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Mastitis: Symptoms and treatment

Mastitis is a painful condition that causes inflammation in the breast. Here we discuss mastitis symptoms, treatment, how to continue breastfeeding with mastitis and tips to help prevent it.

Mastitis symptoms usually develop quickly with signs of inflammation normally appearing in one breast, often alongside feeling like you have flu. It’s most common in women who are breastfeeding.

What is mastitis?

Mastitis causes a woman’s breast to become painful, inflamed and often red. It usually occurs within the first three months after giving birth (NHS Choices, 2016a).

Mastitis symptoms

Mastitis symptoms usually develop quickly and might include:

  • a red lump or area on the breast that is sore and hard; it might feel hot and painful to touch
  • a burning pain that might be continuous or happen while you’re breastfeeding

  • nipple discharge that is white or contains traces of blood

  • flu-like symptoms, for example feeling tired and achy, and having a fever and chills.

    (The Breastmilk It’s Amazing, 2009; La Leche League GB, 2016; NHS Choices, 2016a)

What causes mastitis?

Mastitis is often caused by a build-up of milk in the breast – called milk stasis. This can happen because:

  • your baby is having problems sucking
  • your baby is not positioned well or attaching well to the breast during feeds
  • you have cracked nipples that have become infected
  • infrequent or missing feeds. (La Leche League GB 2016; Essential Parent, 2016; NHS Choices, 2016a)

In some cases, this build-up of milk can become infected with bacteria. This is called infective mastitis and you might need antibiotics to treat it.

Continuing to breastfeed with mastitis

If you develop mastitis, continuing to breastfeed will help you get better and it won’t harm your baby. The affected breast might produce less milk for a few days. Encouraging your baby to breastfeed frequently from the affected breast might clear the blockage and help your milk production to increase quickly. You can try to:

  • increase the frequency of feeding to drain the breast fully or use a breast pump if your baby is unable to feed

  • start feeding with the affected breast first

  • express milk between feeds

  • make sure your baby is positioned and latching well for their breastfeeds (consult your midwife, health visitor or seek help from NCT breastfeeding counsellors or other professional breastfeeding support)

  • try different feeding positions so your baby stimulates the blocked area more effectively

  • before feeding, try softening your breast by expressing a little milk, which might make it easier for your baby to feed well

  • massage the affected area in a warm shower or using a warm compress before feeding.

    (The Breastmilk It’s Amazing, 2009; NHS Choices, 2016b; La Leche League, 2016)

Mastitis treatment

Mastitis is usually easy to treat, and most women recover well and quickly. Some self-help measures can be helpful, such as:

  • getting lots of rest and relaxation

  • staying hydrated

  • using paracetamol or ibuprofen for relief from pain or fever

  • avoiding tight or restrictive clothes or bras until you’re better

  • continuing to breastfeed even if you have an infection. This will help improve your symptoms and won’t harm your baby

  • it might also help to feed more frequently than usual

  • making sure your baby is positioned and attached well to your breast. (NHS Choices, 2016b)

Contact your GP if you think you might have mastitis. In the meantime, continue with self-help measures before your appointment. You might need antibiotics to treat mastitis. If so you will need antibiotics that are safe to use while breastfeeding. You might also need to contact your GP if you:

  • continue to feel feverish or if your temperature rises above 38.4°C

  • see pus or blood in your milk

  • have a cracked nipple that looks infected

  • see red streaks on your breast or your breast becomes red, hot, and swollen.

    (NHS Choices, 2016a; La Leche League, 2016; Essential Parent, 2017)

Some women with mastitis or recurrent mastitis can go on to develop a breast abscess – a collection of pus, which might need to be drained surgically (NHS Choices, 2016b). So if you think you might have mastitis talk to your GP as soon as possible.

Preventing mastitis

If you find you have reoccurring mastitis, seek breastfeeding support and make sure your baby’s position and attachment is good. You should also check that your baby doesn’t have any underlying medical conditions like a tongue-tie. Try to take these steps to help prevent mastitis:

  • Feed your baby frequently and let them finish their feeds.

  • Ask a breastfeeding counsellor to check your baby positions and attaches well and breastfeeds efficiently.

  • Breastfeed your baby exclusively for six months if you can.

  • Reduce breastfeeds gradually. (NHS Choices, 2016b)

Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our support line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk.

National Breastfeeding Line (government funded): 0300 100 0212

NHS information on mastitis.

Best Beginnings - Bump to Breastfeeding DVD Chapter 7 'Overcoming Challenges'.

Healthtalkonline.org: Managing Breastfeeding – dealing with difficult times.