How to recognise the symptoms of mastitis and prevent it?

Mastitis refers to localised inflammation of the breast. It can appear gradually or suddenly. Mastitis is the term used when a breast becomes tender, red, warm and painful.

In some cases, the inflammation remains localised. In others, it is accompanied by general symptoms resembling flu-like illness: intense fatigue, chills, body aches and a fever above 38.5°C.

Two main forms are distinguished: inflammatory mastitis and infectious mastitis. The first is generally linked to poor milk drainage. The second involves a bacterial infection, most often by Staphylococcus aureus [2].

Knowing how to identify the symptoms of mastitis quickly is essential in order to act before the condition worsens.

The first signs are often localised. An area of the breast becomes painful, red and warm to the touch. It may feel firmer, as though a small lump has formed. This area frequently corresponds to a blocked milk duct or an unresolved engorgement.

As the inflammation progresses, general symptoms may appear. The mother may experience sudden fatigue, muscle aches, chills and a high fever. These symptoms of mastitis can sometimes feel like coming down with flu within the space of a few hours.

If symptoms persist for more than 24 to 48 hours or worsen, medical advice should be sought.

Mastitis is most often linked to insufficient drainage of the breasts. When milk stagnates, this is referred to as milk stasis. This accumulation causes inflammation upstream of the blockage.

Several factors contribute to the development of mastitis [3]:

• Nipple cracks or lesions
• Spaced or scheduled feeds
• Absence of night feeds
• Blocked duct
• Poor latch
• Hyperlactation
• Bra that is too tight
• Fatigue or stress

Returning to work, with longer intervals between feeds, can increase the risk of mastitis if milk expression is not sufficiently regular.

Fortunately, it is possible to significantly reduce the risk.

Prevention relies above all on thorough breast drainage. Feeding on demand, avoiding skipped feeds, and checking that your baby is latching correctly are simple but highly effective measures. A well-emptied breast is far less likely to become inflamed.

It is also important to prevent engorgement. If the breast becomes too full, expressing milk or gently massaging the tense area can help to avoid milk stasis.

The choice of underwear also matters. A bra that is too tight can compress the ducts and disrupt milk flow. It is better to opt for soft, wire-free styles.

Finally, hygiene and rest play a key role. Washing your hands, properly cleaning breastfeeding equipment, and allowing yourself time to recover all help to reduce the risk of infection.

At the first signs of mastitis, it is essential to act quickly. Rest is the priority. Lying down with your baby and increasing the frequency of feeds encourages drainage and limits deterioration.

Contrary to some common misconceptions, breastfeeding should not be stopped. Continuing to put your baby to the breast helps to avoid complications such as abscess [4].

To relieve pain, applying heat before a feed can encourage milk flow, whilst cold after a feed helps to reduce inflammation. Massages should be performed gently, always in the direction of the nipple.

In the event of significant pain, paracetamol or ibuprofen are compatible with breastfeeding according to the CRAT. Antibiotics are not systematic: they are prescribed in the event of a confirmed infection or lack of improvement after 24 to 48 hours.

Fewer than 3% of mastitis cases progress to an abscess, but it is important to consult a doctor, an IBCLC, etc. if the situation does not improve.

To check the compatibility of a medication with breastfeeding, you can consult the official CRAT website:
https://www.lecrat.fr/

Recognising the symptoms of mastitis quickly allows for early intervention and helps prevent complications. Knowing how to identify mastitis, understanding its causes, and applying simple preventive measures are the keys to continuing breastfeeding with peace of mind.

If in doubt or if symptoms worsen, it is always preferable to consult a healthcare professional (doctor, midwife, IBCLC, etc.). With appropriate support, mastitis can be treated effectively and breastfeeding can continue safely.