Breast Mastitis

What is breast mastitis?

  • May, or may not, involve an infection.
  • Involves redness, tenderness and heat in the breast, along with a fever and flu-like symptoms such as nausea, aches and chills.
  • Usually occurs within the first six weeks of breastfeeding, but can occur anytime.
  • Often starts with engorgement.
  • May occur the first time your baby sleeps through the night and/or goes an unusually long time between feedings.
  • Onset is sudden with intense pain in one breast, rarely in both breasts.
  • Symptoms usually last 2-5 days and peak on the second and third day.
  • Non-infective mastitis (not related to an infection) may progress to infective mastitis (which is infection- or bacteria-based and may need to be treated with antibiotics).
  • Bacteria may enter the breast through a crack in the nipple and spread through the ducts.
  • Poor drainage of the breast could trigger mastitis especially when you are exhausted from lack of sleep and stress.  

Tips to prevent breast mastitis

  • Reduce stress and fatigue.
  • Prioritize tasks and get household help.
  • Take naps when your baby sleeps.
  • Delay return to work as long as possible.
  • Breastfeed often, at least 8-12 times per day.
  • Massage any red or firm areas of the breast especially while breastfeeding.
  • Pump or express milk if you miss a feeding
  • Pump or express milk if your breasts are engorged or still full after a feeding
  • Avoid underwire bras that block milk flow
  • If you’ve had mastitis before, even with another child, you are more likely to get it again
  • Do all the above to prevent it before it occurs

What to do if you get breast mastitis

  • Keep nursing.
  • Your baby will not get sick from your milk.
  • Start with the unaffected breast to allow your milk to let-down in the affected breast before feeding. This should reduce pain.
  • Keep the affected breast as empty as possible.
  • Breastfeed often and hand express or pump after breastfeeding several times per day.
  • Call your healthcare provider and/or a lactation consultant.
  • Antibiotic treatment will reduce the chance of recurrence or an abscess.
  • Make sure to complete your full course of antibiotics.
  • Get in bed. You need to rest to get better.
  • Take your baby to bed with you so you can breastfeed often.
  • Allow others to help with household chores and caring for other children.
  • Apply ice packs or hot packs to your breasts — whichever gives you the most comfort.
  • Heat will help drain the breast and provide pain relief.
  • Drink plenty of fluids.
  • Take pain medication such as acetaminophen or ibuprofen.
  • Wear a supportive bra that does not cause painful pressure.

Reviewed by Diane L. Spatz, PhD, RN-BC, FAAN on August 01, 2012