• Red, painful area of the breast, either localized, sometimes wedge shaped, or over the whole breast
  • Aching flu-like feeling, increased temperature, shivering, feeling tired and tearful
  • A lumpy breast which feels hot to touch - this feeling can start very suddenly and get worse quickly

Mastitis means inflammation of the breast - this may be infective or non-infective initially. Untreated non infective mastitis may progress to infective mastitis and even form an abscess.

Causes - as for blocked ducts, primarily:

  • Poor attachment leading to milk stasis
  • Infection due to cracked nipples
  • Unresolved engorgement
  • Unresolved blocked duct
  • Sudden cessation of breastfeeding
  • Unusually long gaps between feeds
  • Substituting Formula for some breast feeds
  • Mother tired, under stress or run down
  • Anaemia - if mastitis is recurrent
  • Over abundant milk supply
  • Previous damage to breast tissue

Treatment - As for blocked ducts plus:

  • Keep feeding
  • Feed more frequently
  • Feed from sore side first to drain it as thoroughly as possible
  • Try feeding in different positions
  • Good positioning and attachment
  • Check any clothing which is pressing into the breast - this includes a bra
  • Express after feeds if necessary, to prevent further milk stasis
  • Rest as much as possible
  • Possible antibiotics/ ibuprofen anti-inflammatory

It is vital that the mother continue to breastfeed as abrupt weaning off breast milk will increase the chance of abscess formation.

Antibiotics may be necessary if symptoms do not start to improve within 12-18 hours using above methods (37, 36). The possible antibiotic side effects on the baby - loose, frequent stools.

Improvement should be seen in 12 - 24 hours

Breastfeeding should continue.

Recurring mastitis needs a full assessment of possible causes - refer the mother for experienced breastfeeding support and also to her GP, to exclude underlying illness. (36, 37, 38).

Useful guidance can also be found in:

The Breastfeeding Answer Book (38), Breastfeeding Network Mastitis leaflets. (37)

For further information click here.

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