What causes mastitis during breastfeeding?

Milk can collect when feeds are missed, feeding patterns change suddenly, attachment is shallow, or pressure from tight clothing restricts part of the breast. The resulting inflammation can cause a hot, tender or firm area and make you feel unwell. Cracked or damaged nipple skin may allow bacteria to enter, but inflammation does not always mean there is a bacterial infection.

Pain can make feeding harder, which may reduce milk removal and prolong the problem. Support with positioning and attachment can help address this cycle.

Continue breastfeeding responsively if you can, without repeatedly trying to empty the breast or using forceful massage. A cool compress after feeds, rest, fluids and a supportive bra may ease discomfort. Check that your baby is attaching deeply and avoid firm pressure over the sore area. A lactation professional can observe a feed and suggest practical adjustments.

Discuss suitable pain relief with a pharmacist or clinician, especially if you have allergies, other medical conditions or take regular medicines. Antibiotics are used when a clinician thinks bacterial mastitis is likely; they are not needed for every inflamed breast.

Arrange prompt medical assessment if you feel increasingly unwell, develop fever or chills, redness spreads, pain is severe, or symptoms are not improving with supportive care. Seek urgent help for confusion, faintness, breathing difficulty or a rapidly worsening condition. A persistent, very painful lump may need examination for an abscess, which can require drainage.

Ask whether your symptoms fit inflammatory or bacterial mastitis, whether a breast lump needs imaging, which pain medicines suit you, and where to obtain feeding support. Mention nipple damage, recent changes in feeding, previous mastitis and any medicine allergies.