Ow. OWWW! Mastitis affects approximately one in 10 breastfeeding women, usually in the first three months after giving birth, and it's not very nice at all.
What is it?
Mastitis is inflammation of the breast tissue, most commonly experienced when a woman is breastfeeding. Sometimes it can occur as a result of milk remaining in the breast tissue (called milk stasis) because it has not been properly drained, or by an infection which comes about as a result of bacteria entering the milk ducts.
Although it's not entirely clear why non-infectious mastitis occurs, it could be because your milk contains something called cytokines; proteins which help your baby to resist infection. If the milk is not being drained properly, it's possible a mother's own immune system could mistake the cytokines for an infection, and inflame the breast tissue to get rid of it.
Often, the cause of both types of mastitis is a baby failing to latch on properly when feeding.
If they are not feeding quite correctly, then they will be failing to extract enough milk during a feed. This can be quite painful and is likely to quickly lead to sore and cracked nipples. If the nipples are bleeding, and there are open wounds, then bacteria from your own skin, or from your baby's mouth, can enter the breast.
Usually mastitis only affects one breast (small mercies!) and the symptoms include a hard area on your breast, which is painful to touch, or a reddened area, and a burning sensation which might only occur when feeding, or might be continuous.
There may also be some nipple discharge, which is usually white but may be streaked with blood.
Some women also experience flu-like symptoms: a fever, aches and pains and lethargy.
Although not usually serious, if it's left untreated, mastitis can become severe and lead to the development of an abscess in the breast – a very painful, pus-filled lump, which will require draining and could leave you unable to breastfeed again.
What can I do?
Only half of women with mastitis find it makes them feel very unwell, so if you experience any of the symptoms above, go and visit your GP – they're likely to be able to diagnose it just by taking a look and asking you about your symptoms.
If your doctor believes you have infectious mastitis, they will prescribe you a course of antibiotics, and in most cases, this should solve the problem – do be sure to complete the course, and be aware that antibiotics might make it more likely for you and your baby to develop thrush.
If you have severe mastitis, if the antibiotics don't work, or if your mastitis is recurring, then you doctor might want to test your milk to pinpoint the specific bacteria which is causing the problem.
Non-infectious and infectious mastitis can also be helped in a number of other ways, and the major one is to continue breastfeeding if you possibly can.
Feeding on demand, rather than to a strict routine, is likely to be better for your breasts and will make it less likely for milk stasis to occur.
You might be offered some help and advice from a breastfeeding expert (if not, ask for it!) – they will check how you feed your baby, and possibly suggest different positions that might enable your little one to drain the breast more effectively. They'll also check how your baby latches on, and show you what you can do to encourage them to do it correctly.
You should feed from the affected breast as regularly as you can, and if necessary, express any remaining milk in between feeds. Massage can also help to relieve milk blockages. Take some ibuprofen to relieve the tenderness, and gently massage the lumpy area, pushing it towards the nipple.
If your breast is very sore, applying a warm flannel for a while can help to soften the tissue and make it easier to either feed, or massage the blockage away.
In most cases, mastitis will clear up nicely – and don't be worried about feeding your baby from the affected breast, it's what you need to do, and it poses them no harm whatsoever.
More resources
If you are having trouble with breastfeeding, do ask your doctor or midwife about where you can get some help and support, or call the The Breastfeeding Network's National Breastfeeding Helpline on 0300 100 0212 for advice.