There’s nothing like a case of mastitis to throw off your breastfeeding routine. Find out everything you need to know about mastitis so you can be prepared.
There are some breastfeeding challenges that you expect, like having tender nipples as you and your baby learn how to breastfeed. Dealing with the simultaneously embarrassing and silly experience of leaking milk out in public. Figuring out how to balance breastfeeding and, well, the rest of new parent life.
But other problems can catch you totally off-guard. You might be going about your day, lost in your routine when you notice a dull, throbbing pain in your breast. You ignore it for a bit, but it doesn’t go away. In fact, it gets worse. And you’re starting to feel just plain awful.
This yucky feeling may be a case of mastitis.
What is mastitis?
Mastitis usually starts as a painful area in one breast. It may be red or warm to the touch, or both. You may also have fever, chills, and body aches.
Regardless of how it starts, though, mastitis should always be taken seriously. Ask any parent who has had it: mastitis can lay a breastfeeding parent flat.
This painful breast inflammation is a serious issue that requires immediate attention because it can turn into infection, abscesses, and impact your milk supply when ignored.
What causes mastitis?
Several things can cause mastitis. Or, more accurately, create the conditions where mastitis is likely to happen.
Mastitis can occur when:
Clogged ducts create a backup of breast milk, causing bacteria to grow in the milk.
Bacteria on the skin or in saliva get into breast tissue during nursing. This is most likely to happen when nipple tissue is injured (e.g., cracks, sores, blisters, etc.)
Your immune system is overworked.
The last point is especially important for breastfeeding parents to remember—during your postpartum period, your body needs time to heal and adapt to parenthood. You’re already sleeping less and doing more just by caring for your baby, especially if you’re breastfeeding every two to three hours. If you’re also working, cleaning, cooking, entertaining, you can easily find yourself run down and vulnerable to illness.
Signs of mastitis worsening include swollen, painful lymph nodes in the armpit next to the infected breast, a fast heart rate, and flu-like symptoms that get worse. Mastitis can lead to a breast abscess, which feels like a hard, painful lump.
How do I know if I have mastitis?
For many breastfeeding parents, mastitis comes out of the blue. Or maybe they suddenly realize they have a headache or a sore, throbbing breast. However it appears, though, mastitis is hard to ignore. If you have it, you’ll experience intense pain in your breast and a warm, red, sore area where the mastitis is located.
There are quite a few other symptoms, though, making mastitis a full-body, flu-like ailment. You might experience:
Nausea or vomiting
Aches and pains
Swollen, painful lymph nodes
Is it a clogged duct or mastitis?
The symptoms of mastitis, especially early and non-systemic mastitis, can often feel like a clogged duct. And while clogged ducts can lead to mastitis, they are two different things. How to tell the difference? Here are the key differences between the two.
Clogged duct: Blocked milk flow in your breast. Clogs usually are gradual and affect only one breast. Clogged ducts can feel hard, lumpy, or swollen. The area around the clog can feel hot or tender. Nursing or pumping can relieve the pain.
Mastitis: Mastitis is breast inflammation. It tends to occur suddenly and only affects one breast. Mastitis symptoms are the same as clogged ducts but are often more intense. You may see red streaks radiating from where you have mastitis. Mastitis also includes the above-mentioned symptoms of fever, chills, flu-like aching, nausea, and more.
Risk factors for mastitis
While any breastfeeding parent can get mastitis, some indicators make getting mastitis more likely. These include:
Having had mastitis before, whether previously in this breastfeeding journey or when nursing another child.
Cracked or irritated nipples, which can be caused by poor latching or poor positioning during nursing.
Recurring clogged ducts
Frequently missing, delaying, or skipping nursing or pumping sessions, which can lead to engorgement, which in turn can lead to mastitis
While mastitis can occur at any point in breastfeeding, it’s more likely in the first several months as you and your baby establish a regular breastfeeding routine.
Will mastitis affect my milk supply?
When you’re dealing with mastitis, you might notice that your milk supply drops from the affected breast. This decreased output is due to inflammation and the slower movement of milk.
Lots of parents worry that their low supply will be long-term, but there’s usually no need to worry. As long as you keep nursing or pumping, hydrating, and resting, your milk supply should rebound after your mastitis resolves.
How to treat mastitis
If you’ve just developed mastitis and it hasn’t progressed to a breast infection, then your first approach should be to get as much rest as possible. If it’s an option, take 24 hours off and rest completely. Let your partner, a friend, a grandparent help care for your baby—and bring your baby to you to nurse frequently.
Mastitis treatment should also include:
Breastfeeding frequently on the affected side to relieve engorgement
Using breast massage to encourage milk flow and improve circulation
Resting and hydrating—a lot (Yes, we just said it, but it’s important!)
Avoiding compression or constriction of your breasts
Not overstimulating your breasts—nurse or pump until your breast is drained but no longer than that
Using a cold compress to alleviate swelling and inflammation
Increasing Vitamin C intake
Eating a healthy, balanced diet
If tolerated, pain relievers like acetaminophen can help with pain and fever, and ibuprofen can help with pain and inflammation. Make sure to read and follow all instructions on the label. Both medications are breastfeeding safe.
While massaging alone won’t resolve mastitis, it will help you break up painful clogs and relieve some of your discomfort. Using firm pressure, massage the affected area down toward the nipple before or during nursing or pumping. Alternate with compression around the edges of the blockage to break it up. Do this on any part of your breast where you feel hard or lumpy areas.
If symptoms don’t improve within 24 hours, contact your healthcare provider for an appointment.
If, at any point, you develop a fever, red streaking on your breast, find blood or pus in your milk, or your symptoms are sudden and severe, then you should see a medical care professional immediately. In these cases, you may be prescribed antibiotics for mastitis. If your healthcare provider does prescribe them, though, make sure to take as directed and to take the entire course of medicine.
Note: Antibiotics can leave you more vulnerable to thrush and other fungal infections. Consider taking a probiotic along with your antibiotic to protect your gut health.
Yes! In fact, it’s the best thing you can do besides resting and hydrating. Although it can be painful, frequently breastfeeding is important to do. Emptying your breasts as much as possible helps you:
Keep milk moving, which helps resolve clogged ducts and prevent milk from building up.
Prevents the development of abscesses
Protect your milk supply from dropping
Note that sometimes breast milk can taste different when a mom has mastitis due to the increased sodium content in the milk. In these cases, pump your breast milk but make sure to save it—breast milk has uses besides feeding, including home remedies for skin and injuries, baking, jewelry, milk baths, and more.
Are antibiotics safe to take when breastfeeding?
If you’re prescribed antibiotics by your healthcare provider during a case of mastitis, they’re safe to take. They won’t affect your baby. That being said, taking antibiotics when breastfeeding can increase your risk for thrush. Consider taking a probiotic along with your antibiotic to decrease your risk.
Do I need to pump and dump when I have mastitis?
There’s no need to pump and dump! Here’s why:
Your breast milk is safe for your baby when you have mastitis
Antibiotics are safe for your baby when you’re breastfeeding through mastitis
If you’re unsure about your breast milk at any time, pump and save, then consult an IBCLC or your healthcare provider. There’s never a reason to pump and dump—you can always contact an IBCLC to help evaluate whether you can feed your baby the breast milk.
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