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Your question:

How do I manage mastitis?

Expert’s answer:

Mastitis is an inflammation of the breast. It can be caused by engorgement or poor feeding, a blocked duct or infection.

Mums usually notice a hard, painful lump or hot, red wedge-shaped area of engorgement in the breast. The breast may feel tender, hot, swollen or look reddened. There may be red streaks extending outward from the affected area. The pain, heat and swelling with mastitis can be very intense.

Other symptoms usually include a fever (high temperature) 38oC (101.3oF) or higher, chills, and flu-like symptoms such as aches and pains all over the body.bincludes:

Rest and pain relief

Take Ibruprofen or paracetomol regularly for pain relief and to manage fever. Bed rest is important. Sleep when your baby sleeps, and feed your baby in bed. Ask your partner, family or friends to help with older children.  

Heat and massage

  • Loosen bra and any tight clothing to help milk flow.
  • Use heat and gentle massage before nursing as for ablocked duct
  • A cold compress after feeding can give relief too.

To make a warm compress that lasts longer than a warm facecloth, use a clean disposable nappy. Wet it with hot water (test the temperature of the water on your wrist first to avoid scalding), squeeze the nappy out a bit, then place it against your breast with the inside against your skin.

Empty your breast

To begin, empty the affected breast as fully as possible. You can do this by feeding your baby on the affected breast and then removing any milk they haven’t taken by hand expressing or with a breastpump.

Try to express or feed your baby, about 1 hour after taking pain relief

Continue to feed your baby frequently. Start with the affected breast at each feed. If it hurts too much to do this, start on the unaffected breast, but switch to the affected breast as soon as your milk starts flowing (let-down). Feed as for as long and often as possible on the affected breast to keep it as empty as possible. Don’t forget to feed off the un-affected breast also.

Reducing the frequency of feeding from the affected breast, or stopping fully can cause more severe problems to develop, such as a breast abscess.

Ensure good positioning and latch – use whatever position is most comfortable and allows the sore area to be massaged.  ‘Dangle feeding’ can be useful – lay baby on their back with their face towards the ceiling. Kneeling up and resting on your elbows, lean over baby and position your nipple directly above their mouth. Feeding in this position with your breast dangling, gravity will help with milk flow and making sure that your breast empties fully.

After feeding, if your breast isn’t fully emptied hand express or use a breastpump to help keep the affected breast as empty as possible.

Use a cold compress between feedings to help relieve pain and inflammation.

If you’re feeling very ill or your mastitis symptoms have not improved after 24hrs contact your GP.


Most women with mastitis that has not cleared in the first 24hrs need antibiotics:

  • it is important that you continue to breastfeed while on the antibiotics;
  • your doctor will probably prescribe 10-14 days of antibiotics – this is best practice to help prevent any recurrence; and  
  • your doctor may need to get a sample of your milk to test if the mastitis continues when on treatment or comes back after treatment is completed.



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