What is the painful breastfeeding condition mastitis? From symptoms to treatments

·6-min read
Breastfeeding. (Getty Images)
There are simple treatments to help relieve the symptoms of mastitis caused by breastfeeding. (Getty Images)

With mastitis affecting roughly up to 20% of women, this World Breastfeeding Week is a great time to understand the condition a little better.

While it is a common breastfeeding complication and usually nothing to worry about, it's important to know how best to help ease it (or even prevent it from happening at all), to reduce the amount of discomfort you experience.

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What is mastitis?

Mastitis happens when a blocked milk duct is not relieved, and can make your breast feel swollen, hot and painful, according to the NHS. While it is most common in breastfeeding women, women who are are not breastfeeding and men can also get it.

“If caught very early then mothers can sort the problem out by emptying their breasts effectively via either breastfeeding or using a breast pump," says Clare Byam-Cook, The Baby Show‘s breastfeeding expert.

"If it persists and becomes hard, red and shows signs of infection, then you should see your GP who will prescribe you with antibiotics.”

Byam-Cook explains mastitis can happen to anyone, either out of bad luck or if your baby is latching on incorrectly to your nipple, for example. “Your breast becomes blocked up, nipples become sore and infection travels up and can create a hard-lumpy area," she explains.

"If you continue to breastfeed or breast pump and the symptoms disappear then you don’t need to do anything, but if symptoms continue then you should go see your GP.”

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What are the symptoms of mastitis?

Mastitis usually only affects one breast, with symptoms often coming on quickly. As per the NHS, they can include:

  • a swollen area on your breast that might feel hot and painful (the area may also appear red, but this can be harder to see on darker skin)

  • a wedge-shaped breast lump or hard area on your breast

  • a burning pain in your breast that might be constant or only when you breastfeed

  • nipple discharge (this may be white or contain streaks of blood)

“Women may also experience flu-like symptoms such as chills, aches, feeling generally unwell and will usually develop a temperature over 38°C,” Liz Halliday, deputy head of midwifery at Private Midwives adds.

Mastitis is most likely to occur within two to three weeks of birth, but can also occur at any time, according to Halliday.

“It usually develops suddenly and quickly. Quick action at the first signs may stop it developing but if this does not work antibiotics should be considered,” she says.

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What should you if you think you have mastitis?

The amount of medical attention you need might depend on how long you've had symptoms for.

“If you think you have mastitis it is a good idea to call your midwife or a lactation consultant,” Halliday says, referring to those breastfeeding. “If it has been more than 24 hours or you are very unwell you should contact your doctor immediately for antibiotics.”

Halliday says it is imperative that women suffering from mastitis do not stop breastfeeding as this could lead to a severe case of mastitis and even a breast abscess forming.

“Emptying the breast is important,” she adds. “Feed baby regularly, and if baby is refusing the breast or you are finding it too painful, express instead. Aim to empty the breast every two hours, and don’t forget about the other breast!”

In full, NHS self-help tips include:

  • soak a cloth in warm water and placing it on your breast to relieve the pain (a warm shower or bath may help the same way)

  • rest and rink lots of fluids

  • take paracetamol or ibuprofen to reduce pain or fever

  • continue to breastfeed (as Halliday urges)

  • start feeds with sore breasts first

  • express milk from breast in between feeds

  • massage your breast to clear blockages (stroke from the lumpy or sore area towards your nipple)

You should avoid:

  • wearing tight-fitting clothing or bras until your symptoms ease

  • not taking aspirin

But remember, if you do not feel better within 24 hours despite continuing to breastfeed, you get mastitis and are not breastfeeding, or your symptoms do not get better 48 hours after antibiotics, see a GP.

Woman breastfeeding. (Getty Images)
Prevention for mastitis is better than cure, where possible. (Getty Images)

Prevention for mastitis

While you can't always guarantee you won't be affected by it, there are some things you can do to reduce the risk of mastitis.

According to the NHS' Better Health Start for Life, these include (if possible to do):

  • breastfeed exclusively (avoid using first infant formula to top up, or a dummy)

  • feed frequently and responsively (long gaps in between feeds can create a build-up of breastmilk)

  • encourage your baby to feed if you feel your breasts are getting full

  • make sure your baby latches on properly (try different breastfeeding positions)

  • wait for your baby to finish feeding (they should release when finished)

  • when you want to stop breastfeeding, try cutting down your feeds gradually (don't suddenly go longer between feeds)

  • avoid wearing a bra or clothing that is too tight and puts pressure on your breasts.

It's also important to remember that people who aren't breastfeeding might get mastitis caused by factors like smoking (toxins found in tobacco can damage breast tissue), damage to the nipple (like a piercing or skin condition), if you have a breast implant, if you have a weak immune system due to a health condition or shaving or plucking hairs from around your nipples.

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Mum and baby at doctors. (Getty Images)
If self-help methods don't work, don't delay in seeking professional help. (Getty Images)

Treatment for mastitis from a doctor

As explained, if you don't feel better, and have had to consult a GP for help with mastitis, they will usually prescribe antibiotics.

But while this may cause concern, the NHS website advises that although a small amount of the antibiotic may go into your breast milk (if you are breastfeeding), there is no risk to your baby. However, it might make them irritable and restless.

If mastitis comes back, it might be due to problems with positioning and attaching. As with any breastfeeding problems, contact a midwife, health visitor or breastfeeding specialist as soon as possible.

Halliday also says it's important to contact your health care provider if you have been in hospital recently, your baby is less than two weeks old, you have broken skin on the breasts or nipples and clear signs of infection, there is pus or blood in your milk, you are deteriorating quickly, you are feeling very sleepy, your temperature has gone up suddenly, you have become suddenly very unwell or friends and family are concerned that you are not yourself.

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