Your breasts will no doubt be tender and swollen when you first start breastfeeding. After all, they’re filling with milk! But if you notice that either one becomes extra painful or you’re suddenly hit with a flu-like feeling, you might be dealing with mastitis.
Mastitis requires attention ASAP, but once you know that’s what you’re dealing with, the infection is relatively easy to treat. Here’s more about what causes mastitis, how to tell if you have it and what to do to start feeling better fast.
What is mastitis?
Mastitis is a breast tissue infection characterized by painful, swollen breasts and flu-like symptoms. It’s estimated that up to 10 percent of breastfeeding moms will deal with a bout of mastitis over the course of the nursing journey.
The risk for mastitis is highest during the first six weeks postpartum, but it can occur at any point while breastfeeding. The infection usually only affects one breast, though it's possible to have mastitis in both breasts at once.
What causes mastitis?
Mastitis happens when harmful bacteria gets trapped in the breast tissue, triggering an infection. Most often, that occurs when a milk duct in the breast becomes clogged and doesn’t get drained.
Mastitis can also develop when germs (either from your skin's surface or your baby's mouth) enter the breast through a crack in your nipple or through one of the milk ducts. Bacteria then multiply, causing an infection.
What’s more, any breastfeeding woman can be affected. But there are some factors that might make you more prone to mastitis, like:
- Going too long between nursing or pumping sessions. Missing a usual feeding time can cause engorgement, which can lead to a clogged duct.
- Poor latch or positioning. Both can make it harder for your little one to adequately drain your breasts, which can lead to clogs.
- Having cracked nipples. Cracks, sores or open skin make it easier for bacteria to get into your breast tissue.
- Wearing tight-fitting bras. They put extra pressure on your breasts, upping the risk for clogs.
- Having mastitis in the past. Experts don’t understand why yet, but having mastitis once makes you prone to getting it again.
What are the symptoms of mastitis?
Besides the obvious swelling, pain and redness that come standard issue with a breast infection, your breast may feel warm to the touch.
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You may feel exhausted (even more than the usual newbie mom weariness), run down and generally weak. It’s common to experience a painful or burning sensation while breastfeeding, too.
You might also develop a fever (usually 101 degrees Fahrenheit or more) and other flu-like symptoms (such as chills) — which can sometimes come on suddenly. Get a COVID-19 test if you experience any fever or flu symptoms.
Sometimes you can spot mastitis from the outside. An infected breast may appear swollen or red, and the redness could look wedge-shaped. You might also feel a hard or thick lump — likely a clogged duct that’s the source of the infection.
How do you treat mastitis?
First things first: Call your practitioner right away. Mastitis is easy to treat when caught early, but waiting longer can lead to pus forming around the infected tissue, which may need to be drained surgically.
Your doctor will be able to make the diagnosis and prescribe the right treatment. Oral antibiotics usually do the trick, clearing the infection and making you feel better pretty quickly. (If you don't improve within a day or two after starting the antibiotics, call again.) Ask, too, about acetaminophen or other mild pain relievers for the pain.
Once you’ve started antibiotics (or while you’re waiting on your prescription), take measures at home to ease your discomfort and help the infection clear more quickly. First up? Keep nursing as much as possible, starting with the infected breast first. It’s safe (even if you’re on antibiotics) and helps unblock any clogs and clear away the infection. Be sure to finish the full course of antibiotics as prescribed, and don’t stop taking them even if you feel better.
If it's too painful to nurse from the infected breast or your baby doesn’t drain the breast completely, use a breast pump or express the milk by hand. Warm compresses before a feeding can help encourage the milk to flow, as can gently massaging your breast while your baby nurses. Be sure to drain the infected breast as best you can to avoid another bout.
Consider going braless or wearing a loose-fitting bra without an underwire, too. That'll keep extra pressure off of your breast, helping you feel more comfortable and allowing your breast to drain better.
Another home remedy you can try: Apply chilled green cabbage leaves to the swollen breast. While the leaves won't treat the infection, some research (and plenty of anecdotal evidence) indicates that they can help ease the pain while the antibiotics kick in.
Mastitis vs. clogged duct: How can you tell the difference?
Mastitis often develops from clogged ducts, so the symptoms of mastitis tend to be more intense.
Both clogged ducts and mastitis can cause a hard, tender or sore lump in your breast. If you have a clogged duct, the pain will be confined to right around the lump. But with mastitis, your entire breast will likely feel painful and swollen. It’ll also look red and feel warm to the touch.
And unlike clogged ducts, mastitis typically affects your entire body. You’ll have flu-like symptoms including a fever, chills and a general feeling of weakness or exhaustion.
Can you continue breastfeeding if you have mastitis?
You not only can, you should. Breastfeeding often — eight to 12 times in a 24-hour period — drains your breast, clears out the infection and speeds up the healing process. And the antibiotics aren’t harmful to your baby.
Apply a warm compress to your breast before nursing to encourage milk flow. If nursing is painful, feed your baby from the other breast and let milk from the infected breast drain onto a towel or cloth.
And if your baby doesn’t completely drain your breast, or if you’ll be away from your baby for more than a few hours, pump to keep the milk flowing.
How can you prevent mastitis?
The bad news is that there’s no foolproof way to guarantee you won’t get mastitis. The good news? There are plenty of steps you can take to reduce your risk as much as possible.
- Make sure your baby has a good latch and position. If you’re running into latching issues or are having trouble finding a position that works, a lactation consultant can help you troubleshoot and find the best solutions.
- Care for sore nipples. Taking care of sore, cracked nipples by applying a natural lanolin cream may help decrease mastitis risk.
- Nurse often. In the early months, you should breastfeed your baby eight to 12 times in a 24-hour period. Make sure she drains the first breast fully before offering the other side. If you’re away from your baby for longer or she sleeps through a feed, pump regularly to prevent a backup. (However, avoid overpumping — doing so can create an oversupply problem and also contribute to mastitis.)
- Address plugged ducts ASAP. Clogs can morph into mastitis when left untreated.
- If you smoke, quit. Smoking seems to increase mastitis risk — just one more reason to kick your habit to the curb.
- Ask your doctor about taking lecithin for recurrent mastitis. The fatty substance, derived from soybeans or egg yolks, is thought to possibly make milk thinner and less "sticky," so it’s less prone to clogging. While there’s not much research to back this up, many nursing moms who are prone to clogged ducts and mastitis say that it helps, and lecithin is considered safe to take while breastfeeding. Of course, you should always get the green light from your doctor before taking any new supplement.
- Talk with your doctor. Recurrent mastitis can sometimes happen if the antibiotics you take don’t clear the infection. Your doctor can test your milk to find out what germs are causing the mastitis — and which antibiotic will do the best job of getting rid of them.
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