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.
For more information or to schedule a consultation with a lactation specialist at CHOP, call 215-590-4442 or contact us online.
Reviewed by: Diane L. Spatz, PhD, RN-BC, FAAN
Date: August 2012