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Managing Mastitis

Apr 21, 2022

First of all - what even is mastitis?

The usual definition of mastitis is a tender, hot, swollen, wedge shaped area of breast associated with a temperature and flu-like symptoms.

But did you know that mastitis literally means inflammation of the breast. This inflammation may or may not involve a bacterial infection.

It's likely that it goes like this:

Engorgement -> Non-infective Mastitis -> Infective Mastitis -> Breast Abscess


What can cause it?

Well, it’s a long list. Including:

  • Damaged nipples

  • Infrequent or scheduled breastfeeds

  • Missed breastfeeds

  • Poor attachment or weak suck

  • Illness in mum or baby

  • Oversupply of milk

  • Rapid weaning

  • Pressure on the breast (e.g., tight bra)

  • Blocked nipple pore or duct (milk blister/bleb)

  • Stress and fatigue


The most important treatment?

Effective milk removal!

  • Breastfeed more frequently, starting on the sore breast

  • Positioning baby at the breast with their chin or nose pointing to the blockage

  • After feeding, you may express milk by hand or pump

  • Keep your breasts as close to empty as possible


Supportive Measures

Focus on rest, fluids & nutrition!

That may mean utilising family, friends, or if possible paid help, so you can actually rest.

You can also use heat, such as a shower or hot pack, just prior to feeding to help with the let-down, and use cold packs after feeding to help reduce swelling.


Is pain relief allowed?

Yes! An anti-inflammatory such as ibuprofen (brand name Nurofen) is often recommended.

Being in pain can inhibit your let-down reflex, and we don't want that.


What about antibiotics?

If symptoms are mild and have been present for less than 24 hours, effective milk removal and supportive measures may be enough.

If symptoms are not improving within 12–24 hours or if you are acutely ill, antibiotics should be started.

Discuss with your doctor the best course of action for your individual circumstances.


Mastitis is a literal pain, so please get support early.


As always, you’ve got this mama, and I’ve got you.

Source: Academy of Breastfeeding Medicine.

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