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Everything You Need to Know About Mastitis

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:

  • You have a breast milk oversupply, also known as hyperlactation.
  • You have an imbalanced breast microbiome that allows “bad” bacteria to overgrow, also known as dysbiosis. Contributing factors include (but are not limited to) genetics, nipple shield or breast pump use that doesn’t allow for healthy microbial exchange between mom and baby, antibiotic use, or an overworked immune system.

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, fever, and flu-like symptoms that get worse. Mastitis can lead to a breast abscess, which feels like a hard, fluid-filled, 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:

  • Fever
  • Fatigue
  • Nausea or vomiting
  • Aches and pains
  • Chills
  • Swollen, painful lymph nodes

Risk factors for 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 risk factors make getting mastitis more likely. These include:

  • Having had mastitis before, whether previously in this breastfeeding journey or when nursing another child, especially if it was inadequately treated
  • Deep breast massage, damage from improper pump use or fit, or other trauma to the breast, which can cause inflammation 
  • Oversupply or breast pump overuse
  • Antibiotic use, which can lead to dysbiosis

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, 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 on demand.

Mastitis treatment should also include:

  • Breastfeeding  on demand on the affected side to relieve engorgement
  • Light lymphatic drainage (avoid deep massage, which can increase inflammation)
  • Resting and hydrating—a lot (Yes, we just said it, but it’s important!)
  • Avoiding compression or constriction of your breasts but keeping them supported with a well-fitting bra
  • Not overstimulating your breasts—nurse or pump to comfort but no longer than that
  • Using a cold compress to alleviate swelling and inflammation
  • Take an anti-inflammatory medication, such as ibuprofen
  • Increasing Vitamin C intake and consider a probiotic
  • Eating a healthy, balanced diet

If tolerated, pain relievers like acetaminophen can also help with pain and fever.. Make sure to read and follow all instructions on the label. Both ibuprofen and acetaminophen are breastfeeding safe.

Breast Massage

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.

Book an Appointment Know

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, as well as recurrent mastitis, especially if you do not complete treatment. Always complete the full course of antibiotics as prescribed, and consider taking a probiotic along with your antibiotic to protect your breast health.

Worried you have mastitis? Not sure how to manage it? Book a convenient online video appointment with a Nest Collaborative IBCLC.

Mastitis FAQs

Is it safe to breastfeed when you have mastitis?

Yes! In fact, it’s the best thing you can do besides resting and hydrating. Although it can be painful, continuing to breastfeed on demand is important to do. 

Note that sometimes breast milk can taste different when a mom has mastitis due to the increased sodium content in the milk. If your baby rejects this milk, 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 without contacting an IBCLC to help evaluate whether you can feed your baby the breast milk first.

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