Mastitis While Breast-Feeding: Topic Overview

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Topic Overview

What is mastitis?

Mastitis is a breast inflammation usually caused by infection. It can happen to any woman, although mastitis is most common during the first 6 months of breast-feeding. It can leave a new mother feeling very tired and run-down. Add the illness to the demands of taking care of a newborn, and many women quit breast-feeding altogether. But you can continue to nurse your baby. In fact, breast-feeding usually helps.

Although mastitis can be discouraging and painful, it is usually easily cleared up with medicine.

What causes mastitis?

Mastitis most often happens because the breast gets too full. Usually this is because you have missed a feeding or have not completely emptied the breast. When milk builds up, it can leak into breast tissue. The tissue can become swollen and easily infected.¹

Infection can also happen when nipples become cracked or irritated. Make sure your baby is latched on and positioned correctly to avoid sore nipples. When nipples are cracked, bacteria can get into the breast.

Learn about the different ways to breast-feed so that you know how to completely empty your breasts and avoid cracked nipples.

What are the symptoms?

Mastitis usually starts as a painful area in one breast. It may be red or warm to the touch, or both. You may also have fever, chills, and body aches. If you have these symptoms, call your doctor today.

Signs that mastitis is getting worse include swollen, painful lymph nodes in the armpit next to the infected breast, a fast heart rate, and flu-like symptoms that get worse. Mastitis can lead to a breast abscess, which feels like a hard, painful lump.

What increases my risk of developing mastitis?

You are more likely to get mastitis while breast-feeding if:

• You have had mastitis before.¹
• You delay or skip breast-feeding or pumping sessions. When you don't empty the breast regularly or completely, your breasts become engorged or too full, which can lead to mastitis.
• You have cracked or irritated nipples, which can be caused by poor positioning or latch-on to the breast.
• You have anemia. Anemia makes you tire more easily and lowers your resistance to infections like mastitis.
• You use nipple shields or shells, breast pads, or other breast-feeding aids. These can block milk flow and increase germs on the nipple surface, increasing the chance of infection.
• Your nursing bra is too tight.
• You wear breast binders, which are used to suppress milk production.

Breast-feeding mothers can get mastitis at any time, but especially during the baby’s first 2 months. After 2 months, the baby’s feeding patterns become more regular, which helps prevent mastitis.

How is mastitis diagnosed?

Your doctor can tell whether you have mastitis by talking with you about your symptoms and examining you. Testing is usually not needed. However, mastitis will not go away on its own, so you should see a doctor for treatment.

How is it treated?

Antibiotics can usually cure mastitis. If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of pills. The antibiotics will not harm the baby. If treatment doesn't work at first, your doctor may send a sample of your breast milk to a lab to help identify the type of bacteria causing the infection.

You can help yourself feel better by getting more rest, drinking more fluids, and using cold packs on your painful breast.

Before breast-feeding your baby, place a warm, wet washcloth over the affected breast for about 15 minutes. Try this at least 3 times a day. This increases milk flow in the breast. Massaging the affected breast may also increase milk flow.

You can safely take acetaminophen (such as Tylenol) for pain. You can take ibuprofen (such as Advil) along with acetaminophen to reduce inflammation.

Breast-feeding from your affected breast is safe for your baby and helps to treat your mastitis.¹ If starting with the affected breast is too painful, start feeding on the other side, then switch sides after your milk lets down and starts flowing easily. If your nipples are too cracked and painful to breast-feed from that breast, use a breast pump to empty the breast of milk. Use it each time that you cannot breast-feed.

This is a good time to consider getting help from a lactation consultant. This person—usually a nurse—specializes in helping women with breast-feeding. You can breast-feed more effectively with less pain and help prevent future mastitis if you remember to change positions and make sure that your baby is latching on properly.

It’s important to get treatment for mastitis. Delaying treatment can lead to a breast abscess, which can be harder to treat.

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Last updated:	January 25, 2006
Author:	Amy Fackler, MA
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Liisa Honey, MD, FRCSC - Obstetrics and Gynecology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman