Mastitis: a clear primary-care approach

Mastitis describes inflammation of the breast and may include a painful, warm, swollen area, a firm region, feverishness, or body aches. It can occur during breastfeeding, but a person who is not nursing can also have breast inflammation. A breast lump or breast pain is a presentation that deserves assessment in context; it does not by itself identify the cause.

A primary-care assessment considers how quickly symptoms began, whether the skin changes are spreading, how unwell you feel, and whether a lump remains. The clinician may also ask about feeding, nipple damage, pressure on the breast, and previous episodes.

Use gentle feeding or expression for comfort rather than repeatedly trying to empty the breast. Avoid deep massage, tight clothing, and prolonged heat if these make swelling worse. A cool pack wrapped in fabric, rest, fluids according to thirst, and suitable pain relief may help. A clinician or pharmacist can check medication safety for breastfeeding and other health conditions.

If feeds are painful or milk transfer seems difficult, a lactation consultation can review attachment and positioning. This can address a mechanical trigger without adding unnecessary pumping or breast manipulation.

Arrange prompt review for marked feverishness, rapidly spreading redness, severe or increasing pain, repeated episodes, or a lump that does not settle. Seek urgent help if you feel faint, confused, unable to drink, or seriously unwell. A clinician may consider antibiotics or imaging when the examination suggests infection or a collection; treatment depends on the findings.

Ask what features support mastitis, what alternative causes need consideration, and what improvement should look like. Ask when to return if the redness or lump persists, whether medication is appropriate, and whether a feeding assessment or imaging is needed.