If you’re breastfeeding and experiencing breast pain, flu-like symptoms, or feeling suddenly unwell, you may be wondering what is mastitis and whether it could be affecting you. Mastitis is a common inflammatory condition of the breast that can develop quickly but is usually very treatable with the right care.
This article explains what mastitis is, how to recognise the symptoms, and the most up-to-date guidance on treating mastitis effectively and safely.
What is Mastitis?
Mastitis is inflammation of the breast tissue. It most commonly occurs during breastfeeding but can affect anyone with breast tissue, including those who are not lactating and, more rarely, males.
Current clinical guidance describes mastitis as part of a spectrum of breast inflammation, rather than a single condition. This spectrum can include:
- Milk stasis (milk not draining effectively)
- Ductal narrowing and inflammation
- Inflammatory mastitis
- Bacterial mastitis (infection)
- Breast abscess (uncommon)
In breastfeeding, mastitis often begins when milk is not removed efficiently from the breast. This can lead to increased pressure within the ducts, triggering inflammation. In some cases, bacteria may enter the breast tissue through damaged or cracked nipples, particularly where latch or positioning is suboptimal or when tongue-tie is present.
Understanding what mastitis is helps explain why early, gentle intervention is so important.
Mastitis Symptoms: How to Recognise It Early
It’s crucial to identify mastitis early and you can do this by recognising how symptoms may appear across different skin tones. The hallmark signs include redness, swelling, and warmth in the affected area of the breast. On lighter skin, this can present as a red patch, whereas on darker skin tones, the redness might be subtler or appear as a deeper discoloration. On all skin, the area may also be warm to the touch. Common mastitis symptoms include:
Feeling generally unwell or run down
Localised breast pain or tenderness
Swelling or firmness in one area of the breast
Warmth over the affected area
Changes in skin colour
Redness or pinkness on lighter skin
Darker, purplish, or less visible colour changes on darker skin
Flu-like symptoms such as fever, chills, body aches, or fatigue
If you suspect you have it, the first step is to ensure the affected breast is emptied regularly. You can do this by continuing to breastfeed or by expressing milk by hand or with a pump. This can help to clear any blockage in the milk ducts. It’s often recommended to start feeding or pumping on the affected side first, as the stronger suction at the beginning of a session can help. Warm compresses before feeds and gentle massage during nursing or pumping can also provide relief and support milk flow. Bes sure to rest, drink plenty of water and eat well as this all helps with recovery from mastitis.
In some cases, mastitis may require medical treatment, particularly if it doesn’t improve within a day or two, if there is a high fever or if symptoms worsen. Antibiotics may be prescribed to treat a bacterial infection, and they are usually safe to use while breastfeeding but do check with your doctor. Pain relief, such as paracetamol or ibuprofen, can also help manage discomfort and reduce inflammation. However, always consult a healthcare professional before taking any medication while breastfeeding.
Mastitis can develop rapidly and feel intense, but early treatment usually leads to a quick improvement.
Treating Mastitis: What Current Evidence Recommends
When it comes to treating mastitis, early supportive care is key. Current evidence focuses on reducing inflammation, supporting comfortable milk removal, and avoiding practices that may worsen symptoms.
1. Continue Breastfeeding or Expressing
Stopping breastfeeding suddenly can increase inflammation. Continue to feed or express regularly, aiming for comfortable milk removal rather than forceful emptying.
If feeding is painful, you may prefer to start feeds on the unaffected side, but the affected breast should still be used regularly.
2. Gentle Handling of the Breast
Deep or aggressive massage is no longer recommended, as it can increase tissue inflammation. Instead:
- Use gentle touch only if comfortable
- Avoid excessive pumping or overstimulation
- Wear a supportive, non-restrictive bra
3. Use Cold to Reduce Inflammation
Cold compresses applied between feeds can help reduce swelling and pain. Heat is not routinely recommended when inflammation is present.
4. Rest, Hydration and Nutrition
Treating mastitis effectively also means supporting your body. Rest as much as possible, stay well hydrated, and eat regularly to aid recovery.
5. Pain Relief
Paracetamol or ibuprofen can help manage pain and inflammation and are generally safe during breastfeeding. Always check with a healthcare professional if you are unsure.
When Mastitis Requires Additional Support
You should seek medical advice if:
- Symptoms do not improve within 24–48 hours
- You develop a high or persistent fever
- Pain, swelling, or skin changes worsen
- You feel increasingly unwell
If bacterial infection is suspected, antibiotics may be prescribed. Most commonly used antibiotics are safe during breastfeeding, but always confirm with your GP or prescribing clinician.
Prompt medical treatment reduces the risk of complications such as breast abscess, which is rare but may require specialist care.
Where can I get support for mastitis?
Support for mastitis is available from:
- Your GP
- Your health visitor
- A lactation consultant or breastfeeding specialist
- The National Breastfeeding Helpline (UK): 0300 100 0212
A breastfeeding specialist can help identify underlying factors such as latch difficulties, positioning issues, or nipple trauma that may increase the risk of mastitis recurring.
Learn More About Breastfeeding & Mastitis Prevention
Education plays a key role in preventing mastitis and recognising early warning signs. Preparing for breastfeeding during pregnancy or seeking early postnatal support can significantly reduce challenges.
For comprehensive, evidence-based guidance, the NowBaby Breastfeeding Course provides practical support for new parents, including how to recognise and respond early to issues like mastitis:
NowBaby Breastfeeding Course:
https://www.nowbaby.co.uk/on-demand/breast-feeding-course/