Mastitis: symptoms, treatment and whether to keep breastfeeding

Mastitis is inflammation of the breast tissue. According to MedlinePlus, when there is an infection it is usually caused by a common skin bacterium (staph) that gets in through a crack or break in the nipple. It happens mostly in women who are breastfeeding.

It often starts as a clogged milk duct: a tender, sore lump in the breast. If milk doesn’t flow well, the area can become more inflamed.

Breast inflammation or infection that is not related to breastfeeding is different: MedlinePlus explains it can be due to a rare form of breast cancer, and it always needs an in-person evaluation with imaging. We refer you.

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• When the pain started and whether you have a fever or chills
• Whether there is a red, warm or hard area on the breast (you can show it on camera or send a photo)
• Your baby’s age and how breastfeeding is going
• Your medicines and allergies
• The name of your pharmacy

Mastitis is handled in a doctor visit, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. We do not bill insurance; the pharmacy charges separately. See all prices.

According to MedlinePlus, symptoms are usually on one side only:

• Pain, warmth and swelling in part of the breast
• Red skin, often in a wedge or triangle shape
• A lump or hard area in the breast
• Fever and flu-like symptoms, such as feeling unwell, nausea or vomiting
• One breast fuller or larger than the other
• Sore or swollen lymph nodes in the armpit on the same side
• Nipple discharge, which may contain pus

Don’t stop breastfeeding. MedlinePlus and the Office on Women’s Health (OWH) advise continuing to breastfeed, or to pump, including on the affected side, while you are treated. This keeps the milk flowing.

Rest and look after yourself. Drink fluids, rest as much as you can and wear a supportive bra that isn’t tight. If appropriate, the doctor tells you which pain reliever you can take while breastfeeding.

An antibiotic, if needed. When there is an infection, MedlinePlus explains that antibiotics work very well and mastitis usually clears quickly. The doctor decides whether you need one and chooses one that is compatible with breastfeeding.

If there is an abscess, a pocket of pus, it has to be drained with a needle guided by ultrasound or with a procedure. That is done in person, as with a large boil on the skin.

Get an in-person evaluation the same day, with your OB-GYN or at an urgent care center, if:

• You notice a swollen lump that seems to have pus or fluid in it, or a lump that won’t go away: it may be an abscess
• You don’t feel better within 24 hours, or your fever doesn’t improve with treatment
• You have symptoms in both breasts
• You see pus or blood in your milk, or red streaks on the skin of the breast

An infection can spread to the blood (sepsis). For your safety, go to the emergency room or call 911 if you have:

• Confusion, unusual sleepiness or trouble staying awake
• A very fast heartbeat or very fast breathing
• High fever with hard chills, or a very low temperature
• Severe dizziness or fainting
• Mottled skin, or you feel very ill