7 Treatment tips for mastitis

What is mastitis?

Mastitis is inflammation of the ducts, milk making glands and connective tissue of the breast. It can be caused by an excess of milk and other fluid in the breast or a bacterial imbalance in the breast. It used to be thought that blocked ducts also caused mastitis, but research has shown that the ducts (think of the duct like a milk carrying tube) don’t get something lodged in them that blocks the way, but that the walls of the duct narrow either from bacterial build up along the duct walls or being squished by an excess of milk and lymphatic fluid.

The inflammation and stuck lymphatic fluid (think swollen ankle when you twisted it) causes the area to be sore or tender because the milk making glands and ducts are being stretched. Many mums notice a “lump” of hard, swollen breast tissue and reddened area on the skin over the sore area.

When the narrowing of the ducts doesn’t resolve or gets worse, the inflammation can progress to inflammatory mastitis. Inflammatory mastitis can make you feel very unwell, really quickly. Symptoms include fever, chills, achy joints and fast heart rate (as well as breast pain mentioned earlier). Unresolved inflammatory mastitis can progress on to bacterial mastitis due to an imbalance in the good and bad bacteria in the milk and may require antibiotic treatment to resolve.

So, what to do if you think you have mastitis?

Check out these 7 treatment tips for mastitis:

1. Feed your baby according to their need (on demand).

It used to be thought that keeping the breast as empty as possible by breastfeeding and/or expressing more often was the best way to treat “blocked ducts” and mastitis, but breastfeeding (or expressing) more often than usual will increase your supply which can back up the system more and can make the inflammation and swelling worse. Breastfeeding your baby on demand will keep your supply at the right level for your baby.

2. Check your baby is latching well

When your baby is latching well, they can empty your breasts more effectively. This helps to regulate milk supply and avoid overfull breasts compressing the ducts to form a blockage. Find out how to tell if your baby is latching well here.

3. Anti-inflammatory medication

Anti-inflammatory medications (like nurofen/ibuprofen) can help reduce the inflammation in the breast which can ease the congestion of milk and other fluids in the breast. Anti-inflammatory medications are safe to take while breastfeeding but are unsafe for people with some medical conditions (including pregnancy). Check with your doctor to make sure these medications are safe for your medical situation.

4. Apply cold to the breast

Place cold packs on the inflamed areas of your breasts to soothe the inflammation. Many mums find using a first aid gel pack that’s been in the fridge, a bag of frozen peas wrapped in a thin tea towel, or cold cabbage leaves tucked into the bra (great shape to fit around the breast) all work well.

5. Avoid massaging/squeezing/vibrating the breast

All of these actions increase the inflammation to the breast tissue and can make the problem worse. Lymphatic massage can be helpful to move some of the extra fluid away from the breast and ease the congestion in the ducts, but this should be done super lightly in gentle sweeps of the skin with the palm of the hand towards the centre of the chest (between the breasts) and towards the arm pit.

6. See your GP if fever and fast heart rate last more than 24 hours.

If you still have a high temperature and/or hot and cold chills after 24 hours, it’s important to see your GP. Your GP may prescribe antibiotics to treat bacterial mastitis. Make sure you take the whole course of antibiotics (along with continuing the other treatment tips mentioned here) to make sure the infection is treated completely and the inflammation resolves.

7. REST!

I know, I know… You’re a mum! How can you rest when you’ve got a baby to look after?! But this is so important! Resting (even if you’re not asleep) can help with recovery. You’re important too and you deserve to rest and recover. Only do the things you absolutely need to (feed yourself and your baby) and either get help with the other things from your partner, family or friends, or wait to do them until you’re feeling better. The washing will still be there to fold when you’re better 😉

If you’re feeling extremely unwell or in a lot of pain, please seek help from an IBCLC AND your GP ASAP.

References

Mitchell, K. B., Johnson, H. M., Rodrıguez, J. M., Eglash, A., Scherzinger, C., Zakarija-Grkovic, I., Cash, K. W., Berens, P., Miller, B. & The Academy of Breastfeeding Medicine (2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeeding Medicine, 17(5). https://doi.org/10.1089/bfm.2022.29207.kbm