Mastitis means inflammation of the breast tissue. The first sign of mastitis is a red, swollen, usually painful area on the breast. You may get mastitis when milk leak into breast tissue from a blocked duct. The body reacts in the same way as it is does to an infection by increasing blood supply. This produces the inflammation and redness. When treated early, more serious infections such as breast abscesses can be prevented.
DO NOT STOP BREASTFEEDING DURING MASTITIS AS THIS CAN MAKE YOUR MASTITIS MUCH WORSE. CONTINUING TO BREASTFEED WILL HELP YOU RECOVER MORE QUICKLY AND WILL NOT HARM YOUR BABY.
Signs of Mastitis
- A red area on part of the breast, often the outer, upper area, which may be painful to touch
- A lumpy breast, which feels hot to touch
- The whole breast aches and may become red
- Flu-like symptoms: aching, increased temperature, shivering, feeling tearful and tired. This feeling can sometimes start very suddenly and get worse very quickly.
NB: You may not have all of the above signs during mastitis.
Factors which make mastitis more likely
- Difficulty with attaching your baby to the breast. This may mean that the breast is not drained well.
- Pressure from tight fitting clothing, particularly your bra, or a finger pressing into the breast during feeds
- Nipple damage such as grazes or cracks
- Engorgement: An over-full breast that may make it difficult for baby to feed
- A blocked duct
- Stress and tiredness
- Sudden changes in how often the baby is feeding, leaving the breasts feeling full
- Favouring one breast
Prevention of Mastitis
- Position and attach your baby to the breast correctly. The nipple may look slightly stretched after the feed but should not be squashed or flattened.
- Ensure the breast offered first is soft and comfortable before offering the second side.
- Wash your hands before handling your breasts or nipples.
- If your baby only feeds on one side, you may need to express some milk from the other side to relieve the pressure.
- Gently feel your breasts for lumps or tender areas before and after a feed.
- If you find a lump or tender area, massage towards the nipple before and during feeds.
- Use different feeding positions and place your baby’s chin towards the fullest area during feeds. This will ease the fullness.
- Try to avoid suddenly going longer between feeds. If possible cut down gradually.
- Make sure your breasts don’t become overfull.
- Avoid pressure on your breasts from clothing and fingers.
- If you feel unwell, feel your breasts for lumps and look for redness (using a mirror can be helpful).
- If you feel pain when breastfeeding or think you may have mastitis, please seek help from your nurse, doctor or lactation consultant.
These measures will help to clear blocked ducts and engorgement:
- Keep on breastfeeding: You may feel ill and discouraged but continuing to breastfeed is the quickest way to get better, and won’t hurt your baby.
- Feed your baby more frequently or express between feeds if your breasts feel uncomfortably full.
- Feed from the sore side first to drain it as thoroughly as possible.
- Point your baby’s chin to the affected area during feeds.
- Express gently after feeds, so that your breasts are kept as well drained as possible. Keep expressing until you feel better.
- Check that your baby is well positioned and attached to your breast. Try feeding with your baby in different positions.
- Soften your breast, by expressing a little milk or running warm water over it, so that the baby finds it easier to feed well.
- Massage the area toward the nipple before and during feeds.
- A drop of vegetable oil may help prevent skin friction.
- A warm pack can be used just before feeds to help milk flow.
- Apply a cool pack or a washed cabbage leaf after the feed.
- Check for any clothing that is pressing into your breast, some women find it helpful not to wear a bra. Bumps or knocks from toddlers can also have the same effect.
- It is important to rest and get help at home.
- Take pain relief as directed to relieve pain and other symptoms.
If you do not begin to feel better despite using self-help measures, especially if you start to feel worse, you should speak to your doctor. You may need to take antibiotics. You should feel improvement in 12-24 hours.
Reduces the inflammation, relieves pain and reduces temperature. Take 400 mg, three times a day after food. Ibuprofen should not be taken by women with asthma, stomach ulcers, or are allergic to aspirin. The levels of ibuprofen which pass to the baby are small. Ibuprofen is safe to take while breastfeeding.
Relieves pain and reduces temperature, but has no anti-inflammatory effect. Take two 500 mg tablets, four times a day.
Aspirin should not be taken by breastfeeding mothers.
- May be needed if no improvement is seen with self-help measures. Most antibiotics can be safely taken while breastfeeding.
- The World Health Organization recommend flucoxacillin 500 mg, four times a day for 10-14 days.
- The full course of antibiotics must be completed to minimise re-occurrence
- Breastfeed first if a dose of antibiotics is due at the same time.
- Your baby will not get sick. The infection is in the breast tissue not the milk.
- Your baby may have runny bowel actions and/or be a little unsettled.
- Antibiotic treatment can sometimes cause thrush. If symptoms develop treatment will be needed.
- Take extra care with hand washing.