Mastitis: symptoms, comfort and care

Mastitis may cause a tender, warm or reddened area, swelling, a firm patch and pain during feeding or at other times. You may feel tired, achy or feverish. Milk stasis, pressure on the breast, missed feeds, an overly full breast or nipple damage can contribute. Inflammation does not automatically mean there is a bacterial infection, but infection can develop and needs clinical judgement. Painful breastfeeding can also result from positioning or latch problems, so the pattern matters.

Feed responsively and avoid trying to empty the breast repeatedly, which may increase inflammation. Check the latch and position, use gentle breast handling, rest, and apply a cool pack between feeds if it helps. Wear a supportive bra that does not press tightly on the breast. Avoid vigorous massage, deep pressure and sudden weaning. A lactation consultation can help identify latch, positioning or milk-removal problems. A clinician can decide whether medicines or further assessment are needed.

Contact a clinician promptly if you feel significantly unwell, develop a high fever, notice rapidly spreading redness, or cannot keep fluids down. Arrange review when symptoms are not improving with supportive care, return repeatedly, or form a persistent lump or fluid-filled area. Seek urgent help for severe weakness, confusion or breathing difficulty. Breast pain that is unexplained or continues after inflammation settles also deserves assessment.

Does this look like inflammation, infection or an abscess? Should I continue breastfeeding or expressing? What pain relief is suitable for me? Could a latch problem be contributing, and would a lactation consultation help?