Mastitis is one of the most painful complications of breastfeeding — and one of the most mishandled. Many mums stop breastfeeding when they develop mastitis because they assume they have to. They don't. Here's everything you need to know to treat it quickly and prevent it from recurring.
What Is Mastitis
Mastitis is an inflammation of the breast tissue that may or may not involve bacterial infection. It causes a wedge-shaped area of redness, warmth, and pain in the breast, accompanied by flu-like symptoms: fever above 38°C, chills, fatigue, and body aches. It most commonly occurs in the first 3 months of breastfeeding but can develop at any point.
What Causes It
Mastitis almost always begins with a blocked duct that is not resolved promptly. When milk is unable to drain from a section of the breast, it creates a warm, nutrient-rich environment where bacteria can proliferate. Risk factors include: infrequent or missed feeds; a sudden drop in nursing frequency; a poor latch that prevents full breast drainage; pressure on the breast from a tight bra, car seat strap, or sleeping position; cracked nipples that allow bacteria to enter the duct.
The Single Most Important Treatment: Keep Feeding
The most counterintuitive thing about mastitis is that the treatment is to continue breastfeeding or pumping — frequently, from the affected side first. Stopping feeding causes milk to stagnate in the inflamed tissue, dramatically worsening the condition. Breast milk from a mastitic breast is completely safe for your baby. The bacteria that cause mastitis in you are your own skin bacteria — they are not harmful to your baby's digestive system.
What to Do in the First 24 Hours
Feed or pump from the affected breast every 2–3 hours. Apply a warm compress for 5 minutes before each feed to encourage milk flow. During the feed, gently massage from the outer edge of the breast toward the nipple, focusing on any firm or tender areas. After feeding, apply a cool pack to reduce inflammation. Rest as much as possible — mastitis genuinely improves with rest.
When You Need Antibiotics
If your symptoms have not improved significantly within 12–24 hours of frequent drainage and rest, you need antibiotics. Mastitis that is not treated promptly can progress to a breast abscess — a collection of pus requiring drainage, sometimes surgically. See your doctor without delay if: your fever is above 39°C; symptoms are worsening despite frequent feeding; there is a firm, fluctuant lump that doesn't soften with feeding; you notice pus or blood in your milk.
Preventing Recurrence
Mastitis that happens once is likely to happen again if the underlying cause is not addressed. The most common recurrent causes are: a latch problem preventing full drainage (see an IBCLC); a tight bra or underwire worn during sleep; skipping feeds without pumping to compensate; high stress and inadequate sleep suppressing immune function. Addressing these factors specifically, rather than waiting for the next episode, is the most effective prevention strategy.
The Emotional Weight
Mastitis is not just physically brutal — it is emotionally defeating. It often strikes at the moment when breastfeeding was starting to feel manageable. If mastitis makes you question whether to continue breastfeeding, make that decision when you are well, not when you are febrile and in pain. Many mums who pushed through mastitis describe their breastfeeding relationship becoming stronger and more resilient on the other side.
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