5 Pieces Of Expert Advice For New Parents In 2024 - Forbes
Experts on the Forbes Health Advisory Board are sharing their best pieces of advice for new parents heading into 2024.
mastitis
“Did you know the holidays can bring the gift of <anchor>mastitis</anchor> and/or low milk supply? In this season of business, feedings may get spaced farther apart than normal,” she says. “That, coupled with potential stress, can be problematic for breastfeeding moms. Set a recurring alarm on your phone to feed your little one.”
Mastitis: Causes, Symptoms And Treatments – Forbes Health
Mastitis: Causes, Symptoms And Treatments – Forbes Health

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Women's Health



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Men's Health



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Family



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# What Is Mastitis? Causes, Symptoms And Treatment

[Amanda Krupa](https://www.forbes.com/health/author/amanda-krupa/ "Amanda Krupa")

By [Amanda Krupa](https://www.forbes.com/health/author/amanda-krupa/)

Contributor


Medically Reviewed


Dr. John Whitfield is a board-certified gynecologist and the owner of Signature GYN Services in Fort Worth, Texas.


[John Whitfield, M.D., F.A.C.O.G.](https://www.forbes.com/health/medical-advisory-board/john-whitfield/) Gynecology

Updated: Aug 14, 2023, 6:51am


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## Table of Contents

- [What Is Mastitis?](#what_is_mastitis_section)
- [What Causes Mastitis?](#what_causes_mastitis_section)
- [Most Common Symptoms of Mastitis](#most_common_symptoms_of_mastitis_section)
- [Mastitis Treatments](#mastitis_treatments_section)
- [Mastitis Prevention](#mastitis_prevention_section)
- [Discuss Any Feeding Concerns With Your Pediatrician](#discuss_any_feeding_concerns_with_your_pediatrician_section)

{{ tocState.toggleTocShowMore ? 'Show more' : 'Show less' }}

If you’re pregnant or a new mom, you need to be on the lookout for postpartum mastitis, or inflammation in the tissue of the breast. It can be a sneaky condition for nursing and non-nursing women alike, and many new moms even confuse their mastitis symptoms with those of COVID-19. Know what signs to look for—and how to treat them—so you can stay strong and healthy for your little one.

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## What Is Mastitis?

Clinically speaking, mastitis is “a tender, hot, swollen, wedge-shaped area of the breast associated with a fever, chills, flu-like aching, and systemic illness,” according to the American College of Obstetricians and Gynecologists (ACOG). Chances are you know someone who has experienced it—research suggests the condition can occur in as many as 33% of lactating women, especially in the first few weeks postpartum.

“This is not just a condition that can happen to women who are breastfeeding,” says Jessica Madden, M.D., a pediatrician, neonatologist, certified lactation consultant and medical director of Aeroflow Breastpumps. “Mastitis can absolutely happen to a mother who is exclusively pumping, feeding twins or combination feeding with formula. If your breasts are making milk, you are at risk.”

## What Causes Mastitis?

Similar to a clogged bathroom sink, a blocked or clogged milk duct in the breast can stop or slow the flow of breast milk and predispose a person to mastitis. In most cases, the source of the clog resides deeper in the breast tissue versus directly on the nipple. Mastitis due to a blocked duct is benign and not an infection, but it could progress to one if it’s left untreated and persists for more than 24 hours. At this point, it will require medical treatment.

### What Can Cause Blocked Milk Ducts?

- Infrequent feedings
- Missed feedings
- Sudden weaning
- Unrelieved engorgement

Another major cause of mastitis, according to Dr. Madden, is any abrasions or wounds on your nipples acquired from either nursing your baby at the breast or pumping. “The opening into your breast is an entry point for bacteria on the skin,” she says. “Poor latching at the breast or an ineffective suck from your little one can also cut or damage the nipple, which can potentially lead to an infection.”

## Most Common Symptoms of Mastitis

The most common signs of mastitis often appear without warning and can vary from one mother to the next, so take a moment for a postpartum breast self-exam.

- Does one or both your breasts feel achy or painful?
- Are you developing hard, painful areas on your breasts that aren’t draining after breastfeeding or pumping?
- Is one of your breasts red or hot to the touch?
- Is your baby getting fussy when nursing on one side?

The first symptom that occurs with mastitis is pain and swelling in the breast, says Dr. Madden. Another sign is fever. “While it’s normal to be lethargic and emotionally spent as you recover from childbirth, it should not lead to a fever,” she says.

A fever is a marker of infection or inflammation somewhere in your body. Because normal body temperature can vary by age, gender and even time of day, take your temperature when you’re feeling well to get an idea of your baseline.

### The Difference Between COVID-19 and Mastitis

“You won’t see respiratory symptoms with mastitis,” says Atlanta-based pediatrician Jennifer Shu, M.D. “The pain and discomfort are localized to the breast, so if you feel pain in other parts of your body, that’s a marker something else is going on.”

Symptoms of COVID-19 include:

- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea

If you didn’t already receive the [COVID-19 vaccine before or during pregnancy](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html), know it is safe to do so after birth and while breastfeeding. Recent reports show women who received COVID-19 mRNA vaccines (Pfizer and Moderna) have antibodies in their breast milk, which could help protect their babies.

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## Mastitis Treatments

Mastitis is not a condition you want to self-diagnose or address solely with the advice of friends and family members. “If you have any symptoms of mastitis, this is a situation where there absolutely needs to be a discussion with your doctor or midwife,” says Dr. Madden.

Some cases are mild, but others are serious enough to need a 10- to 14-day course of antibiotic treatment. In either case, it’s essential milk be removed frequently from the affected breast(s). Nursing is a good way to speed up recovery.

### Tips for Easing Mastitis-Related Pain and Discomfort

- **Empty your breasts frequently.** “It can be helpful to think about the concept of supply and demand before expressing a lot of milk,” says Dr. Shu. “You’ll find there’s a fine line between expressing enough breast milk to relieve pain and expressing so much that you give your body the unintended message to produce even more.” To help relieve the pain, she recommends putting a warm compress on the affected area or taking a warm shower before trying to slowly drain little milk from the breast.
- **Try breast massage therapy.** The right massage techniques can help drain the breast at the blocked area and move the milk towards the nipple. In fact, a 2019 literature review showed breast massage was effective in reducing immediate pain in study participants. Dr. Madden says there are many helpful videos online to get you started and recommends seeking advice from a lactation consultant.
- **Take ibuprofen if needed.** Ibuprofen is an anti-inflammatory medicine safe for women to take after they give birth and while nursing.
- **If prescribed antibiotics, take all of the medicine**. Mastitis may come back, so be sure to finish your medication even after your symptoms improve.

While most women with mastitis can successfully be treated on an outpatient basis with the methods mentioned above, hospital admission may be required if:

- You show signs of sepsis.
- Your infection progresses rapidly.
- You are immunocompromised.
- You have an underlying mass or [breast cancer](https://www.forbes.com/health/conditions/breast-cancer/early-signs-of-breast-cancer/) is suspected.
- A breast abscess is suspected.

### Can I Breastfeed While on Antibiotics for Mastitis?

ACOG guidance says yes, stating: “Women should be reassured that the antibiotics and anti-inflammatory medications used to treat mastitis are safe for their infants. Unless otherwise indicated, the patient should be encouraged to either continue breastfeeding her baby or to express her milk.”

Dr. Madden notes this recommendation is intended for babies who are full term.

“Recommendations vary for really small and fragile preemies or those in the PICU,” she says. “If a mom hasn’t been treated yet with antibiotics or isn’t far enough along into treatment, it might be a situation where we recommend not feeding the infant breast milk from the infected breast.” Your baby’s doctors will advise you on what’s best based on your situation.

## Mastitis Prevention

You might be asking yourself if there’s anything you can do to prevent mastitis from happening to you. “I think that’s the million-dollar question right now,” says Dr. Madden. “Like so many things, we definitely need more research, but there are some things we know that can predispose a new mother to the condition like a history of mastitis.” In other words, if you had it with your first baby, you’re at a greater risk of having it with your second. You’ll also want to:

- **Get help early from a certified lactation consultant.** It’s better to haveany problems with latching nipped in the bud early on to prevent engorgement, pain and nipple tearing. The International Lactation Consultant Association has a directory to help you [find those in your community](https://portal.ilca.org/i4a/memberDirectory/index.cfm?directory_id=19&pageID=4356) [who carry the I.B.C.L.C. credential](https://portal.ilca.org/i4a/memberDirectory/index.cfm?directory_id=19&pageID=4356).
- **Avoid tight bras or ones with an underwire.** These can restrict milk flow and increase your risk of forming a blocked milk duct.
- **Consider taking a probiotic.** We all have probiotics in our digestive systems, and some women may benefit from adding a supplement. Talk with your doctor, as there is emerging evidence that probiotics can help prevent mastitis.

## Discuss Any Feeding Concerns With Your Pediatrician

“Pediatricians are often the first to help new moms through the evaluation and diagnosis of breastfeeding problems and mastitis because they see them more,” says Dr. Madden. “There’s usually a six-week gap before a new mom’s first \[visit\] with her own medical provider after delivery, and those early weeks are when mastitis is most common.”

Bottom line: Never leave an office visit with your new baby without having all of your feeding questions and concerns addressed. And when in doubt, just call.

## Sources

### References

- [Benign Breast Conditions: Frequently Asked Questions.](https://www.acog.org/womens-health/faqs/benign-breast-problems-and-conditions) American College of Obstetricians and Gynecologists. Accessed 6/2/2021.

- Anderson L, Kynoch K, Kildea S, Lee N. [Effectiveness of breast massage for the treatment of women with breastfeeding problems: A systematic review.](https://journals.lww.com/jbisrir/Abstract/2019/08000/Effectiveness_of_breast_massage_for_the_treatment.14.aspx) JBI Database System Rev Implement Rep. 2019;17(8):1668-1694.

- Arroyo R, Martín V, Maldonado A, Jiménez E, Fernández L, Rodríguez JM. [Treatment of infectious mastitis during lactation: Antibiotics versus oral administration of Lactobacilli isolated from breast milk.](https://pubmed.ncbi.nlm.nih.gov/20455694/) Clin Infect Dis. 2010;50(12):1551-1558.

- Boakes E, Woods A, Johnson N, Kadoglou N. [Breast infection: A review of diagnosis and management practices.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092150/) Eur J Breast Health. 2018;14(3):136-143.

- [Breastfeeding Challenges: ACOG Committee Opinion, Number 820.](https://journals.lww.com/greenjournal/Fulltext/2021/02000/Breastfeeding_Challenges__ACOG_Committee_Opinion,.46.aspx) Obstet Gynecol. 2021;137(2):e42-e53.

- [Symptoms of COVID-19.](https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html) Centers for Disease Control and Prevention. Accessed 6/2/2021.

- [Information about COVID-19 Vaccines for People Who Are Pregnant or Breastfeeding.](https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html) Centers for Disease Control and Prevention.Accessed 6/2/2021.

- Dixon JM. [Lactational Mastitis.](https://www.uptodate.com/contents/lactational-mastitis) UpToDate. 2020.

- [Ibuprofen.](https://www.ncbi.nlm.nih.gov/books/NBK500986/) Drugs and Lactation Database (LactMed). National Library of Medicine (US). Accessed 6/2/2021.

- Geneva II, Cuzzo B, Fazili T, Javaid W. [Normal body temperature: A systematic review.](https://academic.oup.com/ofid/article/6/4/ofz032/5435701) Open Forum Infect Dis. 2019;6(4):ofz032.

- Jana LA, Shu J. [Heading Home with Your Newborn: From Birth to Reality. 4th Ed.](https://www.amazon.com/Heading-Home-Your-Newborn-Reality-ebook/dp/B083ZJFHSP) American Academy of Pediatrics; 2020.

- Jahanfar S, Ng CJ, Teng CL. [Antibiotics for mastitis in breastfeeding women.](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005458.pub2/full) Cochrane Database Syst Rev. 2009;(1):CD005458.

- Pevzner M, Dahan A. [Mastitis while breastfeeding: Prevention, the importance of proper treatment, and potential complications.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465810/) J Clin Med. 2020;9(8):2328.

- Rainard P, Foucras G. [A critical appraisal of probiotics for mastitis control.](https://www.frontiersin.org/articles/10.3389/fvets.2018.00251/full) Front Vet Sci. 2018;5:251.


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[Amanda Krupa](https://www.forbes.com/health/author/amanda-krupa/ "Amanda Krupa") Contributor

Amanda Krupa, M.Sc., has more than 15 years of public health communications and editorial leadership experience, including more than eight years as the editor of HealthyChildren.org at the American Academy of Pediatrics. Her work has appeared in numerous print and digital publications, including PBSKids for Parents, Business Insider, Parents, Verywell Health, What To Expect and BabyCenter. She has a masters of science in health communication from Boston University and a post-graduate certification in medical writing and editing from the University of Chicago. She’s the mother of three amazing children.


[![John Whitfield, M.D., F.A.C.O.G.](https://thumbor.forbes.com/thumbor/fit-in/64x64/https://www.forbes.com/health/wp-content/uploads/2021/06/John-Whitfield-scaled-e1623878466806.jpg)](https://www.forbes.com/health/medical-advisory-board/john-whitfield/ "John Whitfield, M.D., F.A.C.O.G.")

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Dr. John Whitfield is a board-certified gynecologist and the owner of private practice Signature GYN Services in Fort Worth, Texas. He has more than three decades of medical experience and has delivered over 2,000 babies to families in the Fort Worth area. He now focuses his practice exclusively on gynecology and gynecologic surgery, staying current with the latest medical research and developments. He is experienced in indications including endometriosis, uterine fibroids, menopausal symptoms, vaginitis, sterilization and anemia. Dr. Whitfield is also an active principal investigator with a demonstrated history of working in the clinical research industry, focusing on women's health care.


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