Breastfeeding in the early days can come with its fair share of hurdles (hello, sore or cracked nipples and latching troubles), but there are certain complications that are a little more, well, complicated.
Enter: mastitis.
Swollen and sore boobs, fever and chills, infection and incredible breast pain while feeding — mastitis certainly isn’t pleasant, but it is a relatively common condition. In fact, it affects around 1 in 5 women in Australia [1].
About to welcome a brand-new bub and wondering how to avoid mastitis? Already a breastfeeding mama and dealing with a bout of breast infection?
We’ve put together a guide to treating mastitis when breastfeeding so you can get your breasts back to being fully functional and inflammation-free.
What is mastitis and what are the symptoms?
Mastitis is inflammation that affects the breast tissue [1] — and it can make you feel pretty darn rotten.
Along with swollen and very sore or tender breasts, mastitis often comes with flu-like symptoms and fever.
Most of the time, mastitis afflicts breastfeeding women during the first 6- 12 weeks but can occur up to 6 months after giving birth [2]. It can also occur in non-breastfeeding women and men. It tends to affect just one breast, but in rare cases, it occurs in both.
Mastitis is caused by one of two things [3]. Mostly, it’s due to a blocked milk duct that hasn’t cleared itself of banked-up breast milk [4].
If this milk manages to make its way to the breast tissue, it can lead to the breast tissue becoming inflamed. In this case, it’s known as non-infective mastitis.
Mastitis can also happen as a result of infection. This is often caused by bacteria from the baby's mouth that get into the breast via cracked nipples and breed in the stagnant milk [5]. This is referred to as infective mastitis.
In either case, the symptoms of mastitis can crop up seemingly out of nowhere [4]. They include:
- One breast that's swollen, sore, tender, hard, red or hot — or both, if mastitis is impacting the entire breast area [3]
- A painful or red lump on the affected breast due to a blocked milk duct
- Tight and shiny skin around the affected breast, sometimes with red streaks
- Flu-like symptoms such as fever, chills, achy joints, headache, fatigue and general malaise [6][7]
What are the risk factors of mastitis?
Mastitis can affect any mama who’s breastfeeding, but there are a few factors that can increase the risk of it occurring [5]:
- Previously suffering from mastitis
- Cracked nipples, which make a bacterial infection more likely
- Not draining the breast properly during feedings or skipping feeds — this can cause milk to stockpile in the breast
- Latching issues, including a tongue tie, which make it tricky for bub to empty the breast [6]
- Pressure on the breast, perhaps from gripping it firmly during a feed, wearing a bra that’s too snug, or a tight-fitting seatbelt or bag strap — any of these can restrict the flow of milk
- Illness
- Lifestyle factors such as malnutrition, stress and smoking
Why are breasts prone to infections when breastfeeding?
Breast infections tend to appear in breastfeeding women. Breastfeeding often comes with cracked nipples and opens the breasts up to infectious bacteria, which can enter through the cracks.
Combined with the fact that stagnant milk is also an ideal environment for bacteria to grow, this makes infections like mastitis more likely [5].
How to prevent mastitis when breastfeeding
Like most things, prevention is better than a cure. If you have blocked milk ducts, treat the problem ASAP so you can try and steer clear of mastitis.
Here’s what you can do to prevent mastitis.
Maintain a good latch
Getting your baby's mouth into a good latch will help drain your breast properly and make breastfeeding much easier.
If your baby is having trouble latching, reach out to a lactation consultant or child health nurse who can get things back on track.
Fully drain your breasts
Draining your breasts can help ease a blocked milk duct. Avoid stockpiling too much milk by ensuring your breasts are emptied at each feeding. You can usually tell when your breasts are properly drained.
Offer your baby both breasts during a feed, and alternate the starting breast at every feed so each one gets a chance to empty.
You can also change up your breastfeeding positions during feeds to drain every part of the breast [8].
Keep feeds regular
Skipping feeds or leaving too much time between feeds can cause milk to bank up. If you’re bottle-feeding at any point to replace a feed, express your breasts to drain the milk.
Avoid anything tight-fitting
This goes for bras, clothes and bag straps, which can put pressure on your milk ducts.
Prevent infection
To minimise the risk of contracting a bacterial infection, steps you can take include letting your nipples air out after applying nipple cream or feeding as well as washing your hands after nappy changes.
What is the first-line treatment for mastitis?
It’s best to start mastitis treatment straight away [3]. If you notice the signs of mastitis, you can try treating it at home using a few simple remedies, which we’ll get to shortly.
You can also take pain relief medication to ease the discomfort. If you don’t notice an improvement after 24 hours, you should visit your doctor for an assessment.
Feeding with mastitis
Worried about how to keep your little one going when you're dealing with mastitis? Don’t worry — you can continue breastfeeding.
Your breast milk is still safe for your baby to drink, and by maintaining regular feeds you’ll keep up your milk supply in the affected breast [6]. In fact, breastfeeding or expressing can actually heal your breast faster [9].
By getting your baby to suck or pumping regularly, you can aid in clearing the milk blockage and relieve many of the nasty symptoms of mastitis.
Plus, banked-up milk is a nice breeding ground for bacteria, so emptying your breast can help your body get rid of the infection.
If you're having trouble feeding with mastitis or experiencing significant breast pain, don't hesitate to contact your doctor, a child health nurse or a lactation consultant.
What are the mastitis treatment options?
Here are some easy ways to try and beat mastitis at home.
Continue feeding
As we now know, continuing to breastfeed or at least expressing milk using a breast pump can help relieve mastitis. It might be painful but know that feeding or expressing is a crucial part of the healing process.
Offer your baby the affected breast first — this is when they’re hungrier, making their suck more forceful [4]. You can also give your boob the opportunity to fully drain by trying different feeding positions throughout the feed.
Once again, a lactation consultant or child health nurse can help if you're struggling to feed with mastitis.
Use hot and cold compresses
Applying gentle pressure to the sore breast with a heat pack or warm cloth before a feed can encourage milk flow [3]. Having a warm shower and letting the water flow over your breasts can also provide a bit of welcome relief.
On the flip side, using a cold pack or even a bag of frozen peas wrapped in a cloth can soothe the painful inflammation associated with mastitis. This is best done after a feed.
Try breast massage
Gently massaging your breast and any mastitis lumps can also assist with draining blocked milk ducts.
You can do this using your hands; simply massage in a circular motion around the affected area and move down toward the nipple.
Give yourself some TLC
Mastitis is nothing if not unpleasant. Make sure you’re getting plenty of rest, and that friends, family or your partner are helping out with bub or household tasks while you take a breather.
You should also keep your fluids up and aim for around 8 glasses of water a day [6]. Lastly, make sure your bra and clothing are loose to avoid putting too much pressure on your boobs.
When should I seek medical attention?
If symptoms don’t ease up after a day, or if you feel incredibly unwell, head to your doctor. They may prescribe a course of antibiotics to address the infection [9].
Ensure you take medication as directed by your doctor, and remember that it’s perfectly safe to continue breastfeeding while you’re on these kinds of antibiotics [6]. After 10 or so days, but perhaps up to a few weeks, the infection will likely go away [2].
Other instances where you might want to seek medical attention include:
- Abnormal nipple discharge
- Severe breast pain, especially if there’s no obvious cause
- A lump that seems suspicious
- Trouble breastfeeding due to the pain or swelling.
Can mastitis go away without antibiotics?
In some cases, mastitis might disappear on its own without antibiotics [8]. If you try the treatments we listed earlier and symptoms fade after 24 hours, you may not need a course of medication.
If not, though, get to your doctor — stat. Left untreated, mastitis can make breastfeeding really hard, potentially resulting in stopping it entirely [10]. There’s also a risk that mastitis can turn into a breast abscess, a collection of pus that has to be surgically drained by a medical professional [2].
While not exactly a common occurrence, a breast abscess is a pretty uncomfortable experience we’re sure you’re keen to avoid.
Photo credit: Getty Images
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