Mastitis

Mastitis

What is Mastitis?

Mastitis is inflammation of the breast tissue and milk ducts.

The inflammation is the result of milk flowing backwards through the ducts and into the breast tissue. This is due to an increase in pressure in the milk ducts. Breast milk contains protein, and when the milk enters the breast tissue, this protein is recognised as "foreign" and an inflammatory response occurs in the tissue.

Milk ducts are very easily squashed, or a duct may become blocked due to the pressure from swelling in the surrounding tissue.

Milk is "let-down" - ejected from the breast ducts when the baby first suckles.

Your baby sucks strongly and quickly first, then slows to a more gently, slow suckle. This creates back pressure behind the nipple and ducts and milk is forced into the breast tissue around the milk ducts, causing swelling and other symptoms.

Signs and symptoms?

  • Pain/discomfort in your breasts
  • Swelling, firmness or redness in your breasts
  • Sore nipples and breasts
  • Reduced milk production
  • Fever
  • Fatigue, aching joints and limbs, headache and generally feeling unwell


These are all the signs of inflammation and infection


Common causes of mastitis?

  • Interrupted or erratic breastfeeding
  • Sudden changes in your baby's feeding (baby sleeps longer overnight, oversupply, weather)
  • Skipping feeds
  • Suckling replaced by bottles or pacifiers
  • Finger compression
  • Tight garments, bras
  • Sleeping on your stomach

What you can do?

Breastfeeding should not hurt. Your aim is for successful positioning and attachment. If you suspect you are suffering an episode of mastitis, some suggestions to try include:

  • Feed on demand/as normal if this is possible without pain
  • Try offering the affected breast first - suckling is strongest at the beginning of a feed
  • If latching is painful, break your baby's suction and re-attach by slipping your little finger under your baby's lips
  • Apply warmth before feeding (a warm shower or flannel)
  • Apply cold or ice packs every 1-2 hours for 10-15 minutes to help with pain and swelling
  • Massage lightly (use as much pressure as you would to stroke a cat or dog) towards your armpit to encourage lymph and venous drainage
  • Rest is essential for your recovery, for 4-5 days, put your feet up and minimise any activity you do, including household chores, cooking, shopping, exercising and entertaining visitors
  • Avoid wearing tight bras, tops or breast pads - these compress the milk ducts and cause milk to leak into surrounding tissue, try a maternity singlet instead

FAQ'S

Can I still feed off my affected breast?

Yes you can, provided you can do so without pain. If you are unable to, seek some ultrasound treatment and then you should find your baby feeds more readily off your affected breast with reduced / or no pain.


Should I express in-between feeds?

No research currently supports expressing more frequently to resolve mastitis. If you choose to express, be gently and STOP as soon as your pain and pressure is relieved.


When should I seek help?

As soon as you start noticing symptoms and any changes in your breasts, e.g. pain, swelling, redness or fever, you should make an appointment as soon as possible, preferable on the same day. If treated early, mastitis can usually be resolved quickly, and you can return to breastfeeding normally without pain.


How can we help?


Physiotherapy for mastitis?

Physiotherapy treatments for mastitis may include:


Therapeutic Ultrasound to reduce tissue inflammation and pain and promote accelerated healing in your breasts. This delivers sound waves to deeper tissues. Healing effects are due to vibration within the cells and in and across the cell membrane. The Micro-massage effect loosens cell structure to aid the re-absorbing of fluid trapped in the breast.


Cold Laser Therapy is light energy that stimulates cells to work more efficiently. Light promotes healing, and reduces inflammation and pain. Cold laser is not painful, with the maximum benefit felt 24 hours after laser treatment. Laser speeds healing of nipple damage.


Massage techniques will be explained to you to encourage lymphatic drainage from the affected breast. Use featherlight strokes away from the nipple towards the "bony areas" of the chest and the armpit.



Other breast conditions

If you are experiencing any of the following conditions, please seek assistance immediately.


Vasospasm is nipple pain that is intense and sharp. Your nipple changes colour rapidly from white, pink, red, blue, and purple. Stay warm to feed your baby and seek help.


Nipple Trauma occurs when your baby latches onto the nipple rather than your breast and the pressure causes grazes or tissues.


Bleb / Milk blister is a small blister on the nipple surface that becomes very painful.

Related Blogs

By Kylie Conway October 12, 2025
Understanding Mastitis & How Physiotherapy Can Help Mastitis is one of the most common challenges faced by breastfeeding women — and it can be incredibly painful and distressing. But the good news? With the right support and early intervention, recovery is usually quick, and breastfeeding can continue comfortably. What Is Mastitis? Mastitis is inflammation of the breast tissue, often caused by milk not draining properly (known as milk stasis). When milk remains trapped, it can irritate the tissue and lead to swelling, pain, and sometimes infection. Common signs and symptoms include: Localised breast pain, tenderness, or burning A firm, red, or hot area on the breast Swelling or lumpiness Fever, chills, and flu-like symptoms Feeling generally unwell or fatigued It’s important to seek help early — untreated mastitis can worsen quickly and may require medical treatment such as antibiotics. How Physiotherapy & Ultrasound Therapy Can Help Many people are surprised to learn that women’s health physiotherapists can play an important role in managing mastitis. Alongside medical care and lactation support, physiotherapy can help reduce pain, inflammation, and improve milk flow — especially when using therapeutic ultrasound. What Is Therapeutic Ultrasound? Therapeutic ultrasound uses gentle sound waves to help soften and disperse blockages within the breast tissue. The treatment is non-invasive, painless, and supported by evidence for its role in improving symptoms and promoting recovery. Ultrasound therapy can help to: Break down blocked ducts Reduce inflammation and swelling Improve milk drainage and flow Relieve pain and discomfort Support faster healing Sessions are typically short and safe to continue while breastfeeding. Beyond Ultrasound: Comprehensive Care At your physiotherapy appointment, we’ll do more than just treat the symptoms. We’ll look at the whole picture — what may have contributed to the blockage, and how to reduce the risk of it happening again. This may include: Reviewing your feeding or pumping techniques Recommending gentle self-massage and drainage methods Providing positioning advice for better milk flow Teaching preventative strategies for future episodes Every treatment plan is tailored individually — because every feeding journey is different. When to See Your GP If you experience fever, chills, or flu-like symptoms, or if your symptoms do not improve within 24–48 hours of treatment, it’s important to see your GP. Antibiotics may be needed alongside physiotherapy. The Takeaway Mastitis can be painful — both physically and emotionally — but it’s also very treatable. Early intervention and the right combination of care from your GP, lactation consultant, and women’s health physio can make a world of difference. Ultrasound therapy is a safe, gentle, and effective part of that recovery — helping you get back to feeding comfortably, confidently, and pain-free.
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