Mastitis can be painful, exhausting and overwhelming. Thankfully, our understanding of mastitis has changed, and the advice is now much gentler.
Rather than trying to force out a blocked duct or completely empty the breast, the focus is on reducing inflammation, maintaining comfortable milk removal and addressing the underlying cause.
Mastitis: The key things to know
Keep breastfeeding normally, following your baby's cues. Avoid additional pumping to empty the breast.
Apply cold packs for 10–20 minutes at a time to reduce pain and swelling.
Avoid deep massage, excessive heat and vibrating devices, which can worsen inflammation.
Rest and recover. Eat regularly, drink to thirst and consider appropriate anti-inflammatory medication.
Seek medical advice if symptoms worsen or are not improving within 12–24 hours, or sooner if you feel very unwell.
What actually causes mastitis?
Mastitis is inflammation of breast tissue, which may or may not involve bacterial infection.
Symptoms can include a painful, swollen or warm area of the breast, redness, fever, chills and flu-like symptoms.
What we once called a blocked duct is often inflammation and narrowing of the milk ducts, rather than a physical plug of milk that needs to be pushed out.
This distinction is important because aggressive massage and excessive milk removal can make the inflammation worse.
Old advice vs new advice
Old: Empty the breast completely.
New: Continue breastfeeding or expressing according to your baby's usual needs. Excessive pumping can increase milk production and worsen inflammation.
Old: Massage the lump out.
New: Avoid deep massage, squeezing and vibrating devices. Gentle handling is important when breast tissue is inflamed.
Old: Apply lots of heat.
New: Use cold packs to help manage pain and swelling. Brief warmth may help milk let-down if comfortable, but prolonged heat can increase swelling.
Old: Soak or pop nipple blebs.
New: Avoid Epsom-salt soaks, picking or puncturing nipple blebs. Persistent nipple changes should be assessed.
How to manage mastitis at home
In the early stages of breast inflammation:
Continue breastfeeding or expressing at your usual frequency.
Apply a cold pack wrapped in cloth for 10–20 minutes at a time.
Consider ibuprofen for inflammation and pain, if suitable for you, following medical or pharmacist advice.
Prioritise rest, food and adequate hydration.
Seek support with attachment, milk transfer or pumping if feeding is uncomfortable or ineffective.
When should you see a doctor?
Seek medical review if symptoms are worsening or have not started improving within 12–24 hours. Seek help sooner if you feel very unwell.
Some cases of mastitis are bacterial and require antibiotics. Breastfeeding can usually continue during treatment - milk supply can lower as you are unwell, and some fussing at the breast when baby is feeding can be common.
If symptoms are not improving after 48 hours of antibiotics, or you have a persistent or enlarging lump, further assessment may be needed.
Can probiotics help with mastitis?
Emerging research suggests that certain probiotic strains may support breast health and potentially reduce mastitis symptoms or recurrence. Probiotics are not a replacement for appropriate medical treatment - they may reduce the need for antibiotics, and if antibiotics are taken, they can help to restore healthy bacterial levels in the breasts and gut of mum and baby.
The specific probiotic strain matters. One strain studied in breastfeeding women is Limosilactobacillus fermentum CECT5716.
Two options containing this strain are:
Qiara Pregnancy & Breastfeeding
Contains 3 billion CFU of L. fermentum CECT5716 per sachet.
Available through my practitioner dispensary, vital.ly. Contact me for access and individual guidance.
MotherBloom by Naternal Vitamins
Contains 6 billion CFU of L. fermentum CECT5716 per capsule alongside three additional probiotic strains.
Shop MotherBloom through Naternal Vitamins — 10% off with my referral link*
A higher probiotic count or additional strains does not necessarily mean better mastitis outcomes. I recommend choosing products based on your individual circumstances rather than routinely combining them.
Recurrent mastitis? Let's look at the root cause.
If you are experiencing repeated episodes of mastitis, managing the immediate inflammation is only one part of the picture.
As an IBCLC Lactation Consultant, Midwife and Naturopath, I look beyond the symptoms to understand what may be contributing.
This may include:
Breastfeeding attachment and milk transfer
Oversupply and feeding patterns
Pumping frequency and flange fit
Nipple damage and breast inflammation
Changes in feeding, expressing or weaning
Emotional/energetic causes
My goal is to help you understand why mastitis keeps occurring and create a practical, individualised plan to reduce the likelihood of it happening again.
I offer breastfeeding consultations at House of Health in Moonee Ponds, Melbourne, and online throughout Australia.
Explore breastfeeding consultations
References
This article provides general information and does not replace individual medical advice.
*Affiliate disclosure: Some product links are affiliate links, meaning I may receive a small commission if you purchase through them, at no additional cost to you. Recommendations are based on clinical considerations, and purchasing products is never required to access my care.
