How to Treat Mastitis: A Common Breastfeeding Issue

Many women who start breastfeeding hope to continue for a period of time. However, breast discomfort, infection or injury can cause them to consider weaning earlier than planned.

“Breastfeeding can be affected by a variety of difficulties,” says University Hospitals midwife Jessica Shattuck APRN-CNM, WHNP. “As a result, it’s helpful to know what problems you might encounter and the preventive measures you can take to minimize them.”

What is Mastitis?

Mastitis is an infection in the breast tissue, common in moms who are breastfeeding. Mastitis usually causes a swollen, tender region of the breast that may also be red. Flu-like symptoms such as fever, chills, body aches and feeling unwell may also occur.

What Causes Mastitis?

Poor latch, breast engorgement, plugged ducts and nipple injury are all risk factors for developing mastitis because they cause incomplete emptying of the breasts. When breasts aren’t completely emptied following a breastfeeding or pumping session, milk becomes stagnant in the breasts and can become infected with bacteria. This causes swelling and inflammation of the milk ducts. Without treatment, swelling and inflammation can go on to compress surrounding milk ducts, causing the infection to spread.

Mastitis can also occur if bacteria enter the breast through cracked nipples.

Plugged Ducts: Symptoms & Causes

A plugged duct is characterized by a tender, painful lump felt in the breast. It’s caused by a narrowing in the milk duct as a result of compression. Compression can be due to engorged and swollen breast tissue from excess milk, a tight or unsupportive bra, or incomplete emptying with either breastfeeding or pumping.

How serious are these problems?

If mastitis goes untreated, it can lead to the development of a breast abscess. In rare cases, advanced mastitis can lead to sepsis, a life-threatening infection.

Treatments & Therapies Recommended for Breast Issues

A mastitis infection requires treatment with prescription antibiotics. To relieve pain, it’s safe to take over-the-counter ibuprofen or Tylenol.

Use heat, cold and massage therapies for engorgement and/or plugged ducts. Apply heat to breasts, take a warm shower, and try gentle massage prior to feedings to help improve milk flow and increase emptying. Between feedings, cool compresses can help reduce swelling.

For plugged ducts, position your baby so that his/her chin is close to the plugged duct to encourage emptying of that area. Also consider hand expression to remove excess milk from the breasts and relieve the pressure or sensation of fullness.

Apply expressed breast milk, lanolin and cool gel pads to relieve cracked or raw nipples.

Preventing or Reducing Your Risk

“Feed your baby on demand,” says Shattuck. “If you’re only pumping or you’re having difficulty with latching, arrange to pump regularly, ideally emptying breasts at least every 3-4 hours. Be careful not to pump too much, because that stimulates the breasts to make more milk, which can make engorgement worse. Keep your nipples dry, allowing them to air-dry after feedings. And wear a good, supportive bra that is not too tight.”

Should you wean your baby if you experience problems?

“You don’t need to stop breastfeeding if you experience any of these problems, even if you’re taking an antibiotic,” says Shattuck. “We encourage you to continue breastfeeding and/or pumping to keep milk flowing in order to prevent further swelling, engorgement and blocked milk ducts.”

Most importantly, you don’t have to go it alone. Lactation professionals can provide early assessment, treatment and support to improve breastfeeding success, reduce your risk of developing mastitis and sustain healthy benefits for your baby.

Related Links

Whether you're a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Our Breastfeeding Guide provides answers to common inquiries that mothers — new and veteran – may have.