What Is Mastitis?

Mastitis is a painful inflammatory condition of the breast that commonly occurs during breastfeeding but can also affect individuals who are not nursing. It involves swelling, redness, warmth, and tenderness of the breast, and may or may not involve infection. This condition affects up to 30% of breastfeeding individuals worldwide and is particularly common within the first three weeks postpartum.

The inflammation may result from milk stasis, where milk is not adequately drained from the breast, or from a bacterial infection, often due to cracked nipples. Despite the discomfort, mastitis is treatable, and with early intervention, most people recover quickly and can continue breastfeeding.

Types of Mastitis

Mastitis can be divided into two broad categories:

  • Lactational mastitis: This is the most common type and occurs during breastfeeding due to blocked milk ducts or infection.

  • Non-lactational mastitis: This occurs in individuals who are not breastfeeding and can result from trauma, blocked ducts, or autoimmune conditions.

Other classifications include:

  • Uncomplicated mastitis: Involves mild to moderate symptoms and typically responds well to standard treatment.

  • Complicated mastitis: Involves severe symptoms, abscess formation, or antibiotic-resistant infections.

  • Recurrent mastitis: When multiple episodes occur over time, often due to unresolved underlying issues.

Common Symptoms

The symptoms of mastitis can develop suddenly and include:

  • Localized breast pain, swelling, and redness

  • Skin warmth and tenderness in the affected area

  • A firm or hard lump in the breast

  • Nipple pain or discharge

  • Flu-like symptoms such as fever, chills, and fatigue

  • Swollen lymph nodes in the armpit

In some cases, mastitis can resemble other conditions such as a breast abscess or, rarely, inflammatory breast cancer. Therefore, medical evaluation is essential.

What Causes Mastitis?

Lactational Mastitis often results from two interrelated causes:

  • Milk stasis: When milk isn’t fully drained during feedings, it can accumulate and lead to ductal blockage and inflammation.

  • Infection: Bacteria such as Staphylococcus aureus can enter through cracked or sore nipples. Once inside the breast, these bacteria can cause infection and systemic symptoms.

Non-Lactational Mastitis may be caused by:

  • Ductal blockage unrelated to breastfeeding

  • Autoimmune conditions (e.g., Idiopathic Granulomatous Mastitis)

  • Hormonal imbalances (high prolactin)

  • Smoking, which is associated with ductal damage

  • Trauma or injury to breast tissue

In rare cases, mastitis may be linked to underlying chronic illnesses or be mistaken for malignancy.

Risk Factors

Several factors increase the risk of developing mastitis:

  • Improper latch or infrequent breastfeeding

  • Overproduction of milk or incomplete emptying

  • Use of tight bras or restrictive clothing

  • Cracked or damaged nipples

  • Rapid weaning or missed feedings

  • Sleep deprivation, stress, or poor maternal health

  • Smoking or exposure to toxins

  • History of previous mastitis episodes

Diagnosing Mastitis

Mastitis is usually diagnosed based on physical symptoms and clinical examination. A healthcare provider will assess:

  • Breast tenderness, firmness, and swelling

  • Nipple condition and signs of infection

  • Overall health status, including fever or flu-like symptoms

Further diagnostic tests may be used for complicated or persistent cases:

  • Breast ultrasound to detect abscess or fluid buildup

  • Milk or nipple discharge culture to identify bacterial infection

  • Blood tests to check white blood cell count and inflammation

  • Biopsy (if necessary) to rule out cancer or rare conditions like idiopathic granulomatous mastitis

Treatment Options

Treatment depends on the severity and cause of mastitis. Early intervention helps prevent complications and ensures continued breastfeeding.

At-Home Remedies:

  • Continue breastfeeding or expressing milk regularly

  • Begin feedings with the affected breast

  • Use warm compresses before feeding to improve flow

  • Apply cold packs after feeding to reduce swelling

  • Perform gentle breast massage from the outer breast toward the nipple

  • Rest and hydrate adequately

  • Use OTC pain relievers like acetaminophen or ibuprofen (consult with a healthcare provider)

Medical Treatment:

  • Antibiotics: Prescribed if symptoms persist beyond 24 hours or are severe

  • Corticosteroids: Used in autoimmune-related mastitis

  • Surgical drainage: Required if an abscess develops

  • Ductal surgery: In rare cases where ducts are chronically infected or blocked

Prompt treatment helps avoid abscess formation and promotes healing. Most people respond well to a 10-14 day antibiotic course.

Preventing Mastitis

Prevention involves good breastfeeding practices and breast care:

  • Ensure a proper latch and feeding technique

  • Vary breastfeeding positions to empty all ducts

  • Breastfeed or pump frequently to prevent engorgement

  • Avoid abrupt weaning

  • Wear comfortable, supportive bras that don’t constrict

  • Maintain nipple hygiene and treat cracks promptly

  • Use lanolin or expressed breast milk on sore nipples

  • Consult with a lactation consultant for personalized guidance

Preventing mastitis is not always possible, but awareness and early intervention reduce risk and severity.

Complications to Watch For

If left untreated or inadequately managed, mastitis can result in:

  • Breast abscess: A pocket of pus requiring drainage

  • Milk blister (bleb): A painful white spot on the nipple, often confused with mastitis

  • Chronic mastitis: Ongoing inflammation that may cause tissue changes

  • Premature weaning: Due to pain or milk supply issues

  • Emotional stress: Frustration, guilt, or anxiety from breastfeeding challenges

Severe complications are rare when mastitis is diagnosed and treated promptly.

Living With Mastitis

Dealing with mastitis can be emotionally and physically taxing, but most people recover fully. Support from healthcare providers, family, and lactation consultants can ease the burden. Strategies for coping include:

  • Staying well-rested and hydrated

  • Continuing breastfeeding or pumping as tolerated

  • Managing discomfort with compresses and pain relievers

  • Seeking help early when symptoms appear

With effective treatment, mastitis usually resolves within 7–10 days. Recurrence is possible, so continued monitoring is important.