Mastitis

What is mastitis?

Mastitis is when your breast gets inflamed because of nipple damage and/or or if a plugged duct becomes infected. 

Mastitis is quite common. About 1 in 5 women who are breastfeeding will get mastitis. 

What are the symptoms of mastitis? 

Sometimes mastitis is mild and sometimes it is severe. You might have: 

• Tenderness, reddened areas of your breast   
• Uncomfortable or painful breast lumps. 

Sometimes mastitis feels like getting the flu. You might:  

• Feel unwell 
• Feel hot and cold with a fever 
• Have general body aches 
• Have headaches. 

When to see a doctor 

• If you feel unwell or your breast is red, you should see your doctor as soon as possible. 
• If your doctor gives you antibiotics, follow the instructions. It is safe to breastfeed when you take these antibiotics. 
• After you start taking the antibiotics, if you don’t start to feel better after 48hrs you might need to go back to the doctor.  
• You might need other tests. If you have severe mastitis, the doctor might check if there is a particular bacteria causing your mastitis. This can help them use the right antibiotics.  

You can keep breastfeeding 

• Your breastmilk is safe for your baby even if you have mastitis.  
• You can keep breastfeeding or expressing from both breasts. This will help your milk supply. 

What to do if you have mastitis 

It is important to care for yourself and your breasts at the first signs of mastitis.  

Breastfeeding frequently helps

• Some babies want to feed more frequently when you have mastitis. Try to feed to what your baby wants. 
• Some babies might not want to feed from the breast with mastitis for a while. Keep offering and expressing your milk. Y our baby should start to feed from both breasts soon. 
• A cool pack wrapped in a cloth and placed on your breast after feeding or expressing can help can reduce inflammation. 
• You can put a warm cloth on the affected area to encourage the milk flow before feeding or expressing. If your milk is flowing okay, you don’t need to use warmth.  

You can help improve milk flow  

• You can very gently stroke the breast with mastitis to help improve milk flow. You can do this during feeding or expressing, or in the bath or shower. 
• Between feeds, you can very gently stroke the affected area towards your armpit. This helps to reduce fluid build-up in your breasts. 
• Do NOT try pumping to relieve pressure

Pain relief 

• A cool pack can be good for pain relief. 
• You can take paracetamol or ibuprofen to help with pain. It is safe to take these while breastfeeding. 

Looking after yourself 

• Drink enough water so you are not thirsty.   
• Rest when you can.  
• Ask your partner, family or friends for help with household tasks. 
• Looking after your baby 
• Check your baby is having the usual number of wet and dirty nappies. 

Looking after your breasts 

• Wear comfortable non-restrictive clothing.  
• Avoid pressure on your breasts. 
• Don’t use strong pressure from your hands and fingers during feeding or expressing. 

What causes mastitis? 

We don’t always know the cause of mastitis.

Some reasons you get mastitis could be:  

• Your baby finds breastfeeding hard 
• Nipple damage 
• Narrowed, inflamed milk ducts
• Long gaps between feeds, causing very full 
• Breasts 
• Stopping breastfeeding suddenly
• Tight or underwire bras that put pressure on your breasts. 

How can you help prevent mastitis? 

Feeding to prevent mastitis 

• You should breastfeed frequently. Young babies often need to feed 8 12 times in 24 hours, or more. 
• Don’t miss or delay feeds.
• Offer both breasts for each feed. If your baby doesn’t take the second breast, offer it first next time. 
• Wake your baby for a feed if your breasts start to feel too full. 
• Ask your nurse, midwife or breastfeeding counsellor to check your baby is attaching and feeding well.  
• Avoid giving your baby formula or other fluids unless advised by your nurse, midwife or doctor. 

Expressing to prevent mastitis 

• If your breasts still feel full after a feed, express just enough milk for comfort. 
• If your baby doesn’t want to feed yet, express just enough milk for comfort. 
• If you’re using a breast pump, check the breast shield size is not causing any problems for your nipple or breast. 
• Ask your breastfeeding counsellor if you think your breast pump is causing problems.