Breastfeeding can come with some discomforts and inconveniences, such as cracked nipples, engorgement, or even mastitis . It is characterized by painful breast inflammation and usually occurs early after your baby's birth. It is uncomfortable but harmless; we’re here to help you understand it better.

What is mastitis?

Mastitis is a breast inflammation in mothers during breastfeeding . It can develop into an infection. It is mainly caused by a slowdown or stoppage of breast milk flow (stasis), engorgement, poor drainage, or inflammation. It occurs primarily during the first six months of breastfeeding, and especially within the first three weeks after your baby's birth.

What are the different symptoms of mastitis?

In most cases, mastitis is inflammatory and is caused by overuse of the milk ducts. In some cases, it can be infectious, meaning that bacteria have developed in the ducts.

Inflammatory mastitis

If you have a very red, swollen, hard, and hot breast, it is highly likely that you have mastitis. It is painful and can interfere with breastfeeding sessions with your baby. When mastitis is inflammatory, it can sometimes be accompanied by a fever. Therefore, we can only advise you to consult your preferred healthcare professional (midwife, doctor, or gynecologist), especially if it lasts more than a few days. Often, inflammatory mastitis resolves in a few days , as the duct returns to normal and your baby is able to properly drain the milk from your breast.

Infectious mastitis

After several days, if the symptoms are still present and you have a fever, it is likely that the inflammation in your breast has turned into an infection. This is a complication of inflammatory mastitis . It may take a little longer to settle, but don’t worry—things usually return to normal quickly.

Other pathologies related to breastfeeding

During breastfeeding, it’s not uncommon to encounter other minor issues. Some can be confused with mastitis, and others are directly related to it:

• Breast abscess can develop if treatment for mastitis is delayed. If, after one week of antibiotic treatment, the symptoms of mastitis are still present, it is advisable to check for an abscess. It is a painful, inflamed lump that can cause fever.

• The milk bottle , which may or may not be associated with a blocked duct. It is a lump (yes, like the one on your feet) at the end of the nipple. It is painful and may be accompanied by fever. It can rupture and unblock the duct.

• The congestion , when milk is poorly drained for any reason, which can lead to inflammation and, in turn, mastitis.

• The cracks , which are skin lesions on the nipple. They can be caused by friction and stretching, or by an infection. They often appear at the beginning of breastfeeding.

What are the causes of mastitis during breastfeeding?

Mastitis is most often caused by poor milk drainage for various reasons. It can also be related to the mother’s lifestyle. But sometimes, despite all precautions, mastitis still occurs.

Insufficient breast drainage

When your baby suckles, they drain milk from your breast. That’s why, if they don’t nurse for as long as usual, you may feel that your breasts are swollen and painful. Mastitis can be caused by inadequate drainage , and there are several reasons for this.

Mauvais positionnement de bébé à la tétée

Your little one’s positioning during breastfeeding is essential. It can reduce the risk of engorgement and potential mastitis. If your baby is not in the correct position, their latch will be less effective. That’s why it’s also helpful to check that their face is well aligned, that they take the entire nipple into their mouth, and that they make large sucking movements. If you notice they are swallowing less, you can stimulate their cheek to encourage active sucking.

If, despite this, you feel that your baby is having difficulty nursing, do not hesitate to consult a lactation expert (IBLC, which certifies a certain level of training) or a healthcare professional trained in breastfeeding. They can check whether your little explorer has a tongue-tie issue. This is quite common, and your baby may have more difficulty breastfeeding, and therefore draining milk from your breast correctly.

Insuffisance des tétées

This one, you’re not going to like. If your baby sleeps through the night and doesn’t nurse, you might wake up the next day with horrible breast pain. Technically, a breastfed baby needs to feed more regularly than a bottle-fed baby, because breast milk is much more digestible. If your baby has not breastfed for several hours, your breasts will become engorged, and the risk of mastitis increases.

The same applies if you introduce a bottle, for example; your body will continue to produce the milk it is used to producing, but it will not be consumed by your little one. The same goes for weaning too quickly. Sometimes, a baby will also prefer one breast over the other, which will affect drainage.

Hyperlactation

Hyperlactation—that is, excessive milk production compared with your child’s needs—can lead to blocked milk ducts and therefore a higher risk of mastitis.

Écoulement gêné du lait

Milk flow can be hindered by blocked ducts for various reasons, but also by external factors such as breast compression. This compression has three main causes:

• an overly tight bra;

• sleeping on your stomach at night;

• bits of breast.

The other trigger elements

Other factors can cause mastitis , directly or indirectly. Cracks, for example, increase the risk of bacterial infection and therefore infectious mastitis. Nipple mycoses also increase the risk. Moreover, taking certain medications, such as antibiotics, can also be a contributing factor.

Your overall health and lifestyle habits can affect mastitis. Severe fatigue, anxiety, or certain illnesses such as diabetes and anemia increase the risk of mastitis.

If you have a history of issues related to breastfeeding—engorgement, mastitis, blocked ducts—there is unfortunately a higher chance of developing mastitis.

What are the treatments to combat mastitis?

We will always advise you to prioritize natural treatments when it comes to breastfeeding. In the case of mastitis, if it is inflammatory, that is usually sufficient. If it becomes infectious, you will probably need to turn to medication.

Natural treatments to fight mastitis

The first treatment to fight against mastitis is drainage . The more your baby suckles, or the more you extract your milk , the better your chances of getting rid of the inflammation. If breastfeeding alone is not enough, you can also use a breast pump or perform manual expression to relieve your sore breasts.

Applying heat can also help, as the ducts will dilate and make milk flow easier. You can do this beforehand, but also during breastfeeding. Remember to rest, as it is essential for healing in many cases.

Medication treatments to combat mastitis

If your pain is too intense, a doctor can prescribe painkillers that are suitable for breastfeeding , such as Ibuprofen. This can be done from the very beginning of mastitis. Above all, don’t suffer in silence—talk about it.

When mastitis lasts at least a week, it is likely an infection, and your doctor may prescribe antibiotics that work quickly. Continue the treatment until the end; otherwise, recurrences are common.

It’s true that inconveniences such as mastitis are not enjoyable.
But it can disappear easily if you stay vigilant.
Listen to yourself, take care of yourself . Breastfeeding is a special bond with your little one; if you feel like continuing, do so. And if not, that’s okay too.