What is Mastitis?

Mastitis includes a range of conditions caused by inflammation and swelling in the breast that is not relieved by directly breastfeeding the baby or by pumping. Mastitis starts as swelling of the tissue inside the breast. This swelling can cause narrowing of the milk ducts and prevent the milk from flowing out of the nipple. Mastitis usually occurs in one area of the breast where the milk glands are the fullest. When bacteria enter the milk glands where the swelling is located, the area of the breast may develop worsening redness and soreness. Mastitis may cause flu-like symptoms of fever, chills and a fast heart rate in the mother.

Any individual with mastitis symptoms should seek medical care right away.

Milk removal to help relieve mastitis symptoms

If you are directly breastfeeding the baby and have mastitis symptoms:

• Breastfeed as frequently as the baby is hungry.
• Offer both breasts at each feeding.
• Make sure to have a deep latch so the baby does not cause nipple pain.
• After the feeding, do not remove more milk by pumping. This causes your body to make more milk than your baby needs and can worsen breast swelling.
• Do not compress or massage the breast since this can make the swelling worse.

If you are pumping exclusively:

• Pump your milk each time the baby eats from a bottle.
• Leave pump suction strength at a comfortable level. Do not turn the suction up too high and cause pain at the nipple.
• Only remove the same amount of milk your baby takes by bottle. Pumping significantly more milk can cause an oversupply of milk, which worsens breast swelling.
• If you have less milk than your baby eats, stop the pump when the milk stops flowing. Feed your milk to the baby in addition to formula to give the full feeding amount.

If you are combining breastfeeding and pumping:

• Breastfeed as frequently as the baby is hungry.
• Offer both breasts at each feeding.
• Make sure to have a deep latch so that the baby does not cause nipple pain.
• Do not compress or massage the breast since this can make the swelling worse.
• If you do not feed the baby at the breast for a feeding:
• Pump on a comfortable setting only while milk is coming out.
• Only remove the same amount of milk your baby takes by bottle. Pumping significantly more milk can cause oversupply and worsen the swelling.

Other tips about mastitis symptoms

• Rest, drink plenty of fluids, and eat healthy foods.
• If possible, get help with household tasks and caring for the baby so that you can get rest.
• Do not massage or compress the breast - this can lead to more swelling of the affected area.
• Use cool compresses on the breasts between feeding or pumping sessions to provide comfort.
• Avoid soaking the nipple and do not put topical products on the breast.
• The milk of a mother with mastitis is safe for a baby to drink, so your baby can directly feed at the breast or drink the milk that you pumped when you have mastitis.
• If you are prescribed any medications, make sure to ask your healthcare provider if the medication is compatible with direct breastfeeding or pumping.
• You can take anti-inflammatory medicine such as ibuprofen as recommended by your health care provider.

To prevent mastitis from occurring or from occurring again after the first episode

• Breastfeed the baby at the breast as often as the baby is hungry.
• Latch the baby deeply so there is no pain with breastfeeding. If there is pain with the latch, seek help to prevent nipple soreness.
• If you pump, pump the amount of milk that the baby takes during a feeding. Do not pump more volume than the baby needs. Oversupply of milk can lead to mastitis.
• If a direct breastfeeding session is missed, pump the amount of milk that the baby takes during feeding. Do not pump more volume than the baby needs.
• Avoid a tight-fitting bra; do not wear an underwire bra.
• If you want to wean your milk supply, do so very slowly to prevent swelling of the milk in the breast and potential mastitis symptoms.