Key takeaways can be found at the end of this blog.

Mastitis is a common but painful condition that can affect breastfeeding mums. Whether you're just starting out or you’re further into your feeding journey, our Vhi Midwife, Clare Lucey, shares her expert advice on recognising, preventing and treating mastitis.

What is mastitis?

Mastitis is inflammation in one or both breasts, often caused by milk building up in the ducts. It can be painful and may come with flu-like symptoms in some cases. Common signs of mastitis include:

• A red/darker or sore patch on the breast
• Pain when touched
• Lumps or swelling
• Fever or chills

The red or darker patch isn’t always near the nipple − it can appear anywhere on the breast, including under the arm.

What causes mastitis?

Mastitis is usually caused by:

• Milk ducts not emptying fully during feeds
• Blocked ducts
• Stress and tiredness
• Infection (treatment for infective mastitis differs from non-infective, which I’ll explain further on)

The most important thing is finding a way of feeding that works best for you and your baby. If you do breastfeed, mastitis is most common in the first six weeks of breastfeeding, when your body is adjusting to milk production. Feeding in the same position each time or missing feeds can increase your risk. Aim to feed your baby 8–12 times in 24 hours to keep milk flowing. This can feel like a lot to get used to − and it is − so allow yourself time to learn and not feel like a pro! Your midwife or healthcare provider can give advice if you need.

Early signs of mastitis

The first sign is often a warm, tender area on the breast. This may be followed by flu-like symptoms − or it could happen in reverse order. On lighter skin tones, look for redness. On darker skin tones, watch for patches that appear darker than usual. If you feel unwell, check both breasts for sore and swollen areas. It can be hard to know if what you’re feeling is general parenting tiredness, a flu or mastitis − check in with your healthcare provider if you’re unsure about your symptoms.

Can you breastfeed with mastitis?

Yes, you can breastfeed with mastitis. In fact, it’s encouraged. Breastfeeding helps clear blocked ducts and ease inflammation. If feeding from the affected breast is too painful, you can express milk by hand or pump gently. Your milk supply might dip temporarily (this is completely normal) but it will return once the mastitis clears.

How to prevent mastitis

To help prevent mastitis:

• Vary your baby’s feeding positions. If you’re new to breastfeeding and you find a position that works well for you and your baby, you’re inclined to stick with that position. That’s totally understandable, so just try your best to switch up positions when both you and your baby are relaxed and in no rush.
• Make sure both breasts are emptied regularly.
• Use a well-fitted breastfeeding bra − It needs to be fitted properly so there isn’t too much compression.
• Avoid prolonged use of nipple shields.
• Act quickly if you notice a lumpy or sore area − feed from that breast, massage very gently and check your baby’s latch.
• Ask your midwife or healthcare provider for help early on.

What is the treatment for mastitis?

If your mastitis is not infected, try:

• Try very gentle massage with the palm of your hand, using circular motions on the affected area. You can do this during and in-between feeds, just be careful to not use too much pressure on the breast tissue.
• Warm showers or compresses before feeding. Only do this if it feels good and avoid hot water or compresses – warm is best.
• To help ease discomfort and swelling, you can gently apply a cold pack (like ice wrapped in a soft cloth) or a cool, damp facecloth to the area. This can be done after feeding or between feeds, rather than just before a feed. Try it for about 10 minutes at a time, and you can repeat every 30 minutes if needed.
• Pain relief like paracetamol or ibuprofen (unless advised otherwise by your healthcare provider).
• Rest when you can and try regular breastfeeding or pumping. If you feel no improvement in your symptoms after 24 hours, it’s good to check in with your healthcare provider.

If your symptoms worsen or you develop a fever over 38.3°C, chills or flu-like symptoms, you might have infective mastitis. Contact your healthcare provider so they can check if you need antibiotics. If, after 12-24 hours of antibiotics, you feel no change, you should go back to your healthcare provider for another chat. You might just need a different dosage or to try additional ideas for managing your symptoms.

Dealing with mastitis can feel exhausting and disheartening, but it’s not uncommon and you will recover – and don’t forget your midwife or healthcare provider is there to help guide you through it.

Key takeaways

• Mastitis is breast inflammation, often caused by milk buildup in the ducts, and can present with flu-like symptoms such as fever or chills.
• Common symptoms include sore or darker patches on the breast, pain when touched, swelling or lumps, and general discomfort.
• Causes include blocked milk ducts, incomplete emptying during feeds, stress, tiredness, and infection (which requires different treatment).
• Skin tone affects how visible redness or discoloration appears.
• Breastfeeding is encouraged during mastitis, as it helps clear blocked ducts. If feeding is too painful, gentle pumping or hand expression is recommended.
• Feeding frequency matters – aim for 8–12 feeds in 24 hours to maintain milk flow and reduce mastitis risk.
• Prevention tips include varying feeding positions, ensuring both breasts are emptied regularly, using a well-fitted bra, and avoiding prolonged use of nipple shields.
• Non-infective mastitis treatment involves gentle massage, warm compresses before feeding, cold packs after feeding, pain relief, and rest.
• Infective mastitis may require antibiotics. If symptoms worsen or don’t improve within 24 hours, consult a healthcare provider.
• Support is essential and should be sought early – midwives and healthcare providers can help.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately.