Mastitis 101: What Every Breastfeeding Mom Should Know – Causes, Symptoms, Treatment, and Prevention

Breastfeeding is a beautiful and powerful journey, but it’s not always without challenges. One of the most common (and often surprising) hurdles mothers face is mastitis—a painful inflammation of the breast tissue that can leave moms feeling exhausted, discouraged, and unsure of what to do next.

The good news? Mastitis is treatable, and with the right care and support, most mothers recover quickly while continuing their breastfeeding journey. Let’s break it down:

What is Mastitis?

Mastitis occurs when breast tissue becomes inflamed, often due to a blocked milk duct or infection. It’s most common in the first few months of breastfeeding, but it can happen at any stage of lactation.

Causes of Mastitis

Mastitis can develop for several reasons, including:

• Blocked milk ducts – when milk isn’t fully drained, leading to pressure and inflammation.

• Bacterial infection – bacteria can enter through cracked or sore nipples, especially if milk is stagnant in the breast.

• Infrequent or skipped feedings – long stretches between feeds can cause engorgement.

• Poor latch or positioning – leading to incomplete emptying of the breast.

• Stress and fatigue – a tired immune system may make a mom more vulnerable.

Symptoms of Mastitis

Moms often describe mastitis as feeling like they’ve been hit with the flu. Watch for these signs:

• Breast pain, swelling, and redness (usually in one breast)

• A hard, tender area or lump in the breast

• Warmth over the affected area

• Fever and chills

• Fatigue and body aches

  
  

Mastitis as a Spectrum

Rather than seeing “mastitis” as a single entity, the new framework conceives of a spectrum of conditions, including:

• Ductal narrowing / inflammation

• Inflammatory (non-infectious) mastitis

• Bacterial mastitis

• Phlegmon / abscess

• Galactocele / subacute mastitis

Role of inflammation, dysbiosis, and hyperlactation

The newer model emphasizes that inflammation, imbalance in the breast microbiome (dysbiosis), and oversupply (hyperlactation) (rather than simple “milk stasis” or “clogged ducts”) play central roles in initiating or propagating mastitis.

Avoid overstimulation / excessive milk removal

Frequent pumping or aggressive attempts to “empty” the breast beyond what the infant demands may worsen the inflammatory cascade by stimulating further milk production and exacerbating the imbalance.

Less reliance on heat and deep massage

Traditional advice of warm compresses and deep massage (to “unclog ducts”) has been de-emphasized. Instead, the new recommendations favor cold / ice, gentle techniques, and allowing inflammation to settle. Overzealous massage may cause further tissue injury, increasing risk of worsening or progression.

 Treatment and Recommendations

Intervention	When / Why	Notes & cautions
Continue breastfeeding or gentle milk removal as needed	Maintain milk removal on demand Feed your baby whenever they want Or express a small amount for comfort	❌ Do NOT aggressively pump or try to “empty” the breast completely Over-pumping can worsen inflammation and slow healing
Cold / ice therapy	Use cold compresses or ice packs on the affected area to reduce inflammation and swelling.	Wrap the ice—never place directly on the skin Apply after feeds or when the area is most painful
Gentle lymphatic / skin-level massage / “sweeping”	Use light sweep strokes from the nipple toward the armpit	❌ Avoid deep massage or pressure squeezing Gentle strokes are enough; deep massage can worsen inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs)	Take Ibuprofen (or other NSAIDs) to reduce inflammation, pain, and swelling	Most helpful during the inflammatory stage Check for any contraindications before use (e.g., stomach issues, allergies, other medications)
Probiotics / microbiome support	Consider specific probiotic strains as adjunctive support Some strains have been studied in relation to mastitis and may help prevent recurrence	Evidence is still emerging Not a first-line treatment—use in addition to breastfeeding, gentle milk removal, and other primary steps
Sunflower / soy lecithin (emulsifiers) ·  Natural emulsifiers that help thin breast milk ·  Can prevent or reduce clogged ducts in moms with recurrent blockages	Used in recurrent “plugged ducts” or duct-arrowing situations Helps reduce milk viscosity and improve milk flow	Typical dosage: 3,600–4,800 mg daily Consult a lactation specialist or physician before use
Antibiotics (for bacterial mastitis)	Use antibiotics if mastitis does not improve with gentle milk removal, cold therapy, and other conservative steps Seek antibiotics if you have: Persistent fever Increasing pain or swelling Signs of infection that are worsening	First-line antibiotics: dicloxacillin, cephalexin, or flucloxacillin (10–14 days) Alternate antibiotics: clindamycin, TMP-SMX, etc. ⚠️ Important: Always take the full prescribed course and follow your healthcare provider’s instructions
Ultrasound or imaging to check for an abscess Aspiration or drainage if an abscess is found	If symptoms don’t get better with antibiotics If you feel a painful lump that could be an abscess	Ultrasound shows exact location of the abscess Aspiration or drainage is often needed to fully treat it Always follow your doctor’s instructions
Supportive Measures Rest whenever you can Drink plenty of water Wear a well-fitting, supportive bra Make sure baby latches properly and try different feeding positions Eat healthy, nourishing foods Reduce stress as much as possible	Helps your body heal faster Prevents mastitis from coming back	These steps are essential for your recovery Keep doing them throughout your mastitis journey

💡 Important: Keep breastfeeding if you can. Mastitis is not harmful to your baby, and continuing to nurse often speeds recovery.

Prevention Tips

While mastitis can’t always be avoided, you can lower your risk by:

• Feeding frequently and on demand.

• Ensuring baby has a good latch and varied positions.

• Avoiding tight bras or clothing that put pressure on the breasts.

• Taking time for self-care and rest when possible.

• Gently massaging breasts if they feel overly full.

When to Seek Help

Reach out to a healthcare provider if:

• If symptoms (pain, erythema, swelling, fever) do not improve within 24–48 hours of conservative management → consider bacterial mastitis or abscess.

• You develop a high fever and worsening pain.

• You notice pus or unusual discharge from the nipple.

• If an abscess is suspected (palpable fluctuant mass, worsening signs) → imaging and drainage are indicated.

• In severe cases (e.g. with systemic signs, immunocompromise) → hospitalization, IV antibiotics.

A lactation consultant can also be a wonderful ally, helping you address the root cause (like latch or feeding positions) so mastitis doesn’t keep coming back.

Mastitis can be painful and overwhelming, but with prompt treatment and support, it’s manageable. Remember—you’re not failing if this happens. Your body is adjusting, and with care, you’ll be back to feeling strong again.