Mastitis is an inflammation of the breast, and it doesn’t always lead to infection, which means that antibiotics may not be necessary. 

It usually occurs in the first few weeks after birth, but it can also happen at any time. Sometimes it can appear abruptly and can take a lot of breastfeeding mums by surprise.

So what should you expect if you have mastitis?

First of all, only one breast is usually affected, and you are also likely to see a red patch on the affected breast. Your breast may also be swollen and could be painful.

You may feel as if you have symptoms of the flu and feel generally run down too. In some situations, your whole breast may be lumpy and aching. 

Why does mastitis occur?

One of the most common reasons for mastitis occurring is that at some point, your breast may have become uncomfortably full.

Perhaps your baby wasn’t feeding for a while. Your breast became engorged (which means that there is general congestion going on), and a blocked duct occurred. Blocked ducts, untreated, can lead to mastitis.

Hand covering a sore breast

As a preventative measure for mastitis, it’s important to use hand expression as a means of relieving any engorgement.

In the first instance, if you start to feel uncomfortably full, use your hand to ensure that a small amount of milk comes out of the breast – just enough to make you feel comfortable again.

The use of hand expression will prevent a blocked duct. Look at the information on dealing with engorgement.

One of the most common reasons for becoming engorged in the first place is if your baby is not latched at the breast effectively.

It’s crucial, therefore, that your baby latches on well, gets a good mouthful of breast tissue, and drains the breast as thoroughly as possible.

There can also be other reasons why mastitis may occur. It could be something as simple as wearing a bra that is too tight or even clothing that’s cutting into the breast tissue.

If you are trying to cut down on the number of feedings at the breast or trying to stop breastfeeding, and this is all done too abruptly, it’s possible to become engorged and potentially cause mastitis.

Be as kind to your body as possible and do these things gradually so that your body can make less and less milk over time.

You may also find that if you’ve started to pump your milk alongside breastfeeding, the supply and demand become disrupted. Engorgement can happen in this situation.

It is worth breastfeeding mothers learning how to hand express and to do so to comfort, whenever they feel uncomfortably full, if their baby isn’t feeding at that point, or they’re not expressing.

As babies get older, they start to go through the teething phase (before a tooth comes through). Many babies will begin to come to the breast more often.

There can be changing feeding patterns for various other reasons as well, like growth spurts.

All of these changing patterns can disrupt the supply and demand of milk, which in turn can lead to engorgement, and potentially mastitis.

It’s also possible to get mastitis and blocked ducts if you’ve had breast reduction surgery or augmentation surgery (breast enlargement – implants).

If you believe, after watching this video, that you have mastitis, there are several self-help measures.

First of all, lots of feeding – give yourself and your baby time and opportunity to feed frequently and rest together.

Also, look after yourself.

Over the shoulder view of baby breastfeeding

Other important measures that you can take are to use the warmth from a shower or a bath, or warm compresses on your breast before feeding, coupled with massage.

These measures work well together – a potent combination to help resolve mastitis. 

Mastitis is an inflammation of the breast, so take an anti-inflammatory medication like Ibuprofen 400 milligram dose, which will powerfully work and is research-based treatment too.

Please bear in mind if you have a history of asthma or stomach ulcers or you’re allergic to aspirin, then you should not take Ibuprofen.

You can also take paracetamol for pain relief and reduce your temperature if you have a fever.

Paracetamol and Ibuprofen generally can be taken together – for paracetamol, 500-milligram tablets every four hours. 

If, however, you have been using self-help measures for 24 hours, and feel there is no improvement, and you also have a temperature of 38.4 degrees or above, this suggests that you have an infection as well as the inflammation. In this situation you WOULD need antibiotics.

Please be assured that most antibiotics are compatible with breastfeeding.

The World Health Organisation has recommended Flucloxacillin 500 mg dosages four times a day, for the treatment of mastitis.

Erythromycin 500 milligrams four times a day is also a treatment. Anyone who is allergic to penicillin can take Cefalexin 500 milligrams four times a day.

Although these antibiotics are compatible with breastfeeding, sometimes babies poos can be a little loose during the time you are taking them, but this is not harmful.

Some health providers encourage women to take probiotic capsules if they have been given antibiotics because a thrush infection can sometimes develop due to antibiotic treatment!

Although the antibiotics will achieve their purpose, i.e., to fight the infection in your breast, an unfortunate side effect is that they can potentially kill some of your good bacteria, which can cause things like thrush, a fungal infection, to flourish.

If you are experiencing mastitis, you are likely to be feeling really ill, and maybe even psychologically low at the moment because of the situation, but please be assured that mastitis is a temporary hurdle, and very soon, you’ll be able to feed your baby again comfortably.

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022


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