Mastitis isn’t normally at the forefront of a pregnant mama’s mind. Even when listening to what sounds like harrowing stories of other mamas who came before, most mamas to be put this info to the back of their minds. Fair enough, that’s a future you *maybe* problem, and it probably won’t even happen to you! Well here we are to burst that bubble as a good 30% of lactating women will experience mastitis. It doesn’t discriminate either, with all demographics being susceptible, whether you are a pumping mama, a breastfeeding mama or a bit of both.

The problem lies deeper still, with a health care system globally that poorly manages mastitis, and worse still, poorly understands mastitis. You can read it all over google, mama forums and amongst your friends, “quick! Get straight on the antibiotics, it’s the ONLY way!” Why is this a problem? Mastitis is an infection, right? Infections require antibiotics, right?

Except that mastitis is defined by the World Health Organisation as an inflammatory condition of the breast, that is SOMETIMES accompanied by an infection. Mastitis is the result of milk stasis, a phenomenon where milk doesn’t drain well from the duct and a backup of milk occurs. The body responds to the problem by sending inflammatory proteins to the area. Inflammation can cause symptoms like fever, so it’s understandably confusing since infection also causes fever.

So yes, bacterial infections respond well to antibiotics. Antibiotics are awesome for bacterial infections, but pretty useless at helping swelling and lumps. You wouldn’t take antibiotics for a sprained ankle after all!

So what can you do if you find yourself in the tricky and overwhelming position of a mastitis diagnosis?

1. Rest mama! Your body is telling you something. It’s time to send all the visitors home and take time to recover. The worst of your symptoms will usually pass within 24-48 hours.

2. Warm and cold compresses. Warmth encourages blood and nutrients to the area, whilst cold compresses feel nice on a tender area.

3. Gentle massage to encourage the swelling to move along. This isn’t a sports massage mama, be gentle to your breasts! This is our forte, there’s plenty of different massage and mobility techniques you can do to relieve your symptoms and to prevent mastitis from becoming a recurring problem. Depending on where on the breast your mastitis is, or what the lumps are like, the technique you use will be different. The key is to be persistent and consistent with your massage, as your symptoms aren’t going to resolve straight away, but you can help yourself feel better whilst your body does it’s thing.

4. Keep breastfeeding and/or pumping to your usual routine. It’s best to keep draining the breast to avoid the cycle of mastitis continuing.

5. And when to take antibiotics? Sometimes they are necessary, and there are definitely cases that require them. A good one to look out for is nipple damage, because this is the perfect avenue for bacteria to enter the breast. We always recommend speaking to a doctor straight away about your condition if you are significantly worsening after 24-48 hours of your symptoms starting and if your symptoms are severe, like uncontrolled fevers, vomiting and delirium.

Dr Elise Fuller & Dr Katie Willy are Melbourne based osteopaths who have been actively treating breastfeeding women at the Melbourne Mastitis Clinic since 2015. During the 2020 lockdown they launched their company Your Two Jugs to educate more women about how to treat their own breastfeeding conditions. Their online video based course, Boobology, is available now with heaps of education, recovery plan and follow along hands on massage to teach women the do’s & don’ts for mastitis, blocked ducts & engorgement. You can follow them on Instagram & Facebook@yourtwojugs for more mastitis tips and education.

Understanding Mastitis by Your Two Jugs