02/11/2025
I’m feeling like a broken record, many parents that I speak with, and many health professionals too, have a very old fashioned, outdated, unevidence based idea about mastitis. The evidence base was updated about 4ish years ago and not everyone you meet is aware of it.
So let’s clear some things up:
Mastitis - means a sore b**b. It might be too full of milk, it might have been squashed into a ill-fitting bra, it might have been held tightly to help a baby latch, it might have been bitten/kicked/headbutted by a bigger breastfeeding baby, it might just have been rolled on while you were asleep.
Mastitis = sore breast.
When you injure part of your body, it sends a greater blood supply and additional fluid to aid healing. If you’ve sprained your ankle, this can be very helpful - it can help immobilise the joint while it heals. When your breast hurts and this additional fluid arrives it often makes it feel more uncomfortable and can cause milk flow to slow. This is often referred to as a blocked duct. It’s not plumbing, your toilet is not blocked! Swelling in the tissue around your milk ducts can constrict them and make it harder for the milk to flow.
Your breast is a beautifully efficient, delicate organ (we forget this as it’s stuck on the outside of your body), if you had a problem with your liver folks would not be recommending vigorous massage to “shift the blockage”!
It’s the swelling that causes discomfort and restricts milk flow leading to full, hard, lumpy often hot and tender to touch breasts. The current research suggests three self-help measures; cooling the breast down; a cold compress or some frozen peas in a tea towel will help reduce swelling and promote milk flow. Some mothers might take ibuprofen which will reduce swelling and help with discomfort. And lymphatic massage, a way to move the fluid out of the breast and reduce the swelling. This is a gentle fingertip massage, as soft as you would stroke your baby’s face, moving in long strokes from your ni**le back towards your body - up into your armpit and up towards your collar bone. Feeding your baby or expressing as you normally would is recommended, kept the milk flowing as best as you can. For most parents symptoms will improve in around 24 hours with these self help measures.
Antibiotics are not prescribed for mastitis and they will not fix the problem. Antibiotics can be useful to treat a bacterial infection that might be linked to your sore b**b (mastitis). If you have a temperature, feel unwell, have achy joints or a headache then it might be a good idea to seek some medical support as they are signs there might be a bacterial infection that needs treatment.
It’s important to try and identify what has caused this problem in the first place, this helps you avoid it in the future. Seek some skilled support with your feeding or expressing if you feel you’d like support to work it out, especially if this is something you’ve experienced more than once.