Feeling unwell with a sore, red breast or damaged nipples?
Mastitis (inflammation of the breast tissue) can develop if localised breast inflammation is not treated promptly.
If you have mastitis, you will usually feel unwell and may have a sore, firm or red area on your breast. There may or may not be an infection.
Engorgement, damaged nipples or overfull breasts can lead to mastitis.
Do I have mastitis?
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You may have flu-like symptoms such as a fever, chills or fast heart rate.
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Part of your breast may look red and swollen. The skin may be shiny or have red streaks.
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Your breast may feel hot and painful.
Sometimes mastitis can come on quickly. You may not have noticed the early signs of breast inflammation. Feeling unwell may be your first symptom.
See a doctor if you don't start to feel better (or get worse) within 12 to 24 hours, or sooner if you feel very unwell. Mastitis which is left untreated may become a breast abscess.
Preventing mastitis
Things to do:
- Make sure your baby is positioned and attached well to help them remove milk easily.
- Allow your baby to feed for as long and as often as they want to. If your nipples feel sore you can take your baby off the breast as soon as they stop sucking and swallowing or fall to sleep.
- Treat sore or damaged nipples promptly.
- Start each feed on alternate breasts to ensure milk is removed from both breasts often.
- If one or both breasts become uncomfortably full, you can wake your baby and offer a feed.
- If your baby is not feeding well at the breast, you can express to replace missed breastfeeds.
- You may be more likely to get mastitis if you are “run down”. Resting, drinking to your thirst and eating nutritious foods may help.
- If you are weaning, try to do it gradually, reducing breastfeeds over several weeks.
- Avoid expressing extra breastmilk if your baby is feeding well at the breast.
- Don’t give your baby any other fluids except your breastmilk, unless medically advised.
Managing mastitis
Start treatment as soon as you notice a lump, sore spot or red area on your breast. Early treatment will help you to feel less ill and get better faster.
There are several things you can try at home to reduce inflammation and help keep the milk moving.
Continue to breastfeed your baby
It is important to keep removing milk from the sore breast. This will prevent it from becoming overfull and help to maintain your supply.
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Continue to breastfeed your baby as often as they need.
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Make sure they are positioned and attached well.
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Start each feed on alternate breasts.
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If your baby is not breastfeeding well, you may need to express.
Your breastmilk is safe for your baby to drink. Some babies refuse the breast for a short time because it may taste saltier. If this happens, there are ways you can encourage your baby to feed.
There are a number of ways that you might choose to hold your baby to feed. If your breast is sore and your usual position is uncomfortable, try some other positions.
Help the milk to flow
Sometimes the flow of milk from the sore breast is slower. This may cause your baby to be fussy at the breast. Try some of these tips to help the let-down reflex work and your milk to flow more easily:
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Loosen your bra or take it off.
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Choose a comfortable position that helps you to relax.
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Breathe deeply and evenly.
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Listen to soothing music.
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Hold your baby skin-to-skin.
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Gently stroke your breast towards the nipple before a feed.
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Warm your breast just before a feed. A warmed gel pack or cloth are easy options. Don't use warmth at other times - it can worsen inflammation.
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If your breast still feels full after a feed, express until it feels more comfortable.
Treat inflammation
Cold relieves pain and swelling. You can use covered cool packs on the affected breast between feeds. You can soak and freeze breast pads or nappies to make your own cool packs.
Common anti-inflammatory or pain relief medications can be helpful. Talk to your doctor or pharmacist about your options.
Rest and recover
When you have mastitis, it’s important to get as much rest as possible, keep drinking (water is best) and eat well.
Stay in bed if you can, or at least put your feet up for most of the day. Take your baby and everything you’ll need so you don't have to keep getting up.
Have supplies for changing nappies as well as your own food and drinks. If you have other children, it may be easier to lie down in your living area.
Seek medical help
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See a doctor if you don't start to feel better (or get worse) within 12 to 24 hours, or sooner if you feel very unwell.
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You may need medication to help with the pain and inflammation.
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If you are prescribed antibiotics, it is safe to continue to breastfeed. Make sure you finish the course.
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Some mums may get a thrush infection after taking antibiotics. If you have had thrush in the past, discuss this with your doctor.
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If mastitis is not treated promptly, a breast abscess may form, although this isn’t common.
© Australian Breastfeeding Association February 2023
Read more about breast and nipple care
Evidence-led info and practical tips from our Breastfeeding Information Series
Breastfeeding: Breast and nipple care
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- Lai, B. Y., Yu, B. W., Chu, A. J., Liang, S. B., Jia, L. Y., Liu, J. P., Fan, Y. Y., & Pei, X. H. (2021). Risk factors for lactation mastitis in China: A systematic review and meta-analysis. PloS One, 16(5), e0251182.
- Mitchell, K. B., Johnson, H. M., Rodríguez, J. M., Eglash, A., Scherzinger, C., Zakarija-Grkovic, I., Cash, K. W., Berens, P., Miller, B., & Academy of Breastfeeding Medicine (2022). Academy of Breastfeeding Medicine clinical protocol #36: The mastitis spectrum, revised 2022. Breastfeeding Medicine, 17(5), 360–376.
- Shalev Ram, H., Ram, S., Wiser, I., Tchernin, N., Chodick, G., Cohen, Y., & Rofe, G. (2022). Associations between breast implants and postpartum lactational mastitis in breastfeeding women: Retrospective study. British Journal of Obstetrics and Gynaecology, 129(2), 267–272.
- Wilson, E., Wood, S. L., & Benova, L. (2020). Incidence of and risk factors for lactational mastitis: A systematic review. Journal of Human Lactation, 36(4), 673–686.
