Mastitis | Ū kakā

While mastitis is common in the first month of breastfeeding, it can also occur at any stage when you are lactating (producing milk) and particularly when the number of breastfeeds or milk expressions is suddenly reduced. It can also happen if you are producing more milk than your baby needs, known as hyperlactation.

Symptoms of mastitis include:

• a sore breast
• a lumpy area that's usually red and tender
• fever (a high temperature)
• chills
• feeling unwell with 'flu-like' symptoms, such as tired, aching, run-down.

Image credit: CRUK, Wikimedia Commons

• Mastitis occurs when milk ducts in your breast become inflamed and the tissue around them becomes swollen. This causes the ducts to become narrower and the flow of milk towards the nipple slows down. Milk is still being produced but can't flow out as easily, so the affected part of the breast also becomes inflamed.
• Mastitis is inflammation of the breast tissue. It's not necessarily caused by an infection. Skipping feeding or pumping may cause redness and discomfort – this is inflammation, not infection. 

The following are the key ways of managing mastitis:

• Feed your baby as usual, don't over-feed or over-use a breast pump.
• Take paracetamol and ibuprofen (for pain relief and to reduce inflammation).
• Apply ice or another frozen item (eg, frozen peas) to the affected part of your breast – cold reduces pain and inflammation. Wrap the ice in a cloth before using and apply for about 10 minutes in every 30 minutes.
• Avoid heat to the breast.
• DO NOT use massage.
• Try lymphatic drainage – gentle breast stroking helps reduce swelling. Using a light touch, with similar pressure to what you would use to stroke a cat, stroke your breast from your nipple to your armpit and collarbone. You can do this as often as you like, and especially before breastfeeding or pumping. See the video below.
• Contact your healthcare provider if you don't feel better in 24 hours with these self-care steps, or if you have a fever (temperature over 38.5°C). Your healthcare provider may need to assess you further for a breast abscess or further infection. Read more about breast abscess.

Video: Massage and lymphatic drainage for engorgement and mastitis

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• If you are having breastfeeding problems, ask your midwife for help. You might need a referral to a lactation consultant(external link) for more help. 
• You can phone Plunketline(external link) on 0800 933 92 anytime day or night for advice about breastfeeding. You can also talk to your midwife, doctor or Plunket nurse.(external link)
• Some regions have Kaupapa Māori breastfeeding support. If you're interested in accessing Kaupapa Māori breastfeeding support, ask your midwife or local hauora service what's available in your region. Some of the services available are:
  
  • Ūkaipō(external link) in Canterbury
  • Te Tohu O Te Ora O Ngāti Awa(external link) in the Eastern Bay of Plenty
  • Māori and Pacific Breastfeeding Service(external link) in Wellington
  • B4Baby(external link) in South Auckland.
• Other groups to contact include La Leche League NZ(external link) and your local Parents Centre NZ(external link)  
• You can also search the Women's Health Action(external link) site to find breastfeeding support.
• NZCLA provides a list of lactation consultants available in Aotearoa New Zealand(external link).
• A range of resources is listed on the Health New Zealand | Te Whatu Ora problems with breastfeeding(external link) page.