Mastitis is any form of breast inflammation, and can occur with or without infection. It usually presents as a hard, red or tender area of the breast, and a full body illness including tiredness, fever, headache, nausea, body aches and sometimes shaking.
Mastitis is most likely to occur in the first few weeks after birth, particularly if there is nipple damage, or if engorged breasts lead to blockages in the milk ducts.
Mastitis is caused by components of breast milk getting into the blood stream and is a whole body infection. Even in cases where mastitis is not caused by a bacterial infection, the inflammation causes a whole body response.
In the early weeks after birth, mastitis is more likely to be cause by bacteria entering the breasts, particularly if there is nipple damage. Damage to the nipples can cause bacteria from the skin to enter the breast and cause infection.
When mastitis occurs months after birth, it is less likely to be infective, and may be be a result of other factors that cause engorgement. If not cleared, engorgement can lead to blocked ducts, which can then lead to mastitis. Causes of engorgement and blocked ducts later in breastfeeding are often physical damage or pressure to the breasts for long periods (i.e. from a restrictive bra or sleeping position) or skipping feeds due to work or baby sleeping longer at night.
If you believe you have mastitis and that it is infective, especially if you are in the early weeks after birth and/or have nipple damage, you should contact your doctor straight away. Mention when you make an appointment that you think you have mastitis, and the clinic will likely prioritise your appointment. You will need antibiotics to clear up the infection.
If you believe you may have a non-infective, inflammation-only form of mastitis, and have been feeding for more than a month, you can work to clear up the infection at home. If your symptoms have not subsided in 24 hours you should call your doctor.
Treating mastitis at home
The tips below are for women trying to resolve mastitis at home, either while they wait for a doctors appointment, or because they believe it's non-infective or early stage:
1) Empty your breasts regularly by feeding or expressing, particularly in the early days after birth.
2) Take ibuprofen to reduce pain and inflammation.
3) Take good care of yourself with healthy food, rest and hydration.
4) Try varied feeding positions to try and drain blocked ducts.
5) Use a warm compress before you feed on the inflamed area to help milk to flow.
6) Use a cold compress after you feed to reduce inflammation and relieve pain.
7) Take a warm bath or shower and lightly massage or stroke the inflamed area and/or try to hand express milk. Be sure to be gentle and not damage the breast tissue in the area which will only exacerbate the infection.
8) Look after your nipples if they are sore or cracked, and use compresses to aid healing and prevent infection (i.e. Multi Mam).
9) Wear loose fitting clothing and sleep without pressure on your breasts.