Mastitis is the inflammation of the breast in breast-feeding mothers. It can be caused by blocked milk ducts (non-infective mastitis) or a bacterial infection (infective mastitis). Milk duct blockages cause milk to collect in the breast which forms an ideal environment for bacteria growth and can lead to an infection. If a blocked milk duct is not cleared, symptoms such as fever, aches and pains may develop.

Blocked milk ducts (‘non-infective mastitis’) can cause parts of the breast to become tender or painful, hardened and red.

When mastitis is caused by a bacterial infection (‘infective mastitis’):

• the breast becomes red, swollen, hot and painful
• the skin may appear tight and shiny, and be streaked with red
• you feel very unwell and may have a high temperature

If you have infective mastitis, you need to see your GP before starting physiotherapy to begin antibiotics to clear the infection.

Physiotherapy, specifically ultrasound and massage, can assist in the drainage of blocked ducts to resolve mastitis. It’s optimal, but not necessary, to have your physiotherapy treatment prior to a feed. If possible, physiotherapy treatment should occur on consecutive days.

While you are symptomatic, you should:

• express some milk from the affected side by gently massaging the hard part of the breast toward the nipple and then expressing milk until the hard areas are soft or emptied of milk. Do not over-express as this will increase milk production and may exacerbate your mastitis. The hard areas should lessen with each feed
• always feed with the affected breast first (instead of alternate breasts at each subsequent feed);
• place the baby for feed with its chin in the direction of the affected area – the baby will preferentially drain this region.

You should improve after each treatment and have minimal symptoms after 2 treatments. If this does not occur, you need to return to you GP for assessment.