Mastitis: What it is and How to Treat It

If you’re a nursing mother, you’ve definitely heard the dreaded “M word.”


Approximately 15%-20% of nursing moms experience mastitis at some point while breastfeeding, with most cases occurring in the first couple of weeks postpartum. But have no fear, with some basic knowledge and breast care, there are steps you can take to reduce your chances of getting it or increase your chances of fixing it as soon as any signs occur. Here is everything you need to know about mastitis: what it is, how to detect it, and how to treat it.

What is Mastitis?

Mastitis is inflammation of the breast. It most commonly results from milk stasis and may or may not be accompanied by an infection. Milk stasis occurs when milk is not removed regularly or efficiently from the breast. This sometimes happens soon after delivery when the breasts are engorged, when there are unusually long stretches between feedings, or any time the baby is not latching well. If milk stasis is not resolved quickly, it can result in severe mastitis, so preventing it should be your first priority.

Signs and Symptoms of Mastitis

The first signs of mastitis are typically a warm, red wedge-shaped area on the breast, breast tenderness, general malaise, fever, flu-like aches, shivers and/or chills. Mothers with sore, cracked, or damaged nipples can also develop mastitis, as cracks and fissures offer a point of entry for infection. The onset of symptoms may be gradual or sudden. Mastitis usually affects just one breast, but in severe cases both breasts are simultaneously affected. Women who have previously breastfed and have a history of mastitis are at a higher risk of developing it again, so treating the symptoms thoroughly is very important.

How to treat Mastitis

The basic treatment for mastitis is simple: empty the breasts often and get as much rest as possible. Antibiotics may or may not be needed, depending on the severity of the symptoms. Since milk stasis is the most common cause of mastitis, the most important treatment is frequent and effective milk removal. Now is not the time to stop breastfeeding; breastfeeding is a vital part of treatment and sudden weaning puts you at risk of mastitis worsening into an abscess. Here are some recommendations to help resolve mastitis:

  • Drain the breasts frequently and thoroughly, starting with the affected breast. Loosen any tight bras or clothing to promote milk flow. Breastfeeding (or pumping) at least every 2 hours reduces discomfort and swelling. The goal is to keep the affected breast as empty as possible without neglecting the other. You can also vary nursing positions to promote drainage in all areas of the breast. If you usually nurse in a football hold, try a cross cradle or any other position that’s comfortable for you and your tot.
  • Use heat and gentle massage. Apply a warm compress and gently massage the sore area of the breast prior to nursing. This will help improve your milk flow and assist in complete emptying.
  • Rest is a key component to recovery. Mastitis may be one sign that you are fatigued and stressed. If possible, rest with your baby next to you so that breastfeeding can continue frequently.

As soon as you notice a sore breast or flu-like symptoms, start initial care — more frequent nursing, heat, massage and rest — right away. If symptoms do not subside within 12-24 hours, or if they worsen, contact your healthcare provider immediately. If antibiotic treatment is prescribed, complete the full course; do not stop taking them once you start feeling better. If you don’t take the full course of antibiotics, you run the risk of not clearing the infection. Antibiotics used to treat mastitis are compatible with breastfeeding.

It’s perfectly safe to continue breastfeeding your baby on the affected breast during a bout of mastitis, however, milk from the mastitic breast could taste saltier, because it has higher levels of sodium and chloride. For this reason, some babies refuse to nurse on the affected side, while other babies don’t notice the difference at all. If your tot refuses to nurse, continue nursing on the unaffected breast, expressing your milk often from the affected breast to keep it empty. Once the mastitis has cleared, your tot should naturally go back to that breast.