Mastitis

Mastitis is inflammation of breast tissue, most commonly occurring during breastfeeding, often related to a blocked milk duct that becomes infected. It causes breast pain, swelling, and sometimes fever, but can usually be treated effectively while continuing to breastfeed.

• Breast pain, swelling, and warmth, typically affecting one area of one breast
• Redness of the skin over the affected area
• Fever, chills, and feeling generally unwell
• A hard, tender lump in the breast, which may represent a blocked duct that has progressed to infection

• Most commonly results from a blocked milk duct that is not adequately drained, allowing milk to build up and become a site for bacterial infection.
• Risk is increased by cracked or sore nipples (which allow bacteria to enter), infrequent or incomplete breastfeeding, and poor latch technique.
• Can also occur due to sudden changes in feeding frequency, such as a baby suddenly sleeping longer or weaning.

• Diagnosed clinically based on the characteristic breast pain, redness, and swelling, often with fever, in a breastfeeding woman.

Continuing to breastfeed frequently, including from the affected breast, is recommended and helps clear the blockage — breastfeeding does not harm the baby and is an important part of treatment.

Ensuring effective, frequent milk removal — through breastfeeding, hand expression, or pumping — along with gentle massage of the affected area, supports resolution.

An antibiotic is added if symptoms are significant, do not improve within a day or so of improved milk drainage, or if there are signs of a more established infection.

Pain relief with paracetamol or an NSAID, along with rest and adequate fluids, supports recovery.

A breast abscess (a collection of pus) can occasionally develop if mastitis is not adequately treated, and requires drainage at a health facility.

• Ensure a good breastfeeding latch and position to reduce the risk of blocked ducts and nipple damage.
• Breastfeed frequently and avoid prolonged gaps between feeds where possible.
• Fully drain each breast during feeds, alternating the breast offered first if needed.
• Seek prompt support for any nipple pain or cracking, and seek early treatment for signs of a blocked duct before it progresses to mastitis.