It started with a small sore spot on the side of my right breast. The spot felt hot, tender when touched, and seriously uncomfortable. My second daughter was 9 months old and we were at a friend’s house, finishing up a play date that was especially difficult for my older daughter to wrap up. But as the “20 more minutes” turned into an hour longer, I felt my face turn flush, my skin feel hot, and my stomach begin to churn. It was time to go home. I was experiencing a condition known as mastitis, an illness that many mothers experience, including those who are breastfeeding and even sometimes mothers who’ve never breastfed before.

Mastitis is inflammation of the breast and is caused by either plugged ducts (non-infective mastitis) or a bacterial infection (infective mastitis).

If you develop mastitis, you will probably only feel pain in one breast, as it tends to occur unilaterally, or on one side at a time. The inflamed breast may feel warm and firm. It will be sore and painful, and you might feel a shooting sensation while breastfeeding. The skin may appear tight, shiny, or red. The sore spot may be streaked with red or it may appear in the shape of a wedge. It is common for the location of the tender spot to move. Mothers experiencing mastitis may experience general malaise, nausea, and vomiting or even develop flu-like symptoms, including a fever. I was one of these women, lucky me!

Occasionally, plugged ducts temporarily lessen the milk supply, and you may rarely notice your milk becoming thicker and even stringy or grainy. With infective mastitis, milk may have lumps within the liquid and may contain pus, blood, or mucus. Some babies will resist the milk because it tastes saltier due to an increased sodium content.

How Can I Avoid Mastitis?

Avoiding mastitis may be difficult, but you can help reduce your exposure to infections and to situations which lead to plugged ducts. There are a number of factors that increase the risk of developing plugged ducts, the largest contributor to mastitis. Plugged ducts often occur when the baby isn’t attaching to the nipple correctly or his feeding time is limited, which causes poor drainage of the breast. Holding the breast too forcefully during feeding, wearing a bra that is too tight, sleeping in the exact same position night after night, and trauma to the breast (pressure from a seatbelt, for example) all predispose a woman to blocked milk ducts.

The risk of infective mastitis increases the longer a mother stays in the hospital, as exposure to bacteria occurs more frequently in hospitals. Past history of mastitis, use of bacteria-breeding nipple creams, preexisting infection of the nipple, and cracked, sore, or bleeding nipples are additional risk factors. Anemia, stress, fatigue, and poor overall health all make it likelier that a woman will have mastitis.

Can I take Care of Mastitis at Home?

Treatment of mastitis differs depending on severity. If you believe you may have a blocked duct, make sure you go braless or wear a bra that doesn’t impede circulation. Breastfeed on the affected breast at least every two hours to keep the milk flowing and prevent engorgement. You should massage the sore spot, moving your fingers gently in the direction of your nipple. A warm, moist compress may also provide relief. Rest, drink plenty of fluids, and make sure you choose nutritious foods.

Before each feeding, apply the warm compress and massage the breast. Try filling a disposable diaper with hot water. Squeeze out some of the excess water, and put the inside of the diaper around your breast. This will stay warmer much longer than a wet washcloth. Or, you may prefer to take a hot shower. In the shower, try using a soapy, large-toothed comb to massage the affected area. A third option is to soak your breast in hot water. Simply fill your sink or a bowl with hot water and massage while soaking. Some women find that adding Epsom salts to the water is helpful.

Since it’s imperative that you breastfeed regular, especially when you have a clogged duct, make sure you’re doing it correctly. Hold your baby in whatever position is most comfortable and that allows you to massage the sore spot while feeding. Make sure that she has a good latch. Try “dangle feeding,” or leaning over your baby while feeding. You should also perform breast compressions throughout feedings. If you haven’t received breastfeeding education already, ask your doctor or nurse for tips. They may recommend that you work with a lactation specialist. Immediately after nursing, either pump or squeeze with your hand to make sure that all milk is expressed. You should also apply a cold compress to reduce inflammation and lessen the risk of infection.

When to Seek Treatment

If, after trying these remedies, your breast does not feel and look better within twenty-four hours, you need to call your doctor. Keep in mind that you should not wait and try home remedies, but call your doctor straightaway, if you have a fever, notice blood or pus in the milk, red spots, or if the onset of your symptoms was sudden and severe. While mastitis usually only occurs in one breast, call if both breasts look infected. You may have another kind of infection.

Your doctor may prescribe oral antibiotics, which are the most common treatment for infective mastitis. If you don’t see improvement after two days of taking antibiotics, follow up with your doctor. If mastitis isn’t treated correctly or if it is the result of a blocked milk duct, an abscess can form a breast mass. If this rare event occurs, the mass may need to be drained surgically.

Because mastitis takes a toll on the body, treat yourself like you would if you were staying home sick. Hire someone or ask friends and family to help you complete your day-to-day tasks. While, as a mother of two myself, I understand how difficult it can be to rest, it’s very important. You can’t take care of your babies if you are getting sick or struggling to stay healthy. Stay in bed, and increase your fluid consumption. Taking it easy and following your doctor’s orders will help you feel better as quickly as possible.