Mastitis nursing management: practical steps for breastfeeding

Mastitis is inflammation in breast tissue. It can cause a tender, warm, swollen area, a firm patch, or flu-like feelings such as chills and tiredness. A breast lump or painful feeding can be a presentation of mastitis, but these symptoms can also have other causes. The aim is to reduce pressure and irritation without repeatedly squeezing or aggressively massaging the breast.

Continuing to breastfeed is often possible. Milk from an inflamed breast is generally suitable for the baby, while a feeding assessment can identify shallow attachment, pressure from a bra, or long gaps that may be contributing.

Feed responsively and use the position that feels least painful. If direct feeding is too uncomfortable, express only enough milk for comfort or for the baby’s usual feed; extra pumping to empty the breast can increase inflammation. A cool pack wrapped in cloth after feeds may ease swelling. Support the breast gently, avoid deep massage, and choose loose clothing.

Drink to thirst, eat what you can, and arrange rest. A pharmacist or clinician can check which pain-relief options fit breastfeeding and your health history. A lactation consultation can help correct attachment and review a feeding plan.

Contact a clinician promptly if you feel very unwell, develop a high fever, notice rapidly worsening redness or swelling, or cannot keep fluids down. Arrange medical review when symptoms are not starting to settle with supportive care, or when a lump remains after the acute tenderness improves. An abscess may need examination and drainage; do not try to drain it yourself.

Ask whether your symptoms fit inflammatory mastitis or need another assessment, whether your baby’s attachment should be checked, and which analgesic is appropriate for you. You can also ask how much milk to express, what changes would suggest an abscess, and how to prevent pressure or missed feeds from recurring.