Spotting mastitis symptoms

Early signs of mastitis include engorged, swollen and tender breasts

If you’re pregnant or recently gave birth, you’ve probably heard the saying: “Breast is best.” It’s true, breast milk provides the highest nutritional value for baby, while protecting against infection. And it comes with a whole host of physical and emotional benefits for mom, too.

But that doesn’t mean it’s always easy — and comfortable.

Some soreness when you’re just starting out is normal. But if you notice breast tenderness or throbbing pain during feeding, it could be mastitis — an inflammatory condition of the breast that’s common in breastfeeding moms.

“Mastitis can cause a sharp burning sensation during feeding that can lead some moms to wean their babies earlier than expected,” says Kristen Ulmer, DO, an obstetrician and gynecologist at Geisinger. “When spotting mastitis symptoms early, you can get the treatment you need to feel better and prevent complications — and continue your breastfeeding journey comfortably.”

What is mastitis?

Mastitis is redness and inflammation of the breast tissue, most commonly affecting breastfeeding moms. It usually starts with milk stasis — when milk is not effectively drained from the breast. Leftover milk can cause a clog or get backed up, which triggers inflammation and allows bacteria to multiply and cause an infection.

Milk stasis can occur because of infrequent feedings, missed pumping sessions or pressure from tight clothing. A baby’s ineffective latch also can lead to residual milk after feeding — and sore and cracked nipples. This compromised skin barrier and bleeding in nipples provide a pathway for bacteria that lives on our skin to enter the breast.

“Mastitis can happen in one or both breasts at any time, but it’s most common 3 to 4 weeks after giving birth,” says Dr. Ulmer. “First-time breastfeeding moms and women who wear tight bras or have abrupt feeding schedule changes that lead to engorgement are at an increased risk.”

Mastitis symptoms

Mastitis symptoms can come on quickly and range from mild to severe. Early signs typically involve engorged, swollen breasts that may feel tender and warm to the touch.

Other mastitis symptoms may include:

Redness that may look wedge-shaped or appear as streaks
A hard or painful lump from a blocked duct (abscess)
Nipple pain or a burning sensation, especially during feeding
Fever and chills
Fatigue and generally feeling unwell

Recognizing mastitis symptoms right away is important to start treatment earlier and help prevent complications. Left untreated, a bacterial infection can lead to a pus-filled abscess that will need to be surgically drained.

Contact your doctor if symptoms don’t improve within 48 hours, especially if you notice pus or foul-smelling nipple discharge, a painful lump or fever. These are signs of an infection and require prompt medical attention.

Mastitis treatment

Mastitis treatment combines at-home remedies and professional care to reduce inflammation, restore milk flow and manage an infection, if you have one.

In some cases, mastitis can improve on its own. But if you’re feverish and symptoms persist for more than 48 hours, a bacterial infection is likely to blame. Your provider will prescribe a 10-day course of antibiotics that are safe for breastfeeding moms.

“With treatment, most moms feel better in a few days,” says Dr. Ulmer. “But it’s important to complete the entire course of antibiotics, even if you no longer have symptoms, to make sure the infection is fully cleared.”

Self-care at home also can relieve symptoms and make it more comfortable to feed your baby:

Breastfeed your baby on the affected side first to help clear the blockage. Babies suck harder at the start when they’re hungriest.
Try different feeding positions to fully drain your breast.
Apply warm compresses before feeding to encourage milk flow and use cold packs between feeds to ease pain and swelling.
Use gentle breast massage during or after feeds to help open a blocked duct. Be gentle, though, aggressive massage can worsen inflammation.
Stay hydrated and get plenty of rest to help your body fight the infection and recover.
Try over-the-counter pain relievers, such as ibuprofen or acetaminophen, to reduce pain, swelling and fever.

It’s safe — and recommended — to continue breastfeeding your baby. It keeps milk moving to reduce inflammation and can help clear a blockage.

“You can’t pass a breast infection onto your baby through breast milk,” says Dr. Ulmer. “And weaning your baby suddenly actually can make symptoms worse.”

How to prevent mastitis

The good news is prevention is possible. It starts with good hygiene to prevent bacterial spread and consistent feeding to keep milk flowing.

“If it’s your first time breastfeeding, consider meeting with a lactation consultant or attending a breastfeeding class,” says Dr. Ulmer. “They’re available to teach you proper breastfeeding techniques and what a good latch looks and feels like to help you avoid complications like mastitis.”

If you’re breastfeeding, here are 7 ways to help prevent mastitis:

Feed or pump on a regular schedule. Avoid long gaps that cause engorgement. If you have to skip a session, express milk later to relieve fullness.
Ensure proper latch and rotate feeding positions. When baby latches properly, it can prevent nipple damage and reduce risk of infection. And changing feeding positions helps to fully drain your breast ducts evenly.
Address nipple pain or cracking early. If you do get sore nipples, use ointments recommended by your provider and correct latch issues promptly. If you’re pumping, check the settings and flange size to avoid nipple trauma.
Practice good hygiene. Wash your hands with soap and warm water for at least 20 seconds before and after feeding or pumping. Also, clean pump parts thoroughly after each use.
Wear a loose-fitting bra. Choose a supportive, well-fitting bra that does not compress breast tissue.
Prioritize self-care. Manage stress, stay hydrated, eat healthy and get enough rest whenever possible to support milk flow and immune health.
Don’t stop breastfeeding abruptly. Wean your baby gradually rather than stopping abruptly to reduce milk stasis.

“Whether it’s your first or fourth baby, following best breastfeeding practices promotes healthy breasts and milk flow to help prevent blockages,” says Dr. Ulmer. “So, you can keep the focus on nursing and nourishing your baby comfortably and confidently.”