Lactation and breastfeeding are a unique experience for every parent and infant. The Department of Obstetrics and Gynecology at Massachusetts General Hospital busts myths and shares new evidenced-based information.
What is mastitis?
Mastitis is an inflammation of the breast tissue. Infections may or may not occur with mastitis. It often affects women who are breastfeeding.
What causes mastitis?
Mastitis may occur because of sore or cracked nipples, latch problems, plugged ducts, oversupply, yeast infections, or milk not draining well.
What are the symptoms of mastitis?
These are the most common symptoms of mastitis:
Hot, swollen breasts
A red, painful, or hot "wedge-shaped" swelling on a breast, or both breasts
A red, painful, or hot lump in your breast
Red streaks on your breasts
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
If you have these symptoms, contact your healthcare provider as soon as possible. You may need treatment for mastitis.
How is mastitis diagnosed?
Your healthcare provider will examine your breasts. In most cases, you won’t need lab tests. But you may need the following tests:
Breastmilk culture. This may be done if an infection is severe, occurred in the hospital, or hasn’t responded to a previous course of antibiotic treatment. This can be used to guide the choice of antibiotics.
Ultrasound. You may need this imaging test if the mastitis is linked to breastfeeding and doesn’t get better with treatment in 48 to 72 hours.
Blood cultures. These will be done if the breast redness keeps growing or your vital signs become unstable.
How is mastitis treated?
Mastitis treatment includes draining the breast, applying heat, getting rest and plenty of fluids, and taking pain medicine. Antibiotics may be prescribed.
It’s very important to keep the affected breast "empty" through frequent breastfeeding or pumping sessions.
It may be too painful to have your baby nurse on the infected breast. Move your baby to the other breast, open both sides of your bra, and let the milk flow from your sore breast onto a towel. Milk from the infected breast can also be removed by a breast pump. You can feed your baby the expressed breastmilk if they accept it.
Massage the area. Start at the sore spot and move your fingers in a circular motion and massage toward the nipple.
Put heat on the area with a warm, wet cloth.
Wear a well-fitting bra that is not tight. Sometimes a tight bra constricts milk ducts and causes problems.
Ask others to help so you can get some extra rest and sleep. Breast infections are often a sign that you are doing too much and getting overtired.
If you think a latch problem may have helped cause your mastitis, think about seeing a certified lactation consultant.
It’s very important to rest and keep hydrated by drinking a lot of clear fluids.
You can take ibuprofen or acetaminophen for the fever or mild pain.
An antibiotic may be prescribed for 10 to 14 days. Take all of the medicine or the mastitis may come back. The antibiotics used for mastitis are generally safe to use while breastfeeding.
Key points about mastitis
Mastitis is an inflammation of the breast tissue. It often affects women who are breastfeeding.
Symptoms include hot, swollen breasts, red streaks on the breasts, and body aches and chills.
Treatment includes draining the breast, putting heat on it, and getting rest and plenty of fluids.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.
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