Every breastfeeding experience is different. Some mothers have small challenges that become bigger with time. It is important to be aware of breast changes because sometimes they are signs of a breastfeeding challenge that is about to become a bigger issue.

Mastitis is inflammation or swelling of the breast tissue that may or may not include a bacterial infection. Mastitis can occur anytime during lactation, but usually happens in the first six weeks of breastfeeding.

Mastitis (mast-EYE-tiss) is soreness or a lump in the breast. It can cause symptoms such as:

• Fever and/or flu-like symptoms, such as feeling run down or very achy
• Nausea
• Vomiting
• Yellowish discharge from the nipple that looks like colostrum
• Breasts that feel warm or hot to the touch and appear pink or red

A breast infection can happen when other family members have a cold or the flu. It usually happens in only one breast. It is not always easy to tell the difference between a breast infection and a plugged duct, because both have similar symptoms and can get better within 24 to 48 hours. Some breast infections that do not get better on their own need to be treated with prescription medicine from a doctor.

What you can do

• Breastfeed on the infected side every two hours or more often. This will keep the milk moving freely and your breast from becoming too full.
• Massage the area, starting behind the sore spot. Move your fingers in a circular motion and massage toward the nipple.
• Apply heat to the sore area with a warm, wet cloth.
• Rely on others to help you get extra sleep, or relax with your feet up to help speed healing. Often a breast infection is a sign that you are doing too much and becoming overly tired.
• Wear a well-fitting, supportive bra that is not too tight, since a tight bra can constrict milk ducts.

Ask your doctor for help if you do not feel better within 24 hours of trying these tips, if you have a fever, or if your symptoms get worse. You might need medicine. See your doctor right away if:

• You have a breast infection in which both breasts look affected
• There is pus or blood in your breastmilk
• You have red streaks near the affected area of the breast
• Your symptoms came on severely and suddenly

Mastitis can be due to many reasons like:

• a delayed or missed feeding or pumping session
• when your baby does not feed well
• trouble expressing breastmilk
• constant pressure applied to your breast
• damaged nipples
• oversupply of milk
• have a milk bleb or blister
• rapid weaning
• engorgement

You may have mastitis if you are having any of these symptoms:

• An area in your breast that is hot or swollen
• An area in your breast that is tender or painful to the touch
• An area of the breast that may be pink or red
• You may have a fever of 101.3F or greater
• You are having chills or flu-like symptoms
• You have a decrease in milk supply due to a symptom listed above

• Avoid long breaks between feeds or milk expression (pumping).
  Long breaks between feedings and expressions increase your risk of milk stasis, or buildup, which can cause mastitis.

• Ensure your baby has a good latch.
  A good latch ensures healthy nipples. A poor latch could cause pain and damaged nipples that could lead to mastitis.

• Avoid engorgement.
  Keep your breasts soft by feeding your baby or by expressing milk often. Don’t limit your baby’s feedings or wait until your breasts feel full to feed. You always have milk available for baby. Also, feed as long as baby wants.

• Avoid plugged ducts.
  Plugged ducts that are not resolved can lead to mastitis.

• Always check for signs of milk stasis.
  Check your breasts for lumps, pain, swelling, or redness. Milk stasis can lead to many issues, including mastitis.

• Get rest.
  Fatigue plays a role in mastitis. Having a baby takes a lot of energy and your body needs rest to heal from the birth. Don’t be afraid to ask for help so that you can get the rest needed to heal.

• Practice good hygiene.
  Hand hygiene is important for everyone, but especially mothers. Your hands can be a source of bacteria that can cause mastitis. Be sure to wash your hands and your breastfeeding equipment before breastfeeding or milk expressions.

If You Have Plugged Ducts or Engorgement

• Increase the number of times you breastfeed or express milk. Feedings should not be limited. This will help resolve any milk stasis, or buildup, faster. Remember to ensure that the baby is latched well and your breast will be softer after the feed. For moms who are expressing milk with a breast pump, check that your pump is working properly and that your flanges fit well.

• Before feeding the baby or using a breast pump, apply a warm towel to the entire breast for 10 minutes. Warmth increases blood circulation, causing more milk to flow through the milk ducts. This helps break up milk plugs. If the plugged duct area is large (larger than a dime) or swollen, use cold packs instead. This will help with swelling and improve the milk flow to dislodge any milk plugs.

• Massage the breast with downward strokes towards the nipple. A massage can help milk flow and may soften the breast quicker. You can do this before or during feedings while expressing milk.

If you Have Damaged Nipples

• Ensure a good deep latch. A shallow latch will cause nipple damage that can cause mastitis.

• Avoid using creams, lotions, and salves on your nipple. Using topical ointments can cause tissue damage or infections.

No matter the reason, if you have mastitis, getting rest, adequate fluids and good nutrition will help you. It is important to continue to breastfeed or express milk when you have mastitis. There is no evidence of risk if your healthy term baby breastfeeds from the breast with mastitis or drinks your pumped breastmilk.

Get breastfeeding help if...

• Your whole breast becomes warm, or swollen, or is tender

• Breastfeeding is painful

• You cannot get the baby to latch on well

Call your health care provider if...

• You get a temperature greater than 101.3F

• You have flu-like symptoms for more than 24 hours

• Your breast symptoms do not improve after 24 hours