Mastitis affects around 1 in 5 breastfeeding women. The most important thing — and the most misunderstood — is that you should keep feeding. Here's what actually helps.
The most widespread piece of harmful advice about mastitis is to stop breastfeeding from the affected breast. This is wrong. Continuing to feed — or express — from the affected breast is the single most important thing you can do. Milk that stays in the breast makes the infection worse, not better.
Feeding may be uncomfortable. Feed anyway, or express if it is too painful to latch. Frequent milk removal is the treatment — not rest from feeding.
Mastitis starts as inflammatory mastitis — a blockage causing inflammation — and can progress to infectious mastitis where bacteria are involved. In the early stages, frequent feeding and warm compresses may resolve it without antibiotics.
If you have flu-like symptoms (fever, aching, shivering) alongside breast pain and redness, this indicates infectious mastitis and you need antibiotics promptly. Don't wait to see if it resolves. A 10–14 day course of antibiotics is typically prescribed — and you should complete the full course even when you feel better, to prevent recurrence.
Most mastitis develops because milk isn't being fully drained from part of the breast — usually because of poor latch or positioning allowing milk to pool in one area. A baby who isn't latching deeply, or who tends to feed on one side more comfortably than the other, creates conditions for blockage.
Recovering from mastitis without addressing the underlying feeding pattern often means it comes back. A lactation consultant or infant feeding specialist can assess your latch and positioning — this is worth asking for even if things feel 'fine.' Your health visitor or GP can refer you, or you can contact the National Breastfeeding Helpline on 0300 100 0212.
What helps: frequent feeding from the affected side, warmth before feeding (a warm flannel), gentle massage towards the nipple during feeding, ibuprofen (anti-inflammatory as well as pain relief — preferable to paracetamol for mastitis specifically), rest.
What doesn't help (and may harm): stopping feeding, aggressive massage between feeds (can worsen inflammation), tight bras, ice packs immediately after feeding (use warmth before, not cold after).
Most mastitis clears with antibiotics within 48–72 hours. If it hasn't improved after 3 days of antibiotics, go back. You may need a different antibiotic, or there may be an abscess forming.
A breast abscess — a pocket of infected fluid — develops in a small number of mastitis cases, more commonly when treatment was delayed or incomplete. Signs: a hard, painful, localised lump that doesn't improve on antibiotics, sometimes with visible redness and a fluctuant (fluid-filled) feel. An abscess needs drainage — usually by ultrasound-guided aspiration. You can and should continue breastfeeding throughout treatment.