What is breast mastitis?

• May, or may not, involve an infection.
• Involves redness, tenderness and heat in the breast, along with a fever and flu-like symptoms such as nausea, aches and chills.
• Usually occurs within the first six weeks of breastfeeding, but can occur anytime.
• Often starts with engorgement.
• May occur the first time your baby sleeps through the night and/or goes an unusually long time between feedings.
• Onset is sudden with intense pain in one breast, rarely in both breasts.
• Symptoms usually last 2-5 days and peak on the second and third day.
• Non-infective mastitis (not related to an infection) may progress to infective mastitis (which is infection- or bacteria-based and may need to be treated with antibiotics).
• Bacteria may enter the breast through a crack in the nipple and spread through the ducts.
• Poor drainage of the breast could trigger mastitis especially when you are exhausted from lack of sleep and stress.  

Tips to prevent breast mastitis

• Reduce stress and fatigue.
• Prioritize tasks and get household help.
• Take naps when your baby sleeps.
• Delay return to work as long as possible.
• Breastfeed often, at least 8-12 times per day.
• Massage any red or firm areas of the breast especially while breastfeeding.
• Pump or express milk if you miss a feeding
• Pump or express milk if your breasts are engorged or still full after a feeding
• Avoid underwire bras that block milk flow
• If you’ve had mastitis before, even with another child, you are more likely to get it again
• Do all the above to prevent it before it occurs

What to do if you get breast mastitis

• Keep nursing.
• Your baby will not get sick from your milk.
• Start with the unaffected breast to allow your milk to let-down in the affected breast before feeding. This should reduce pain.
• Keep the affected breast as empty as possible.
• Breastfeed often and hand express or pump after breastfeeding several times per day.
• Call your healthcare provider and/or a lactation consultant.
• Antibiotic treatment will reduce the chance of recurrence or an abscess.
• Make sure to complete your full course of antibiotics.
• Get in bed. You need to rest to get better.
• Take your baby to bed with you so you can breastfeed often.
• Allow others to help with household chores and caring for other children.
• Apply ice packs or hot packs to your breasts — whichever gives you the most comfort.
• Heat will help drain the breast and provide pain relief.
• Drink plenty of fluids.
• Take pain medication such as acetaminophen or ibuprofen.
• Wear a supportive bra that does not cause painful pressure.