Mastitis

Mastitis is inflammation of the breast that usually occurs in someone who is breastfeeding. Some people are more likely to develop mastitis and can have repeated episodes.

If the inflammation isn't dealt with early, bacteria from the skin can get into the milk and cause an infection.

Symptoms of mastitis can include:

• flu-like symptoms, such as shivers, shakes or body aches
• fever
• a sore area in your breast
• a red, shiny or swollen area of the breast
• breast tenderness

It's not clear exactly what causes mastitis, but there are risk factors that can make it more likely to occur, including:

• poor attachment to the breast during breastfeeding — for example, if your baby has tongue tie
• nipple damage
• breasts engorgement
• a long break between breastfeeds
• stopping breastfeeding too quickly
• wearing an overly tight bra or tight clothing

Mastitis can lead to an infection in your breast. Bacteria can get in through a break in the skin, such as if you have a cracked nipple. If this happens, you are not contagious and your baby won't catch an infection from your milk.

There are several things you can try at home to help keep your milk moving, and treat the early stages of mastitis. As soon as you notice a painful, hard or red area on your breast, start treatment — this will help you to feel less ill and get better faster. Here are some ways to do this:

• Warm your breast just before a feed to help trigger the 'let-down' reflex — don't use warm compress at other times, as it can make inflammation worse.
• Use cold packs to help relieve pain and swelling in between feeds.
• Continue to feed your baby on the affected breast — if they are not feeding well from the affected breast, you may need to express milk instead.
• Take medicines such as ibuprofen or paracetamol — speak with your doctor or a pharmacist if you're unsure about what you can take.
• Rest and sleep when you can.
• Drink lots of water and eat well.

If your symptoms do not improve quickly, you may need to take antibiotics to clear any infection and prevent further complications. See your doctor if you feel unwell or if the blockage doesn't improve within 12 to 24 hours.

It's important to keep breastfeeding if you have mastitis. Feeding your baby more frequently will help to drain the milk from your breast and reduce the inflammation.

When breastfeeding:

• Alternate which breast you start feeding from at each feed.
• Offer the other breast as well at each feed.
• Ensure your baby is well-positioned and attached to your breast when they feed.
• Loosen your bra or take it off for feeds.
• Aim to relax during feeding — this will help the milk to flow.
• Gently massage your breast by stroking towards the nipple.
• If your breast still feels full after your baby has finished feeding, gently express some milk until it feels better.

There are a few things you can do to prevent mastitis:

• Breastfeed as often as your baby needs — frequent breastfeeding helps to drain the breasts.
• Avoid missing feeds — express if needed.
• Wake your baby to breastfeed if your breasts feel engorged or uncomfortably full.
• Offer both breasts when you feed — if your baby only wants one side, offer the alternate side the next time you feed.
• Avoid giving your baby formula or other fluids unless you've been advised to by a health care professional.
• Treat sore or damaged nipples straight away.
• Aim to rest during the day, drink plenty of water and eat a healthy diet — you are more likely to get mastitis if you are worn out.

If you think you have mastitis, see your doctor if your breast doesn't start to feel better within 12 to 24 hours, or earlier if you feel unwell. It's very important to make sure your mastitis is fully treated to reduce your chance of complications.

If you are having trouble with breastfeeding, see your doctor, a lactation consultant or your child health nurse for breastfeeding support. They will be able to watch your baby feeding and give you some guidance on attaching your baby for feeds.

Untreated mastitis can lead to a breast abscess that may need surgical drainage.

More information and support is available:

• Visit the Australian Breastfeeding Association website or call them on 1800 686 268.

Do you prefer to read in languages other than English?

• The Victorian government has a translated fact sheet on mastitis in English and other languages.