an International Board Certified Lactation Consultant (IBCLC).

You can also read BellyBelly’s article Blocked Milk Duct – Symptoms and Treatments.

Mastitis treatment

If conservative management for mastitis doesn’t ease your discomfort, you’ll need to reach out to your health care provider or doctor for more help.

It can be difficult, even for your doctor, to tell whether or not your mastitis has become infective. Treatment with antibiotics will be required to kill harmful bacteria and therefore your doctor is the best person to see for help.

For some women, mastitis can be so severe a doctor might recommend hospital admission to help reduce serious symptoms.

It’s important to see a doctor or healthcare provider if you have any of the following signs of infection:

  • Flu-like symptoms (e.g. body aches, fever, chills, fatigue)
  • Sore or cracked nipples with signs of infection (e.g. your nipple might be red and hot to touch, and thick, yellow pus might be present)
  • Presence of pus or blood in your breast milk
  • Sudden and severe symptoms
  • A lump in your breast has not cleared within 24 hours.

Remember to check any breast lumps with your healthcare provider.

What can happen if mastitis is left untreated?

Although uncommon, if left untreated, mastitis can turn into a breast abscess that will cause further pain and illness for a mother.

Breast abscesses might require surgical drainage. This is done by a trained doctor, usually under local aesthetic, in hospital.

For more information you can read BellyBelly’s article Breast Abscess And Breastfeeding – 4 Questions Answered.

Rarely, symptoms of inflammatory breast cancer can be similar to symptoms of mastitis. If your symptoms aren’t relieved by mastitis treatment, speak with your doctor.

How to prevent mastitis from occurring

Unfortunately, mastitis can reoccur and it’s important to focus on prevention, to avoid painful bouts of mastitis.

The following tips might help:

  • Continue breastfeeding your baby on demand
  • Avoid stretching out or skipping feeds
  • Make sure you’re attaching and positioning your baby well at the breast so the ducts can be drained effectively
  • Offer your baby both breasts at each feed, alternating the side you start on each time
  • Avoid extra pumping, so as not to create an overproduction of milk
  • Avoid tight, restrictive clothing around the breast area, to reduce the risk of creating a blockage that causes mastitis
  • Rest whenever possible, to make sure you don’t become overtired and stressed.

Can probiotics help with mastitis?

The use of probiotics for the prevention and treatment of mastitis and breast pain is widespread amongst many health professionals, from doctors to IBCLCs.

At this stage, there’s insufficient evidence on the use of probiotics for the treatment or prevention of mastitis. Although some studies were promising, the evidence wasn’t significant enough to recommend the use of probiotics.

If you’d like to take probiotics, that’s totally up to you. Bear in mind, each individual strain of probiotics has its own function in the body.

You can 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 colors), green leafy salads, good fats (coconut oil, olive oil, avocado, egg, fish, etc), nuts and seeds.

Check out Healthy Breakfast – 13 Delicious And Healthy Breakfast Ideas for some tips to start your day on a healthy note.

Can mastitis affect milk production?

The pain, stress, and inflammation of mastitis can have an impact on a mother’s milk supply.

Interruption to the feeding process and ineffective milk removal can indicate to the body the breasts are too full and should therefore slow down production.

With the right support, though, this can be a temporary problem, and one that’s quickly fixed.

Rather than suffer in silence, seek the support of a lactation consultant to help you maintain your milk supply.

Does mastitis affect baby?

You might find that your baby is fussier with breastfeeds from the breast affected by mastitis. This can be because:

  • The milk tastes saltier
  • There has been a temporary drop in milk supply
  • It might be more difficult for your baby to get the milk out.

Even if you’ve been prescribed an antibiotic to help kill bacteria and infection in your milk ducts, you can still feed your baby; the antibiotics are safe.

Demand feeding your baby at the breast, whenever he needs to be fed, keeps the breast milk flowing to meet your little one’s needs.

Be sure to read BellyBelly’s article Baby Hunger Cues | How To Tell If Your Baby Is Hungry.

Women’s bodies and breasts are pretty amazing and can usually compensate when there’s a problem on one side. While the affected breast recovers, the other breast can boost supply to make sure there is plenty of breast milk for your baby.

Once the mastitis resolves, your baby might want to feed more frequently; this will help boost your supply back up again, meeting your baby’s needs perfectly.

If you find your supply is struggling to get back to where it was before the mastitis, speak with the ABA or a lactation consultant, or call your doctor for more ideas.

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Rene Sandeman, RM, IBCLC

Rene Sandeman, RM, IBCLC

Rene Sandeman is a mother of 6, a lactation consultant (IBCLC), midwife and writer, based in Cranbourne, Melbourne. She provides breastfeeding support, breast pump hire, low level laser therapy and more.

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