Breastfeeding is a special part of motherhood that fosters a beautiful connection with your baby. Sometimes, though, breastfeeding challenges can lead to frustration or discouragement. One of these challenges is mastitis.
If you’ve ever experienced mastitis symptoms, you know how quickly they can make you feel unwell. Fortunately, recent progress in understanding the root cause of mastitis means we now know how to treat it more effectively than before.
If you’re experiencing mastitis symptoms, know that you’re not alone. Read on to learn about our updated recommendations, including a useful protocol for treating mastitis at home.
What Is Mastitis?
Mastitis is an inflammatory process in the breast that can lead to a breast infection. Many new mothers experience this condition, though an infection isn’t always present when symptoms start. Mastitis can progress from uncomfortable to serious quickly, so prompt intervention is key.
When I see moms for their one-day or one-week postpartum visits, we always discuss the importance of watching for tender or firm spots in the breast. While this may just be a plugged duct, if left alone, it can easily develop into mastitis.
Mastitis Symptoms: What to Watch For
Mastitis symptoms tend to appear suddenly. The main signs to watch out for include any of the following:
- A visible lump that feels firm and painful.
- Red streaking and warmth in the affected area.
- Fever, ranging from low-grade to high.
- Flu-like symptoms, including chills, body aches, and feeling generally unwell.
- Symptoms usually appear on one side only. If they occur simultaneously on both sides, it is likely not mastitis.
You may experience some of these mastitis symptoms before a bacterial infection sets in. If you notice one or more of the above symptoms, acting quickly may prevent the need for antibiotics.
What Happens If Mastitis Is Left Untreated?
If not treated promptly, mastitis can progress to a breast abscess, which is extremely painful and often requires hospitalization for intravenous (IV) antibiotics and surgical drainage. In some cases, an abscess can lead to sepsis, or an infection of the blood, which is life-threatening.
If you have a low fever that lasts for 24 hours, a high fever for any period of time, or a fast heart rate, don’t ignore it. Reach out to your midwife or physician right away; we want to intervene before there’s any possibility of an abscess forming!
How to Get Rid of Mastitis: Treatments and Protocols
Our understanding of mastitis symptoms and treatment has changed significantly and very recently. In fact, if you had a baby before 2024, the recommendations you received might have been quite different from what you’d hear today.
Midwives and doctors used to recommend massage, heat, and extra pumping to treat mastitis. But that advice has been turned on its head! Today, we advise almost the exact opposite.
Previously, the medical community thought that mastitis symptoms stemmed from an actual plug inside the milk duct. Recently, we’ve found that inflammation in the surrounding tissue is actually squeezing the duct closed. This discovery dramatically changed our approach to treatment.
Armed with this knowledge, our goal is now to reduce inflammation — the opposite of what those old recommendations did — to remove pressure on the duct and allow it to reopen.
How to Treat Early Mastitis Symptoms at Home
As mentioned, immediate treatment of early mastitis (or a plugged duct) may prevent inflammation from progressing to infection. At Haven, we share a simple protocol for moms to follow at home if they notice early mastitis symptoms. In my experience, this protocol prevents the need for antibiotics in a high percentage of cases. If you notice a plugged duct or mastitis symptoms, start this protocol right away:
- Ice the affected area for 10 minutes after each feeding.
- Take ibuprofen (600 mg every 6 hours) around the clock for at least 48 hours.
- Continue breastfeeding or pumping as normal; no extra pumping, just your usual routine.
- Position baby’s chin in the direction of the lump while feeding.
- Apply firm pressure — not massage — to the area of inflammation during nursing.
- Take sunflower lecithin (1200 mg, 4 times daily) to help thin your milk and reduce its “stickiness.”
Remember to avoid:
- Heat, even from standing under a hot shower
- Massage, which can increase inflammation
- Extra pumping, which can signal your body to increase milk supply and therefore worsen the back flow of milk.
Possible additional strategy:
- Therapeutic ultrasound, which requires a specialized machine operated by a physiotherapist. Unfortunately, it can be challenging to get this treatment before antibiotics become necessary.
Often, the home mastitis protocol is sufficient to resolve the inflammatory processes at the root of mastitis. However, if you have a fever greater than 100.4, you have flu-like symptoms, and/or your symptoms last for more than 24 hours without improvement, it would be prudent to have a conversation with your provider.
Since mastitis can become serious quickly, I often recommend a short course of antibiotics if your symptoms aren’t improving on the protocol or if they become more severe. I find this preferable to the possibility of an abscess that needs prolonged treatment (and lots more antibiotics) in the hospital.
I’ve seen firsthand how terrible breast abscesses can be. I don’t want any mom to experience one if she can avoid it!
Can I Nurse With Mastitis?
Yes, you can and should continue nursing even with mastitis symptoms as long as you’re not seeing infectious discharge. Breastfeeding helps keep your milk moving and prevents further complications. However, if you notice any pus, or any greenish, yellow, or pink-tinged milk, it’s best to pump and discard that milk rather than nurse from the breast.
Some helpful mastitis nursing techniques include:
- Positioning your baby’s chin toward the mastitis lump to encourage milk drainage from that area.
- Applying firm but gentle pressure (not massage) while nursing to encourage milk flow.
Should I Pump With Mastitis?
Yes, but only as much as you would normally nurse. For example, if your baby typically nurses for 10 minutes, then only pump for 10 minutes. In addition to stimulating milk production, over-pumping can cause irritation and make inflammation worse.
How to Prevent Mastitis
Where possible, prevention is always better than treatment. Try these tips to reduce your risk of developing mastitis:
- Nurse or pump on a regular schedule to keep your milk flowing.
- Ensure a proper latch.
- Avoid wearing tight bras or clothes that put pressure on the breasts.
- Take sunflower lecithin as a preventive measure if you’re prone to clogged ducts.
One important note: Nipple shields can be problematic. At Haven, we’ve seen a direct correlation between nipple shield use and mastitis, likely because the shields often prevent ducts from fully emptying.
If you’re having trouble with breastfeeding, we recommend talking with a certified lactation consultant for help. Our community here in the Nashville area offers some wonderful resources for prenatal and breastfeeding moms, including:
Mastitis Symptoms and Treatment: Final Thoughts
Our growing understanding of mastitis, its symptoms, and its root cause has helped us refine ways to treat and prevent it. While mastitis is a challenge that can take moms by surprise, staying up to date on the latest guidance means you can make choices that truly support your healing and well-being.
If you’re struggling, know that you’re not alone. Many nursing moms have been in your shoes, and we’re here to support you. Your health matters, and with the right approach, you can continue breastfeeding your little one with comfort and confidence.
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Dawn Swendsen, CNM, MSN, APRN
Dawn Swendsen, CNM, MSN, APRN, is a midwife at Haven Birth and Wellness with 25 years of experience in women’s health. She has participated in nearly 1,500 births in diverse settings across the U.S. With a background in Labor and Delivery, NICU, OB-Emergency, and the Main Emergency Department, midwifery became a natural progression for Dawn. She is passionate about empowering women through education and shared decision-making.Originally from the Pacific Northwest, Dawn now lives in Tennessee with her husband, Taylor, and their five children: Ezra, Lucy, Levi, Micah, and Jude. She enjoys running, camping, and outdoor activities.
Disclaimer: The content on the Haven Birth and Wellness website is created and/or reviewed by qualified Certified Nurse Midwives and healthcare professionals. We strive to provide accurate and detailed information for our readers. However, this blog is intended for informational purposes only and should not be considered a substitute for professional medical advice. Your own healthcare provider is best equipped to understand your unique situation and medical history. Always consult with your healthcare provider before making any decisions that may affect your health.