Mastitis / Breast Inflammation


Hi everyone! I’m Mary, an international board certified lactation consultant (IBCLC) in the Stuttgart area.
I’m excited to be a new member of the awesome Gravidamiga team.
I’m here today to share some info that will hopefully help you on your breastfeeding journey.

One of my favorite times to meet with new parents is during pregnancy; prenatal education is so key to feeling prepared for breastfeeding. We often start our discussion with what is already known about breastfeeding and any concerns.
A common concern among many new parents is mastitis. Soon-to-be parents have heard the horror stories of painful, hard breasts and they are downright scared.
I’m here to tell you today that information is power and the mastitis monster doesn’t have to be scary.
Today’s blog is meant to empower and prepare you for healthy, pain-free breastfeeding and NO mastitis.


Simply put mastitis is breast inflammation. Mast means breast and itis means inflammation.
Symptoms usually include hot, hard breasts, decreased milk flow, fever, chills and breast pain.
Mastitis often occurs when milk stops flowing freely from the breast and inflammation and often infection develops.
During lactation the blood flow to your breasts is increased, milk ducts proliferate (grow), and you have an increase in, well, milk. That’s a lot of fluid and tissue in your breasts. It’s with this setting that by virtue of lactating you are at an increased risk of mastitis, but fear not because mastitis is not a given during breastfeeding and you *can* avoid it altogether.


The key to avoiding the mastitis monster is frequent milk removal, good breast hygiene, and breast movement. Let’s talk a little about each one.


In the early weeks of breastfeeding, babies need to feed quite frequently. They may “cluster feed” wanting to come to the breast every hour for several hours before finally taking a short nap. In fact, for the first several months babies will nurse about 8-12 times in 24 hours. This frequent feeding keeps them growing and thriving, and is great for your milk supply and breast health. It is also common for babies to continue to feed 6-8 times in 24 hours up until one year of age and beyond. This transition to fewer feeds and longer sleep periods at night can mean longer periods between breast milk removal.
A good tip
If your breasts are engorged and uncomfortable during these times, a session of light hand expression just to comfort, can help keep the milk flowing and therefore keep the mastitis monster at bay.


Breast hygiene during breastfeeding is actually quite simple. During your pregnancy you may notice prominent bumps on your areolas as your breasts grow and darken. These bumps are actually called Montgomery glands. They are sebaceous or oil-producing and keep your breast area clean and moist; pretty amazing, right?! While you don’t need special soaps to further clean the breast or nipple area, it is recommended that any open cuts on the nipple be washed with warm soapy water and treated to encourage healing so as to not become a vector for bacteria introduction to the breast. If you experience bleeding or abrasions on the nipple or breast during lactation, a special nipple ointment with lanolin (e.g. Lansinoh or Medela Purelan) or compresses from e.g. Multimam can help or speak to a lactation professional or your midwife.


You’ve likely heard of yoga or gymnastics for limber muscles and increased range of motion, right? This type of movement is also good for your breasts during breastfeeding. Remember what we said in the beginning about increased fluid and tissue in the breasts? It’s very important to move the breasts to avoid milk stasis or pooling of the milk in your milk ducts. A gentle full breast massage and lifting the breast up, down, left and right before breastfeeding can work wonders in preventing mastitis and keeping the milk flowing.


What if you do everything above and you still think you may have mastitis?
There are a few things you can do at home before you may need to reach out to your doctor for further antibiotic treatment.

Mastitis can feel like the flu; you feel generally unwell and require rest. Jump back in bed with your baby, push fluids like warm tea, broths or plain water, and keep your milk flowing. A gentle full breast massage and alternating warm moist heat and cold therapy can help the milk flow and reduce inflammation.
In Germany the recommendation is to use curd (Quark) for cooling, also white cabbage right from the fridge can help to reduce the pain as well as a cream called 
Mercurialis Perennis from Weleda (a natural company) which you can get in the pharmacy.
If your symptoms resolve in 8-12 hours, then no need to see the doctor.
If your fever persists beyond this, if you cannot get the milk to flow, or if you feel worse, it is recommended that you reach out to your doctor (usually your midwife or OB) for antibiotic intervention or go back to the hospital you gave birth in.


Mastitis is just plain awful, but it does NOT have to be part of your breastfeeding journey. Keep the milk flowing with frequent feeding, keep your breasts healthy by treating open wounds, and encourage movement of your breasts to increase blood flow and reduce milk stasis.

Have more questions about breastfeeding?
Here is another interesting post from our Angel Anya.
Gravidamiga is here to help!

Read more about Mary on our Angel Page.

October 2020 Mary Unangst, IBCLC
This blog post has been prepared with the greatest possible care and does not claim to be correct, complete or up-to-date.“

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