Breast infection (mastitis) - Treating mastitis

Mastitis can usually be easily treated, and most women will make a full recovery very quickly.

Many cases of mastitis not caused by an infection will improve through using self care techniques, such as:

making sure you get plenty of rest
drinking plenty of fluids
using over-the-counter painkillers such as paracetamol or ibuprofen to reduce any pain or fever – a small amount of paracetamol can enter the breast milk, but it is not enough to harm your baby (it is not safe to take aspirin while breastfeeding)
avoiding tight-fitting clothing (including bras) until your symptoms improve
if you are breastfeeding, regularly expressing milk from your breasts (see below)
placing a warm compress (a cloth soaked with warm water) over your breast to help relieve the pain – a warm shower or bath may also help

If your GP thinks your mastitis is caused by an infection, you may need to take antibiotics.

Expressing breast milk

If you are breastfeeding and you have mastitis, it is likely to be caused by a build-up of milk within the affected breast. Regularly expressing milk for your breast can often help improve the condition quickly.

One of the best ways to express milk from your breast is to continue breastfeeding your baby, or expressing milk by hand or by using a pump. Continuing to breastfeed your baby will not harm them, even if your breast is also infected.

The milk from the affected breast may be a little saltier than normal, but it is safe for your baby to drink. Any bacteria present in the milk will be harmlessly absorbed by the baby's digestive system and will not cause any problems.

You may find that expressing breast milk becomes easier by:

breastfeeding your baby as often and as long as they are willing to feed, starting feeds with the sore breast first
making sure your baby is properly positioned and attached to your breasts – your midwife or health visitor will advise you about how to do this (read more about breastfeeding positioning and attachment)
experimenting by feeding your baby in different positions
massaging your breast to clear any blockages – stroke from the lumpy or tender area towards your nipple to help the milk flow
warming your breast with warm water, as this can soften it and help your breast milk flow better, making it easier for your baby to feed
making sure that your breast is empty after feeds by expressing any remaining milk
if necessary, expressing milk between feeds (see expressing breast milk for more information)

Contact your GP if your symptoms worsen or do not improve within 12-24 hours of trying these techniques. If this happens, it is likely that you have an infection and will need antibiotic medication.

Antibiotics

If you are breastfeeding and the above measures have not helped improve your symptoms, or if your GP can see your nipple is clearly infected, you will be prescribed a course of antibiotics to kill the bacteria responsible. These should be taken in addition to continuing the self-help measures above.

Your GP will also usually prescribe a course of antibiotics if you develop mastitis and are not breastfeeding.

If you are breastfeeding, your GP will prescribe an antibiotic that is safe to use. This will usually be a tablet or capsule that you take orally (by mouth) four times a day for up to 14 days.

A very small amount of the antibiotic may enter your breast milk, which may make your baby irritable and restless, and their stools may become looser (runnier) and more frequent. This is usually temporary and will resolve once you have finished the course of antibiotics. They do not pose a risk to your baby.

Contact your GP again if your symptoms worsen or have not begun to improve within 48 hours of starting antibiotic treatment.

Surgery

In some cases of mastitis in non-breastfeeding women that recur frequently or persist despite treatment, surgery to remove one or more of your milk ducts may be recommended.

This operation is usually performed with a general anaesthetic (where you are asleep) and lasts about 30 minutes. Most people can go home the same day as the procedure, or the day after.

If all of the milk ducts in one of your breasts are removed during this operation, you will no longer be able to breastfeed using that breast. You may also lose some sensation in the nipple of the treated breast(s). Make sure you discuss all the risks and implications of surgery with your doctor and surgeon beforehand.