Mastitis when breastfeeding: symptoms, what eases it, and when to see a doctor in Singapore

Mastitis is inflammation of the breast tissue, usually from an infection, and it is common when you breastfeed. SingHealth says it can affect up to 10 percent of breastfeeding women, most often in the first 3 months. You may have a red, hot, painful area, a lump, and fever, chills and tiredness. Keep feeding from that side, and get medical help if you feel feverish.

Mastitis symptoms

SingHealth lists breast pain, swelling, redness and warmth, a new lump, and fever, chills and tiredness. The NHS says it usually affects 1 breast and often comes on quickly. You might find a wedge-shaped lump or hard area, or a burning pain that is there all the time or only during feeds. The redness can be harder to see on darker skin, the NHS notes, so go by heat and pain too.

You may also feel as if you have flu. The NHS lists aches, a high temperature or feeling hot, cold or shivery, and tiredness.

What causes it

SingHealth says mastitis can start from a blocked milk duct, or from bacteria getting into the breast through cracks or breaks in the skin or nipple. It names sore or cracked nipples, always feeding in one position and a tight bra as common risk factors. The NHS adds that it can come from milk building up in the breast.

That is why it often follows engorgement or a shallow latch. SingHealth's prevention advice is to feed often, especially when your breasts feel full, to make sure your baby latches well and finishes the feed, and to avoid pressure on the breast.

Easing mastitis at home

Keep breastfeeding or expressing from the sore side. SingHealth's HealthXchange advice says stopping suddenly can make things worse and raises the risk of a breast abscess. From the same advice and the NHS:

• Massage gently before and during a feed. Avoid deep or firm pressure, which can damage breast tissue.
• Hand express a little milk before latching, so your baby can drain the breast.
• Feed on demand and do not try to pump the breast empty. HealthXchange warns this can cause oversupply and more swelling, and the NHS says not to express more than your baby needs.
• Change feeding positions so different parts of the breast drain.
• Use a cold compress between feeds, rest, and drink enough fluids.
• Take ibuprofen or paracetamol for pain and fever. The NHS says not to take aspirin.

When to see a doctor in Singapore

KKH's advice is to seek medical attention or call a lactation consultant immediately if part of your breast is red and painful, or you feel shivery or feverish. SingHealth's HealthXchange advice is to see a doctor if inflammation, pain and fever are getting worse for more than 24 hours, because you may need antibiotics. It names cloxacillin, amoxicillin-clavulanic acid, cephalexin and clindamycin as the usual choices, and says they are compatible with breastfeeding. Your GP, a polyclinic or your gynae can prescribe them.

SingHealth says a course of oral antibiotics is usually enough, but antibiotics through a drip may be needed if it persists or gets worse, and an abscess may need draining. The NHS says to go back to a GP if you are no better 48 hours after starting antibiotics. For help with feeding while you recover, call KKH Lactation Services on 6225 5554 or see a lactation consultant. Our guide to mastitis when breastfeeding compares it with engorgement and a blocked duct.

Frequently asked questions

What does mastitis mean?

Mastitis means inflammation of the breast. In breastfeeding mothers it is usually linked to a blocked duct or an infection, and SingHealth says it is most common in the first 3 months.

Can I keep breastfeeding with mastitis?

Yes, and you should. Stopping suddenly can make it worse. If you take antibiotics, the NHS says a very small amount may pass into breast milk, with no risk to your baby, though it might make them a little irritable or restless.

Does mastitis go away on its own?

Sometimes. The NHS says it does not usually need medical treatment and suggests seeing a GP if you are not better 12 to 24 hours after home care. In Singapore, KKH says to get medical attention immediately if you feel feverish or shivery.

Does mastitis increase the risk of breast cancer?

No. SingHealth says mastitis does not increase your risk of breast cancer.

Related terms

• Engorgement: Breasts that are overfull, hard and painful, most often in the first days after birth as your milk comes in.
• Latch: How your baby attaches to the breast to feed. A deep latch takes in the areola as well as the nipple.
• Expressing (Pumping): Taking milk out of your breasts by hand or with a pump, so your baby can have it later.
• Lactation Consultant (IBCLC): A breastfeeding specialist; IBCLC is the international credential. Helps with latch, pain, supply and pumping.
• Let-down Reflex: The reflex that makes your stored milk flow when your baby sucks. Some mums feel a tingle, others feel nothing.

See every term in the glossary