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Conditions
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How to Prevent and Treat Mastitis

January 14, 2021
Fact checked
Written by Deirdre Bell
Medically reviewed by
Dr. Holly Lucille, ND, RN
  1. Wellness blog
  2. How to Prevent and Treat Mastitis

Becoming a new mom is a time filled with joy, but this transition also often comes with a number of challenges. From experiencing sleepless nights, adapting to body changes, and reacting to the constant demands of a newborn, the postpartum period can take a toll on any new mother. For those who chose to breastfeed, there can be some difficulties with timing or the baby attaching, but developing a breast infection known as mastitis can turn even the most positive breastfeeding experience into misery.

Unfortunately, mastitis in women is very common—affecting up to one in five nursing moms. (1) But the good news is that there are effective ways to prevent mastitis and several home remedies for mastitis that can help you address the condition should it occur.

In this article, we’ll define mastitis, discuss how to avoid mastitis, and explore some of the more effective mastitis remedies.

What is mastitis?

Breast mastitis is inflammation of the breast, often occurring as a result of a blocked or clogged milk duct, with or without the presence of an infection. It usually occurs within the first six weeks of breastfeeding, but it can happen at any time. (1) Mastitis symptoms include:

  • Body aches
  • Chills
  • Fever
  • Hot, tender, swollen breast tissue (1)

In about 3% of women with mastitis, an abscess can also form. If you have an area of your breast that is hard, red, and painful even after treatment, you might have an abscess. (2)

If you have any of these signs of mastitis, it’s important to contact your healthcare provider for treatment and address the inflammation as soon as possible.

What causes mastitis?

Mastitis causes are not entirely clear, but the condition generally starts with a clogged milk duct. The following factors increase the risk of clogged ducts and, therefore, mastitis:

  • Cessation of breastfeeding abruptly
  • Damage to the nipple
  • Excess milk production
  • Illness in mother or infant
  • Milk blister on the nipple
  • Problems with latch that make it harder for the baby to fully drain the milk ducts
  • Skipped, infrequent, or short feedings
  • Stress or fatigue
  • Too-tight bras (1)

Mastitis can also be associated with a Candida albicans yeast infection. If you experience a burning sensation or pain in your nipple(s) or pain that radiates through your breast, you may have a Candida infection. This is typically treated with antifungal agents. (1)

While some of these factors are outside of your control, fortunately, you do have control of some contributing factors, and that’s key in mastitis prevention.

Woman holding baby
Mastitis, a condition characterized by inflammation of the best, affects up to one in five nursing mothers.

How to prevent mastitis

If you want to know how to avoid mastitis, it all starts with avoiding as many of the risk factors as you can. It’s also important to recognize the early signs of mastitis listed above, so you can take the following measures to prevent a full-fledged case of mastitis.

Master the latch.

If you and your baby have any trouble with your latch, contact your healthcare professional or a lactation consultant for guidance. Improper latch can lead to clogged ducts, which in turn can lead to mastitis. (1)

Don’t restrict feeding.

A study published in the journal American Family Physician identified missed feedings as a risk factor for mastitis. The study also noted that the development of the condition is believed to be partly attributed to incomplete feeding or removal of breast milk. (15) As a result, it may be recommended to feed your baby when he or she is hungry, not according to a schedule. (1)

Learn to hand-express milk.

When your breasts are too full for your baby to latch properly, or when you’re still feeling full after a feeding, you can hand-express or use a breast pump to relieve the pressure and prevent clogged ducts. (1)

Get enough rest.

“Enough rest” sounds almost laughable when you’re a new mom, but being overtired can increase your risk of mastitis. (1) Rely on help from others as much as you can and follow the old “sleep when the baby sleeps” adage to avoid burnout—and breast mastitis.

Practice good hygiene.

Staphylococcus aureus is a bacteria that can contribute to mastitis, and proper hygiene can help keep it at bay. Wash all your breast pump parts according to manufacturer’s instructions and maintain good hygiene in general. (1)

Recognize the early signs of mastitis.

Keep an eye out for pain, redness, or lumps in your breast. These can all be signs that milk is not flowing freely. If you notice any of those signs, start feeding more frequently, massage any areas that feel too firm or hard, and apply heat to your breasts before nursing. (1)

How to treat mastitis

Even the most dedicated breastfeeding moms will have their resolve tested by a persistent case of mastitis. But before you give up on breastfeeding, stopping abruptly can actually make your mastitis worse since keeping milk flowing through the ducts is one of the most effective aspects of mastitis treatment. (1)

If the condition progresses and/or your symptoms persist after 12 to 24 hours, your healthcare provider may also recommend anti-inflammatories to reduce pain and help with the let-down reflex (the process that triggers milk to flow to your nipples). In addition, they may prescribe breastfeeding-safe antibiotics to quell the infection. (1)

Some natural remedies exist for mastitis as well, with different amounts of research supporting their use. Probiotics are among the better-researched natural options.

Pregnant woman drinking a glass of water
Certain strains of probiotics may help reduce the risk of mastitis.

Probiotics for mastitis

Antibiotics are sometimes necessary for mastitis, but many women are concerned about taking them, especially while breastfeeding. While certain antibiotics are considered safe for nursing mothers, they do increase the risk of Candida albicans overgrowth, which can result in yeast and breast infections. (9)(1) Those concerns lead many women to look for natural remedies for mastitis.

One popular mastitis natural treatment is probiotics. Probiotics are live microorganisms that when consumed benefit the host. (10) Many different strains of probiotics exist, and they all behave differently in the body. (3) But scientists have identified certain species that may be beneficial for moms and babies.

One study found that in women with mastitis, two particular probiotic strains—Lactobacillus fermentum and Lactobacillus salivarius—were associated with less pain and a lower risk of recurrence of mastitis compared to antibiotics. (4)

Another study found that when pregnant women with a history of mastitis received Lactobacillus salivarius PS2 (a different strain than the one used in the previous study) late in pregnancy, they had a reduced risk of mastitis in the first few months of breastfeeding. (7) Similarly, another study found that taking Lactobacillus fermentum CECT5716 once a day for the first 16 weeks postpartum resulted in a 51% lower incidence of mastitis. (11)

A number of other studies are still being conducted to examine how probiotics might help prevent or treat mastitis. Still, skeptics warn that the research on probiotics for mastitis is far from conclusive due to problems with the design of the studies that have been previously published. They also note that since each strain of probiotic behaves differently, it can not be assumed that one probiotic will have the same effects on mastitis as another. (3) While probiotics are low risk and certain strains may benefit breastfeeding moms, more evidence is needed to determine whether they can effectively and consistently address mastitis.

Other natural treatments for mastitis

Research on other natural treatments for mastitis isn’t as robust and is often conducted on animals, specifically dairy cows. You might come across the following recommendations when you’re researching or talking to other moms, so it’s important to understand the evidence supporting or disputing the use of various treatments and preventative measures.

Lecithin

Lecithin is a natural component of breastmilk. It’s sometimes recommended as a supplement for preventing blocked milk ducts and preventing or addressing mastitis. (14)(13) However, no scientific studies to date have verified its usefulness. (5)

Omega-3 fatty acids

Since mastitis involves inflammation of the breast tissue, it has also been suggested that omega-3 fatty acids, such as those found in fatty fish, may be beneficial due to their anti-inflammatory properties. While this remains to be confirmed in humans, one animal study found that supplementing with omega-3 fatty acids appeared to reduce breast inflammation. (12)

Cabbage leaves

When applied directly to painful, engorged breasts, chilled cabbage leaves are a safe, inexpensive, and natural source of relief. One study compared the use of chilled cabbage leaves and hot compresses in breastfeeding mothers and found that both options safely reduced pain and engorgement. Engorgement, if not resolved, may lead to blocked milk ducts and possibly mastitis. (6)

Essential oils

Some animal and in vitro research suggests that certain essential oils may be useful in treating or preventing mastitis. One study suggests that tea tree oil may inhibit inflammation in cows with mastitis. (16) Another in vitro study found that essential oils of marjoram, thyme, oregano, mint, and garlic may be helpful in preventing mastitis, an effect that may be attributed to their antifungal properties. (8) Since the study was conducted in vitro, more research is needed to determine appropriate application methods and the effectiveness of these interventions in women.

The bottom line

Mastitis can be discouraging for new moms, but the good news is that there are effective preventative measures and treatment options. While a number of natural remedies for mastitis have been proposed, more research is needed to confirm their effectiveness in women. Additionally, research indicates that it’s safe to continue to breastfeed during a bout of mastitis. There’s no evidence to date indicating that breastfeeding through a mastitis episode poses any risk to healthy infants, and keeping your milk flowing is key to keeping mastitis at bay. (17)

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References
  1. Amir, L. H. (2014). ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeeding Medicine, 9(5), 239–243. https://doi.org/10.1089/bfm.2014.9984
  2. Amir, L. H., Forster, D., McLachlan, H., & Lumley, J. (2004). Incidence of breast abscess in lactating women: report from an Australian cohort. BJOG: An International Journal of Obstetrics and Gynaecology, 111(12), 1378–1381. https://doi.org/10.1111/j.1471-0528.2004.00272.x
  3. Amir, L. H., Griffin, L., Cullinane, M., & Garland, S. M. (2016). Probiotics and mastitis: evidence-based marketing? International Breastfeeding Journal, 11(1). https://doi.org/10.1186/s13006-016-0078-5
  4. Arroyo, R., Martín, V., Maldonado, A., Jiménez, E., Fernández, L., & Rodríguez, J. M. (2010). Treatment of infectious mastitis during lactation: antibiotics versus oral administration of lactobacilli isolated from breast milk. Clinical Infectious Diseases, 50(12), 1551–1558. https://doi.org/10.1086/652763
  5. Drugs and Lactation Database (LactMed) . Bethesda (MD): National Library of Medicine (US); 2006-. Lecithin. . Available from: https://www.ncbi.nlm.nih.gov/books/NBK501772/
  6. Effect of chilled cabbage leaves vs. hot compression on brest engorgement among post natal mothers admitted in a tertiary care Hospital. | nursing midwifery research. (n.d.). Nursing Research Forum. https://nrfninechd.com/effect-of-chilled-cabbage-leaves-vs-hot-compression-on-brest-engorgement-among-post-natal-mothers-admitted-in-a-tertiary-care-hospital/
  7. Fernández, L., Cárdenas, N., Arroyo, R., Manzano, S., Jiménez, E., Martín, V., & Rodríguez, J. M. (2015). Prevention of infectious mastitis by oral administration of lactobacillus salivarius PS2 during late pregnancy. Clinical Infectious Diseases, 62(5), 568–573. https://doi.org/10.1093/cid/civ974
  8. Grzesiak, B., Kołodziej, B., Głowacka, A., & Krukowski, H. (2018). The effect of some natural essential oils against bovine mastitis caused by prototheca zopfii isolates in vitro. Mycopathologia, 183(3), 541–550. https://doi.org/10.1007/s11046-018-0246-9
  9. Gutierrez, D., Weinstock, A., Antharam, V. C., Gu, H., Jasbi, P., Shi, X., Dirks, B., Krajmalnik-Brown, R., Maldonado, J., Guinan, J., & Thangamani, S. (2019). Antibiotic-induced gut metabolome and microbiome alterations increase the susceptibility to Candida albicans colonization in the gastrointestinal tract. FEMS Microbiology Ecology, 96(1). https://doi.org/10.1093/femsec/fiz187
  10. Hickey, L., Jacobs, S. E., & Garland, S. M. (2012). Probiotics in neonatology. Journal of Paediatrics and Child Health, 48(9), 777–783. https://doi.org/10.1111/j.1440-1754.2012.02508.x
  11. Hurtado, J. A., Maldonado-Lobón, J. A., Díaz-Ropero, M. P., Flores-Rojas, K., Uberos, J., Leante, J. L., Affumicato, L., Couce, M. L., Garrido, J. M., Olivares, M., Fonollá, J., & the PROLAC Group. (2017). Oral administration to nursing women of lactobacillus fermentum CECT5716 prevents lactational mastitis development: a randomized controlled trial. Breastfeeding Medicine, 12(4), 202–209. https://doi.org/10.1089/bfm.2016.0173
  12. Lin, S., Hou, J., Xiang, F., Zhang, X., Che, L., Lin, Y., Xu, S., Tian, G., Zeng, Q., Yu, B., Zhang, K., Chen, D., Wu, D., & Fang, Z. (2013). Mammary inflammation around parturition appeared to be attenuated by consumption of fish oil rich in n-3 polyunsaturated fatty acids. Lipids in Health and Disease, 12(1), 190. https://doi.org/10.1186/1476-511x-12-190
  13. Mastitis. (2020, August 7). La Leche League International. https://www.llli.org/breastfeeding-info/mastitis/
  14. Scott, C. R. (2005). Lecithin: it isn’t just for plugged milk ducts and mastitis anymore. Midwifery Today Int Midwife, Winter(76), 26–27. https://pubmed.ncbi.nlm.nih.gov/16419666/
  15. Spencer, J. P. (2008, September 15). Management of Mastitis in Breastfeeding Women. American Family Physician. https://www.aafp.org/afp/2008/0915/p727.html
  16. Taga I, Lan CQ, Altosaar I. Plant essential oils and mastitis disease: their potential inhibitory effects on pro-inflammatory cytokine production in response to bacteria related inflammation. Nat Prod Commun. 2012 May;7(5):675-82. PMID: 22799106.
  17. World Health Organization. (2000). Mastitis: causes and management (No. WHO/FCH/CAH/00.13). World Health Organization.

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The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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