Breast Mastitis

Breastfeeding can be a special bonding experience between parent and baby. However, it’s not always easy. One issue that some nursing parents may face is mastitis. This condition may cause breast pain, swelling and flu-like symptoms.

At Banner Health, our team is here to help you manage and treat mastitis. We’ll explain mastitis, its symptoms, causes and treatment options. 

What is mastitis?

Mastitis, or lactation mastitis, is the inflammation or swelling of breast tissue that may lead to a breast infection. As many as 1 in 10 breastfeeding people in the U.S. will get mastitis. Although it usually affects breastfeeding women, in rare cases, it can happen to people who are not breastfeeding.

Mastitis can cause pain, swelling, warmth and redness in the breast. It can also make you feel tired and unwell, cause a fever or cause you to feel like you have the flu. Sometimes, mastitis can cause babies to wean earlier than planned. However, when possible, continuing to breastfeed when you have mastitis is better for you and your baby even if you are taking an antibiotic.

What causes mastitis?

The most common cause of mastitis is blocked milk ducts. If a breast does not empty, a hard lump may form. If the blocked duct isn’t cleared, trapped milk sitting in the breast (called milk stasis) can cause bacteria to grow, leading to an infection.

Mastitis can also be caused by bacteria on your skin or from an infection in your baby’s mouth. These bacteria can enter your breast through a milk duct opening or a crack in the nipple.

Who is most at risk for developing mastitis?

You may be at higher risk of developing mastitis if you:

• Have an oversupply of breastmilk
• Use only one position to breastfeed 
• Wear a tight-fitting bra or anything that puts pressure on the breast
• Have cracked or damaged nipples
• Empty your breasts of milk more than usual
• Had mastitis before
• Have an autoimmune disease like diabetes 

If your baby doesn’t latch correctly, milk may not fully empty out of your breasts and may cause nipple damage. This can lead to engorgement (overly full breasts) and blockages. Smoking, stress and poor nutrition can also increase the risk for mastitis, among other things.

How do I know if I have mastitis?

Symptoms of mastitis can come on quickly. They may include:

• A sore breast or nipple
• Burning sensation while breastfeeding
• Swelling and redness in a specific area of the breast
• Warmth in the affected area
• A hard lump in one breast
• Feeling tired
• Body aches and flu-like symptoms, including fever and chills

See your health care provider or a Banner Health specialist if you notice these symptoms.

Diagnosing mastitis

Your health care provider will perform a physical exam and ask about your symptoms. They may gently press on your breast to feel for lumps or areas that hurt.

In some cases, the provider may take a small sample of breast milk to check if there’s an infection. Usually, they can tell if it’s mastitis by listening to your symptoms and looking at your breasts during an exam. 

An ultrasound may be used to check for any complications like an abscess (a collection of pus) or a different breast condition. An ultrasound helps them see if there is any fluid build-up or if there are any blocked ducts.

How to treat mastitis

Treatment for mastitis involves reducing swelling and pain and preventing an infection. Your health care provider may recommend you take the following steps to treat your mastitis:

• Apply a cold compress: Use an ice pack or frozen bag of vegetables wrapped in a clean cloth to reduce swelling and relieve pain. Apply it for 15 minutes several times a day. 
• Hydrate and rest: Drink plenty of fluids and rest as much as possible. Your body needs extra energy to heal. Take time off work and have someone help you care for your baby. 
• Take pain relievers: Over-the-counter (OTC) pain relievers like ibuprofen or acetaminophen can help reduce pain and swelling. Follow the dosing instructions on the package or talk to your health care provider about what’s best for you.
• Wear comfortable clothing: Wear loose clothing and a supportive, non-restrictive bra. Avoid anything that might put pressure on your breasts, as this can make mastitis worse. 
• Keep breastfeeding and pumping: Even though it might hurt, it’s important to continue breastfeeding or pumping to help drain the milk from your breast. This can reduce swelling. Try to start feeding on the affected side first, as your baby’s strong sucking can help.
• Call your provider: If your symptoms don’t improve within 24 to 48 hours, if you have a fever or chills, or if the infection seems to be getting worse, call your provider. You might need antibiotics to treat the infection. 

Antibiotics work to clear the infection that’s built up in the milk ducts. The infection should clear within a week to 10 days. However, you should begin to feel better within 48 to 72 hours. 

Things to avoid

Avoid the following to prevent making the condition worse:

• Applying heat: Heat can increase inflammation. Don’t take hot showers or use heating pads. 
• Massage: Massaging the breast, especially too forcefully, can damage the tissue and worsen swelling. Use gentle touch while feeding or expressing milk.
• Soaking your breasts: Epsom salt soaks may help reduce swelling and pain but can also thin nipple tissue and lead to cracked, dry skin.
• Skipping feedings or pumping: It might be tempting to skip feedings or pumping because of the pain. However, this can lead to more engorgement and worsen an infection. Instead, keep draining the breasts regularly. 

Complications of mastitis

If left untreated, mastitis may lead to a breast abscess. This type of abscess may require minor surgery or use of a small needle to drain the pus from the milk duct.

How to prevent mastitis

Preventing mastitis is often about maintaining good breastfeeding habits and taking care of your breasts. Here are some tips:

1. Breastfeed or pump regularly: Follow a schedule. Letting milk build up can lead to engorgement and increase the risk of mastitis. Try to empty your breasts entirely during each feeding or pumping session.
2. Ensure a good latch: A proper latch helps your baby remove milk from your breast effectively, which can prevent blockages. If you’re having trouble with latching, speak to a lactation specialist or attend a Banner Health lactation support class.
3. Avoid tight bras and clothing: Wear a comfortable, well-fitting bra without underwires to prevent pressure on your breasts. Also, avoid sleeping on your stomach or carrying heavy bags that press against your chest. 
4. Practice good hygiene: Wash your hands before breastfeeding or pumping to prevent bacteria from entering the breast area. Keep your nipples clean and dry. Avoid using nipple shells or other devices on your breasts.
5. Maintain a healthy diet: Drink plenty of water and eat a balanced diet to keep your body strong and healthy. Proper nutrition helps maintain a good milk supply and supports your immune system. 
6. Rest when you can: Being overly tired can weaken your immune system. Try to rest whenever possible and seek support from family and friends.

These tips can lower your chances of developing mastitis and enjoy a smoother breastfeeding experience. If you notice signs of mastitis, see your health care provider to address them. If you have challenges with breastfeeding, see a lactation specialist or attend a breastfeeding support class.

Don’t wait for care

If you are struggling with mastitis or breastfeeding challenges, contact Banner Health. Our team of experienced providers and lactation specialists is here to support you with expert advice and personalized care. Schedule an appointment today.