Mastitis

Mastitis is inflammation of the breast, sometimes with infection, and it can come on fast and make you feel genuinely awful — hot, achy and fluey, on top of caring for a baby. It’s common in breastfeeding parents, especially in the early weeks, and the good news is that it usually settles quickly with the right care. Knowing what to do (and what not to do) makes a big difference.

What it feels like. Mastitis usually shows as a red, hot, swollen, painful area on the breast, often wedge-shaped, that can come on over just a few hours. Alongside the breast symptoms you often feel unwell in yourself — fever, chills, aches, and a run-down, fluey feeling. It can be alarming how quickly it hits, but it typically responds well once you act.

Why it happens. It often follows milk not draining well from part of the breast — for example after a blocked duct, a missed or rushed feed, pressure from a tight bra or seatbelt, oversupply, or a shallow latch. Milk builds up, the tissue becomes inflamed, and sometimes bacteria (often through a cracked nipple) turn it into an infection. Being run-down, stressed or overtired can make you more prone.

Keep breastfeeding — it helps. The single most important thing is to keep feeding or expressing from the affected breast. Your milk is safe for your baby, and keeping it moving is central to clearing mastitis — stopping suddenly makes it worse and risks an abscess. Offer the sore side, feed frequently, and make sure the breast is drained as well as possible.

What to do at home. Alongside frequent feeding: rest as much as you possibly can (treat it like the illness it is), drink plenty of fluids, and use cool packs after feeds to ease pain and swelling. Current advice leans toward gentle handling rather than deep, aggressive massage, which can worsen inflammation — think soft, light stroking toward the nipple if anything, not vigorous rubbing. Check your baby’s latch and positioning, and vary feeding positions to help drain different areas. Simple pain relief like paracetamol can help you cope and is generally compatible with breastfeeding.

When to see a doctor — promptly. Contact your GP (or after-hours care) within about 24 hours if you have a fever or feel unwell, if there’s a cracked nipple that may be infected, or if symptoms aren’t improving with home care. Mastitis often needs antibiotics, and it’s important to start them promptly and finish the course. Don’t wait it out hoping it passes — early treatment prevents it worsening.

Seek urgent help if. You should be seen urgently if you’re getting rapidly worse, have a high fever you can’t bring down, feel very unwell, notice pus or a firm, very tender lump that isn’t settling (which can signal an abscess needing drainage), or you’re too unwell to care for your baby. Trust yourself — if something feels seriously wrong, get help without delay.

Preventing it (or another bout). Feed responsively and often, make sure your baby is latched well and draining the breast, avoid long gaps or suddenly dropping feeds, and steer clear of tight bras and pressure on the breast. Look after yourself too — rest, food and fluids genuinely matter. If you keep getting blocked ducts or repeated mastitis, a lactation consultant can help you find and fix the underlying cause, such as oversupply or latch issues.

It’s not a sign to stop. Many people fear mastitis means the end of breastfeeding — it usually doesn’t. With prompt care most people recover within days and carry on feeding happily. But if you’re finding breastfeeding relentlessly hard, that’s a valid conversation to have too, without guilt.

Recurrent mastitis. If mastitis keeps coming back, or you get repeated blocked ducts, it’s worth digging into why rather than just treating each episode. Common underlying causes include oversupply (making more milk than your baby takes), a persistently shallow latch, consistently long gaps between feeds, or pressure on the breast from bras, sleeping position or a carrier. A lactation consultant can help you pinpoint and address the cause, and your GP can check whether anything else is going on. Getting on top of the pattern is far kinder than riding out bout after bout.

Looking after your baby too. Your milk stays safe throughout, and continuing to feed protects your supply and comforts your baby. If you’re on antibiotics, both of you may notice a bit more unsettled digestion, which usually passes — mention it to your GP or pharmacist if it’s marked. Keep an eye on your baby’s feeding and nappies as usual, and flag any concerns.

Mastitis is common, it’s treatable, and it’s not your fault. Keep the milk moving, rest hard, use cool packs, and see your GP promptly if you’re feverish or not improving — and lean on the ABA helpline (1800 686 268) for feeding support any time. You’ll very likely be feeling much better within a few days.