So you have a baby – you’re pumping for her, everything is good: and then you get mastitis. Mastitis, in short, is terrible – you are knocked down as if you have the flu (complete with a fever, chills, and pain), your boob feels like it’s going to explode, and oh, you still have to take care of a baby and pump every few hours.
I was lucky enough to not get the boob flu with my son, but I got it twice with my daughter. Here is everything you need to know about how to prevent and treat mastitis when you are exclusively pumping.
What is mastitis?
Mastitis is an inflammation of the breast. Generally speaking, it has two causes: obstruction of milk coming out of the breast (essentially, a clogged duct), or infection. Mastitis that is caused by obstruction can lead to infection, so it can be one or both that is causing the issue.
How can I tell if I have mastitis?
There are two kinds of symptoms – those specific to your breast and those that affect all of you.
- Your breast (the affected one – normally mastitis only hits one breast at a time) will feel painful and very tender to the touch. Sometimes you can feel a lump, which is likely the clogged duct that caused the mastitis. You may see red streaks on your breast, and it might be warm and a bit swollen.
- The rest of you will feel as though you have the flu, minus the nasal congestion – generally, if you have mastitis, you’ll have a fever, chills, and aches. (I also had a dull headache and what I would describe as “general malaise,” i.e., I just did not feel well. That was the only way I could describe it.)
How do I treat mastitis?
If your symptoms have been present for less than 24 hours, only one breast is affected, your baby is more than two weeks old, and you are not acutely ill, you should rest as much as you can, pump as much as you can, drink a lot of fluids, and take ibuprofen for your breast pain.
Regarding pumping as often as you can – the goal is to keep the affected breast as empty as possible. Use a warm compress on your breast before you pump. If it makes it easier to get more pumping sessions in, you can hook yourself up for some sessions on just the affected side. Just make sure you don’t forget about the other side and get yourself a double case of mastitis.
It can be painful to pump on the affected side, especially in the beginning before letdown. Try hooking yourself up to pump only on the good side (cover the “bad” side with a breast pad or something) and then hook up the affected side after letdown. Then make sure you empty the “bad” side by doing breast compressions.
If your symptoms have been present for more than 24 hours, both breasts are affected (you poor thing), your baby is less than two weeks old, or you are very sick, call your doctor. You can call your OB/midwife or primary care doctor, whatever you prefer. It is likely that he or she will put you on an antibiotic, usually for 10-14 days. You should also continue to rest and keep your breasts as empty as you can.
Untreated mastitis can lead to an abscess (which can require surgery to resolve), so be sure to call your doctor if you feel sick for more than 24 hours or are really ill.
How long does mastitis usually last? Usually 1-3 days, though it make take up to a week for the infection to completely clear.
How can I make sure that this never happens to me and my boobs again? How can I prevent mastitis when pumping?
To avoid mastitis as an exclusive pumper, there are two things that you can do. You want to avoid obstruction of milk ducts (i.e., clogged ducts) by 1) sticking to a pumping schedule and 2) making sure that you empty your breasts completely.
In addition, if you do get a clogged duct, do everything you can to clear it before it becomes mastitis.
(The exception to emptying your breasts is when you are weaning – while weaning you should stick to a schedule but not empty your breasts, just very gradually decrease the amount that is “left” in them after pumping.)
If you are prone to getting mastitis, you might want to try lecithin to see if that helps – in some women, it helps thin the milk so that it doesn’t get stuck in your milk ducks. If you keep getting it on only one side, you could also try weaning from just the affected breast and continue pumping on your other side.
Have you had mastitis? Share your tale of woe with us, and what you did to resolve it.
References- Smiley, Rhondda. “Breastfeeding and breast abscess.” https://kellymom.com/bf/concerns/mother/breast-abscess/
- Bonyata, Kelly, IBCLC. “Plugged Ducts and Mastitis.” https://kellymom.com/bf/concerns/mother/mastitis/
- Newman, Jack. “Mastitis Breastfeeding and Blocked Ducts.” https://www.momzelle.com/pages/mastitis-blocked-ducts
Ive had mastitis for 3 days going on 4. I have been prescribed antibiotics but my fever still stays at 99.8 and its gotten to 102.5. I’ve used a hot compress and that does work wonders but still can’t get rid of this.
I don’t have it in my right breast, just my left. I look like a botched porn star. I tried taking a picture of my soon to be 3 week old, and clear as day you can see a legitimate WEDGE in my breast. Sigh* can’t show off these lovely breast feeding boobies.
I have to say, not a lot of women exlclusively pump that I know. Finding this site made me happy and feel less alone. Not being able to nurse my son made me down for the first week.
I hope to see more posts from you. I will be liking your Facebook page!
I had mastitis with my fourth exclusively pumped baby which turned into an abcess. I have never experienced more pain in my life. Abcess eventually opened into a massive hole and I had to give up pumping as the hole was just on the edge of my left aereol. Dr perscribed me two antibiotics to take at once and also for approx a week my GP would drain it.
It was a very scary and painful experience, bubs is now 7 months old and my left breasthas healed nicely and I’m now (accidently!) pregnant with my fifth child, I am extremely worried that I will get mastitis again, finger crossed I don’t!
I’m so glad that I found this site. I am currently infected with my second episode of Mastitis. First time, my LO was 3 months old, and again today, he is almost 4 months old. I think that the first episode may not have completely healed. Both times were in my left breast.
I have read everything on the internet and almost everything talks about baby position, draining your breast while breast feeding, etc. But I have been pumping full time from the beginning (I knew I was going back to work very soon and would be pumping eventually anyways). So I have been doing everything they say to do, from the beginning: heat before pumping, massaging before, during, and after pumping, pumping on a schedule, not skipping pumping times, etc.
However, I still got mastitis twice. This time, I think I finally found a very very very large lump deep in the middle of my breast (my left breast is very large, dense even before getting pregnant). I’m trying to massage it out and it is very firm. I’m thinking this is abscess? I will give it a few more tries and if I don’t make any progress on it, I will go to the Dr and see if it needs to be drained.
Is it possible to wean off one breast and keep pumping from the other?
I’m just discouraged because I think that I have tried everything possible to fix it, and it’s not working. So I would at least like to keep my right breast milk production up.
Hi! Yes, it is! Check this out:
https://exclusivepumping.com/weaning-from-one-breast-when-you-are-exclusively-pumping/
I have been EPing my baby for 8+ months now. I would get painful clogged ducts almost daily, both sides. I now take sunflower lecithin 1200 mg 3-4 times a day (along with plenty of massage and making sure I empty completely) and I don’t get any clogged ducts anymore! I think anyone who gets clogged ducts should give lecithin a try! It’s been an absolute lifesaver.
Omg! Thank you so much!! I fear that if I don’t wean off my left breast it will turn into even more episodes of mastitis. I’m so glad to hear that someone else has been through this too!!!
Hey Amanda, I have been exclusive pumping for almost 2 months now and have mastitis in my right breast. I pump seven times a day for 23 minutes each session. I don’t feel like I can realistically add another pumping session in as I am a stay at home mom and take care of my infant plus my 3 year old. How long should I be pumping each session to make sure I don’t get mastitis again? I am both blessed and cursed that my infant will sleep from 9 PM until 4 AM. By the time I wake up when she does my breasts are engorged. I pump at 4 AM 6:30 AM around 9 AM 11 AM 3 PM 6 PM and 9 PM.
Any advice would be much appreciated!
Hi! I don’t think I would adjust your schedule – I think that looks good. The three things I might try are: 1) taking lecithin, 2) starting to treat a clog at the very first sign of pain, and 3) sticking the schedule religiously and pumping until empty. I hope that helps! Good luck!
I have symptoms of Mastitis but my OB said that since I don’t have redness or soreness, she is not sure. I currently have fever of 100.5 but it goes up to 102 in evenings. Debating if I should start antibiotics or just try to fight it out with Advil?
I would try fighting with advil, rest, and pumping as often as you can. Good luck!
My son is almost a month old, and I’ve had mastitis non stop in different parts of my right breast for over a week! I’ve been on antibiotics, I’ve massaged, used hot and cold compresses but it just keeps coming back. I express every 2 hours for at least an hour at a time to make sure both breasts are fully empty. It’s the most painful and infuriating thing ever!
Is it ok to feed the baby the expressed milk from the affected breast?
Yes!
Hi Amanda 🙂 I currently have mastitis in my right breast, which has always been my “sad boob,” usually pumping only 1oz each session. Since I started my antibiotics last night, the redness has spread almost complete around my areola now, and when I try pumping I get nothing out. Not even a drip. I have been letting that boob drip when I pump the other side and take hot showers, but do you think that would be enough to help fight off the infection? I’m worried that since I’m not draining it at all it’s not going to heal. And the pain is exceuciating. And still bad with my pain meds 🙁
Oh geez I’m so sorry you are dealing with this. I would definitely keep trying and would use warm compresses and massage to try to drain the breast. I really hope it gets better soon!
I got mastitis in my right side. Resolved it using warm compresses and castor oil packs at night. I’m much better now but my milk supply is extremely low. The right side was my good side and now is producing very little. I’ve been trying to pump more frequently but it doesn’t seem to pick up! It’s so frustrating! Does it ever get back to where it was? Any tips?? Thank you
So sorry you had to deal with this! I would keep pumping as much as you can, and try power pumping and oatmeal. How old is your baby?
Thank you for this! I have been exclusively pumping and no mastitis to date. I decided to cut pumping out completely and tried to go cold turkey — almost 24 hours without pumping (taking Sudafed and applying cold cabbage leaves frequently as per your blog post) and I have started to see a redness under my nipple this evening. I don’t have the flu symptoms or fever yet. I took a hot shower and pumped till my breasts were empty. Is it possible to avoid from the fever, etc. or is it inevitable?And is there anything else I can do?
Hi Laura! You definitely did the right thing. Hopefully it was just a clog and you got it out. How have things been going over the past few days?
Hi there!
I got mastitis in my left breast and caught it quickly. I was put on antibiotics and have continued pumping. However after 2 days of having it my milk supply dropped. I typically pump about 30 ounces a day and yesterday I had to power pump practically all day to get 25. And today it’s dropped again. Do you think my supply will just diminish or will it come back?
Hi! Diminishing milk supply when you have mastitis is normal. Do you think you’re over it now? And how old is your baby?
I have been on antibiotics for 4 days and I have been doing hot shower, dipping breast in hot water, warm diapers in bra, and massage. I don’t feel like I have the flu symptoms anymore. I can still feel a soft lump in the breast and it’s a little tender but know where near what it was when I first got it. My baby is also 3 months old. I have about 4-5 days of milk that I am ahead in but it just worries me.
OK great, I would keep doing what you’re doing! Obviously, anything can happen, but my guess would be that if you stick to your schedule, you will either level out where you are or slightly increase when the mastitis is completely gone. Good luck!
Thanks!!
I’m on day 4 of mastitis and finally feeling better, but still pain in my breast. I typically only pump 4x/day for 30 min a piece which gives me an average of 32 oz. I’ve been pumping every 3 hours or so for 30-60 min with mastitis to try to keep empty and producing about 28 oz. I have to return to work in a few days, do you think I could return to pumping four times a day? I don’t want a reoccurrence or to hurt supply more, but I know I cannot pump as often at work. I was going 6 hrs between some pumps during the day and 8 at night.
Hi Megan! So sorry you’re dealing with this. I think that would be fine once the pain in your breast goes away. Do you have a manual pump at all? Not sure if you could get away to pump the affected side only for a few minutes more often while you get over this. Just an idea. I hope you’re 100% better soon!
Thanks! Feeling much better, but my supply tanked! As of yesterday, I’m down 10 ounces!!!
Ugh, so sorry to hear that! Hopefully it recovers soon!
On my first day back to work, I started pumping with my new spectra s2 pump (i use Medela symphony at home and nurse with baby). By the end of the day, i was getting chills and my breast was tender. My pump sessions all day (done on time) yielded normally what I can pump at home. There was also no lump I could feel. Is it possible that the new pump caused mastitis? (Flange seems correctly sized). I have both breasts infected with slight pink streaks. i’m thinking it was an infection and coincidentally happened on my first day with the new pump. Really don’t want to bring the symphony back and forth to work!
Hi Ada! I’m guessing it was a coincidence? I got mastitis a few times out of nowhere (without changing anything), so I don’t think it’s definitely linked to your using the S2. I would pump as much as you can to get rid of mastitis (using both pumps) and then see if it happens again. Good luck!!!!! I hope you feel better soon!
I’m in the middle of weaning and also currently on antibiotics for mastitis The tenderness on my right breast has gone away. I pump 4x/day and am pumping to empty the breast currently to get rid of any infection. Should I continue pumping 4x/day and move to longer stretches between pumps or do I need to finish the antibiotics before I continue weaning? I don’t want to keep pumping to get my milk supply back up and start all over. I’ve had clogged ducts and mastitis throughout this entire pumping journey. I’d just like to wean and dry my milk supply up but it’s taking a lot longer than I thought it would. I take lecithin everyday and doing everything to try to dry my milk up: altoids, cabbage leaves, no flow tea. I just have not tried Sudafed.
Hi San! I think you should ask your doctor about the antibiotics, but my guess is that if you have completely recovered and are just finishing the course, it’s probably okay to start again? So I wouldn’t recommend weaning by moving the sessions further apart, I would try dropping one session at a time:
https://exclusivepumping.com/weaning-from-the-pump/
It sounds like you are doing all of the right things! Best of luck in weaning and so sorry you’re dealing with mastitis.