How new mothers can recognise and prevent mastitis

Posted on 31 January 2018

Mastitis is the often-painful infection of the breast caused by a clogged duct in the nipple of a breastfeeding mother. Mediclinic Vergelegen gynaecologist and obstetrician, Dr Ludwig van Zyl, advises on prevention and treatment.

Mastitis refers to any infection of the breast tissue. The infection is normally accompanied by redness and swelling in the breast, but also tenderness and fever similar to flu symptoms.


Dr van Zyl says there are two main symptoms of mastitis in lactating women:

  1. Inflammation
  2. Swelling

He explains that it usually stems from engorged breasts – when the flow of breast milk hasn’t been established properly.

Engorgement is when the fullness of the breast that occurs during the first few days after giving birth does not dissipate after two to three weeks of breastfeeding. Instead, if the breasts throb, are hard and lumpy, or feel uncomfortable or painfully full, they are likely engorged.

Unrelieved engorged breasts can lead to mastitis (infection), but also low milk supply, or a breast abscess.

Infection of the breast may also occur from bacteria entering the ducts from the outside through a cracked nipple.

Mastitis, when it occurs, is commonly reported during the first three months of breastfeeding but, like engorgement, it does not affect all women who breastfeed. It can also occur when it is time to wean.

‘If breastfeeding is well-established, there’s a good flow of milk, and the mother breastfeeds regularly, it’s usually not an issue,’ says Dr van Zyl.

Diagnosis and Treatment

Not all cases of mastitis involve significant pain. Other symptoms to look out for include:

  • Redness on the breast that may be painful to touch
  • Engorged breasts
  • Fever
  • Chills and body aches
  • Fatigue

An antibiotic may be prescribed but it’s not always necessary.

‘Most mothers can get their milk flowing again if they apply heat or just have warm water running over the breast,’ says Dr van Zyl. He also recommends physiotherapy that involves massaging the breast and/or ultrasound to decrease swelling and promote milk flow.

He assures patients that cabbage leaves are not an old wives’ tale. ‘For some patients, it really works well. Cool cabbage leaves inside a bra can bring relief.’

Preventative measures

Breastfeeding mothers can help avoid mastitis by:

  • Avoiding tight bras or constricting clothing
  • Not sleeping on your stomach
  • Regularly feeding your baby breast milk (missed feeds or not emptying the breasts can cause engorgement)
  • Breast compression or massage before latching
  • Using a breastfeeding pillow to maintain a good feeding position

As Dr van Zyl concludes, ‘You must establish good flow and feed regularly. If you see early signs of mastitis you need to seek help.’

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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