How to Prevent Mastitis

Mastitis can make it difficult to breastfeed and may cause you pain and discomfort. Learn five ways to prevent mastitis. 

By OBGYN and fertility specialist Dr. Kenosha Gleaton

Breastfeeding can be a beautiful and rewarding experience to share with your baby, but it’s not always easy or pain free. It’s common for many breastfeeding moms to experience some sort of discomfort, whether it be sore nipples, cracked skin, clogged ducts, or mastitis. Fortunately, there are some things you can do to try and prevent mastitis from happening. 

What’s mastitis?

Mastitis is an inflammation of the breast tissue. Inflammation refers to a swollen, warm, red, and often painful bodily reaction that happens as a result of injury or infection. There are a few types of mastitis, including lactational mastitis (the kind that happens while breastfeeding) and non-lactational mastitis [1]. Globally, lactational mastitis is seen in up to 30% of those breastfeeding [1]. Mastitis is most likely to occur in the first few weeks postpartum, but may occur at any time during lactation. 

What causes mastitis?

Milk stasis, AKA the buildup of milk, is the primary initiating factor of mastitis [2]. Milk may build up in the breast if there is a blocked duct, if milk is not expressed in a timely manner, if the duration of breastfeeding is cut short, if the baby latches incorrectly while breastfeeding, if there is an overproduction of milk, and various other factors [2]. Once there is a build up of milk, pressure is put on the milk ducts and the breasts begin to swell. This also gives bacteria an opportunity to grow and may lead to bacterial mastitis [3]. Bacterial mastitis may also be caused by bacteria entering the breast from cracked skin. If you’re experiencing sore, dry, or cracked nipples, you may benefit from using a nipple balm. Natalist Nip & Lip Balm is safe for use while breastfeeding. 

What does mastitis feel like?

Mastitis makes the breast tissue inflamed and painful. It’s common to notice swelling, hardening, warmth, redness, and pain around the breast. Pain may last only while breastfeeding or may be ongoing. You may also have flu-like symptoms such as a fever and chills [2]. Mastitis typically only affects one breast, but it’s possible to have mastitis in both breasts. 

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Preventing Mastitis

The best way to prevent mastitis is to ensure regular and correct breastfeeding or pumping techniques. It’s important that your baby has a good latch when breastfeeding, such as ensuring the whole nipple and part of the areola is in their mouth. If your baby has tongue-tie or a high palate, they may have a harder time latching properly [4]. It’s also important you are using your breast pump correctly. If you’re having trouble with breastfeeding or pumping, you may want to consider speaking with a lactation consultant. 

Try to drain your breasts frequently. Avoid long gaps in between feeds and encourage feeding when you can feel your breasts are getting full. It’s best to fully drain the milk from one breast before switching to the other [6]. If you’re hoping to start weaning, make sure you speak to your healthcare provider about appropriate ways to wean and dry up breast milk. You also want to reduce pressure on the breasts, which means avoiding tight clothing and bras. Supportive bras should be comfortable without adding too much pressure. 

To summarize, here are five tips to help you prevent mastitis:

1. Fully drain your breasts when feeding, pumping, or expressing by hand. 

2. Fully drain one breast before switching to the other. 

3. Ensure that position and latch are effective while breastfeeding.

4. Avoid long gaps in between feedings; hand express or pump when necessary.

5. Avoid wearing tight clothing or bras. 

You may be at a higher risk of getting mastitis if you have a history of mastitis, leave a clogged duct untreated, have cracked or sore nipples, or if you smoke cigarettes [4]. Find more tips for breastfeeding education on the Natalist blog. 

Breastfeeding best practices

Breastfeeding has its pros and cons, but if possible, the American College of Obstetrics and Gynecology (ACOG) recommends that you attempt to breastfeed for six months postpartum. Breastfeeding may reduce the risk of many short-term and long-term health problems, provide health benefits to your baby, and potentially reduce the risk of breast cancer and ovarian cancer [5]. 

While breastfeeding, it’s vital that you up your caloric intake to support breast milk production and your overall health. ACOG recommends you consume an additional 450 to 500 calories a day [5]. You should also be drinking plenty of fluids to stay hydrated. Adequate water intake supports breast milk production and the electrolytes in water help your body function properly. 

Speak with your healthcare provider about their specific recommendations for medication use, but you may also benefit from taking a postnatal vitamin to support breast milk quality and overall health. 

Key Takeaways

• Mastitis is a painful condition that usually occurs from breastfeeding and is seen in up to 30% of breastfeeding individuals.

• Symptoms of mastitis include red, swollen, painful breast tissue and in some cases, flu-like symptoms.

• Mastitis is often caused by a buildup of milk in the breast. This can be caused by a clogged duct, long gaps in between feedings, and other factors.

• Mastitis may also be caused by bacteria. Bacteria may enter the body through cracked skin around the nipples or may grow inside the breast from stagnant breast milk. 

• The best way to prevent mastitis is to empty the breasts completely when breastfeeding or pumping. Hand expressing milk is also recommended if breasts become extremely full. 

• Avoid tight clothing and bras to prevent additional pressure on the milk ducts. 

• Other ways to support your body while breastfeeding include eating additional calories, staying hydrated, and taking a postnatal vitamin. 

References:

1. Blackmon MM, Nguyen H, Mukherji P. Acute Mastitis. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.

2. Pevzner M, Dahan A. Mastitis While Breastfeeding: Prevention, the Importance of Proper Treatment, and Potential Complications. J Clin Med. 2020;9(8):2328. Published 2020 Jul 22. doi:10.3390/jcm9082328

3. Abou-Dakn M, Richardt A, Schaefer-Graf U, Wöckel A. Inflammatory Breast Diseases during Lactation: Milk Stasis, Puerperal Mastitis, Abscesses of the Breast, and Malignant Tumors - Current and Evidence-Based Strategies for Diagnosis and Therapy. Breast Care (Basel). 2010;5(1):33-37. doi:10.1159/000272223

4. Committee on Obstetric Practice & Breastfeeding Expert Work Group. Breastfeeding Challenges. ACOG. February 2021. URL. 

5. Breastfeeding Your Baby. American College of Obstetricians and Gynecologists. Updated May 2021. Accessed March 3, 2023. URL. 

6. Mastitis. Mayo Clinic. September 2022. Accessed March 3 2023. URL.