By Dr. Nancy Brent
Mastitis is inflammation of the breast, which if progresses, can lead to a breast infection. Mastitis usually presents with breast pain, redness and warmth. In addition to a red and tender breast, you may feel tired and have body aches.
Early signs of mastitis include pain in a localized area of the breast, which may be tender to touch, appear red and feel warmer than the rest of your skin. This typically occurs on just one breast. The tender area may also feel hard underneath the skin. You may or may not have a fever.
Risk factors for developing mastitis include nipple trauma, milk stasis and previous history of mastitis. Milk stasis, or infrequent milk removal, can lead to plugged ducts, which can contribute to mastitis. You may first feel a slightly tender, hard area in the breast. If you have none of the symptoms mentioned above, you can initially manage this as a plugged duct. You can see our post about How to Heal a Plugged Duct for more information. However, if you have a fever or feel you are getting sick, or if the breast is very red, you should contact your health care provider immediately.
Early on, mastitis may be limited to the inflammatory process. This can be relieved with heat, alternating with cold or ice packs, and over-the-counter anti-inflammatory medications and analgesics. Breastfeeding should continue. It’s recommended to avoid deep breast massage, as this can increase inflammation in the breast. A true breast infection must be treated with antibiotics and your OB or PCP should be contacted. The antibiotics used to treat mastitis are safe to use during lactation. There is no need to pump and dump your milk. Additionally, mastitis can lead to a decrease in milk production on the affected breast. Empty your breasts often, increase your fluid intake and rest as much as possible. These supportive measures can help you feel better faster and protect your milk supply.
Dr. Nancy Brent is the former Medical Director of the Breastfeeding Center of Pittsburgh.