7 Common Mastitis Symptoms Every Woman Should Know

Mastitis is a painful inflammation of breast tissue that most commonly affects breastfeeding women, though it can occur in women who aren’t nursing and, rarely, in men. This condition typically develops when bacteria enter the breast through a cracked nipple or when milk ducts become blocked, leading to infection and inflammation. Recognizing the early signs of mastitis is crucial for prompt treatment and preventing complications. Understanding these symptoms can help you seek medical attention quickly and avoid more serious health issues.

In this comprehensive guide, we’ll explore the most common symptoms of mastitis, their characteristics, and what you need to know about this condition to protect your health.

1. Breast Pain and Tenderness

One of the most prominent symptoms of mastitis is significant breast pain and tenderness. This discomfort typically affects only one breast, though in rare cases both breasts may be involved.

Characteristics of the pain:

• Sharp, burning, or throbbing sensation in the affected breast
• Pain that intensifies during breastfeeding or when the breast is touched
• Localized tenderness in a specific area or throughout the entire breast
• Discomfort that may radiate to the underarm area

The pain often develops suddenly and can range from mild discomfort to severe, debilitating pain that interferes with daily activities. Many women describe it as feeling similar to a deep bruise or intense muscle ache. The affected area may be extremely sensitive to touch, making it difficult to wear regular clothing or lie on that side.

2. Breast Swelling and Hardness

Swelling is another hallmark symptom of mastitis, occurring as the breast tissue becomes inflamed and potentially infected.

The affected breast may appear noticeably larger than the other breast and feel unusually firm or hard to the touch. This hardness results from a combination of inflammation, milk buildup, and tissue swelling. The breast tissue may feel lumpy or contain a distinct hard area that doesn’t soften even after feeding or pumping.

What you might notice:

• Visible enlargement of one breast compared to the other
• Tight, stretched feeling in the skin
• Difficulty expressing milk from the affected breast
• A palpable lump or hardened area within the breast tissue

The swelling can develop rapidly, sometimes within just a few hours, and may worsen if the condition is left untreated.

3. Redness and Warmth

Visible skin changes are common indicators of mastitis, with redness being one of the most recognizable signs.

The affected area typically displays a distinctive red or pink discoloration that may appear in a wedge-shaped pattern radiating from the nipple or as a more diffuse redness covering a larger portion of the breast. This redness indicates active inflammation and possible infection beneath the skin surface.

The skin over the inflamed area also feels noticeably warmer than the surrounding tissue or the other breast. This warmth is your body’s inflammatory response to infection and can sometimes be detected before visible redness appears.

Key characteristics:

• Red or pink streaks extending from the nipple outward
• A wedge-shaped red area on the breast
• Skin that feels hot to the touch
• Redness that may spread or intensify over time

4. Fever and Flu-Like Symptoms

Systemic symptoms often accompany the localized breast symptoms of mastitis, making you feel generally unwell.

A fever of 101°F (38.3°C) or higher is common with mastitis and indicates that your body is fighting an infection. This fever may come on suddenly and be accompanied by chills and body aches that resemble the flu.

Associated systemic symptoms include:

• High temperature with sudden onset
• Chills and shivering
• General fatigue and exhaustion
• Body aches and muscle soreness
• Headache
• General malaise and feeling run down

These flu-like symptoms can be quite severe and may temporarily incapacitate you, making it difficult to care for your baby or perform normal daily tasks. The fatigue associated with mastitis goes beyond normal tiredness from lack of sleep and reflects your body’s energy expenditure in fighting infection.

5. Nipple Discharge or Changes

Changes in nipple appearance or discharge patterns can signal mastitis and should not be ignored.

You may notice unusual discharge from the affected nipple, which can vary in appearance. While milk production continues, you might observe blood-tinged milk, pus, or other abnormal discharge mixed with breast milk. The nipple itself may appear cracked, damaged, or more irritated than usual.

Possible nipple changes:

• Cracked, bleeding, or blistered nipples
• Blood-streaked breast milk
• Thick, yellowish discharge (pus) from the nipple
• Unusual odor from the discharge
• White spots or milk blebs on the nipple

These changes often occur because the nipple serves as an entry point for bacteria. Damage to the nipple from improper latch during breastfeeding or other trauma creates an opportunity for infection to develop.

6. Difficulty or Pain During Breastfeeding

Mastitis significantly impacts the breastfeeding experience, creating challenges that weren’t present before the condition developed.

Women with mastitis often experience intense pain during nursing sessions, particularly when the baby first latches on. The pain may persist throughout the feeding or ease slightly as milk begins to flow. Some women find the discomfort so severe that they hesitate to breastfeed, though continuing to nurse or pump is actually important for recovery.

Breastfeeding challenges may include:

• Sharp, shooting pain when the baby latches
• Burning sensation throughout the feeding
• Feeling that milk isn’t flowing properly or is blocked
• Reduced milk output from the affected breast
• Baby becoming frustrated due to slower milk flow
• Anxiety or reluctance to breastfeed due to anticipated pain

Despite the discomfort, healthcare providers typically recommend continuing to breastfeed or pump regularly, as this helps drain the breast and clear the infection more quickly.

7. Enlarged Lymph Nodes

The lymphatic system responds to breast infection by activating nearby lymph nodes, which can become swollen and tender.

You may notice enlarged, tender lymph nodes in your armpit (axilla) on the same side as the affected breast. These lymph nodes are part of your body’s immune response and become activated when fighting infection in nearby tissue.

What to look for:

• Palpable lumps or swelling in the armpit area
• Tenderness when touching the underarm region
• Sensation of fullness or tightness in the armpit
• Visible swelling under the arm in some cases

Swollen lymph nodes accompanying breast symptoms strongly suggest an infectious process and warrant medical evaluation. While enlarged lymph nodes are a normal immune response, they confirm that your body is actively fighting infection.

Main Causes of Mastitis

Understanding what causes mastitis can help you recognize risk factors and take preventive action. The condition typically develops through one of two primary mechanisms:

Milk Stasis and Blocked Ducts

When milk isn’t adequately removed from the breast, it can accumulate and cause inflammation. This stagnant milk creates an environment conducive to bacterial growth. Common scenarios leading to milk stasis include:

• Infrequent or missed feeding sessions
• Baby’s improper latch preventing effective milk drainage
• Sudden changes in feeding schedule or weaning
• Oversupply of milk
• Pressure on the breast from tight clothing or sleeping position
• Incomplete breast emptying during feedings

Bacterial Infection

Bacteria, most commonly Staphylococcus aureus, enter the breast tissue through breaks in the skin or milk ducts. Entry points include:

• Cracked or damaged nipples from improper latch
• Skin conditions affecting the nipple and areola
• Bacteria from the baby’s mouth or nose
• Transfer from hands during breast handling

Additional Risk Factors

Certain factors increase your susceptibility to developing mastitis:

• Previous episodes of mastitis
• Extreme fatigue and stress
• Poor nutrition or compromised immune system
• Being a first-time mother still learning breastfeeding techniques
• Using only one position for breastfeeding
• Wearing restrictive bras or clothing

Prevention Strategies

While mastitis cannot always be prevented, several strategies can significantly reduce your risk of developing this painful condition:

Proper Breastfeeding Techniques

• Ensure correct latch: Work with a lactation consultant to establish proper positioning and ensure your baby latches correctly, which prevents nipple damage and ensures effective milk drainage
• Feed frequently: Nurse your baby on demand, typically every 2-3 hours, to prevent milk from accumulating
• Alternate breasts: Start feedings on different breasts and ensure both breasts are emptied regularly
• Vary feeding positions: Change positions throughout the day to drain all areas of the breast effectively
• Complete emptying: Allow your baby to finish one breast before switching to ensure thorough drainage

Breast Care and Hygiene

• Keep nipples clean and dry: Gently wash nipples daily and allow them to air dry after feedings
• Treat cracked nipples promptly: Address any nipple damage immediately to prevent bacterial entry
• Practice good hand hygiene: Wash hands before handling breasts or breastfeeding
• Wear appropriate clothing: Choose well-fitting, breathable bras without underwire that don’t compress breast tissue
• Avoid pressure on breasts: Be mindful of sleeping positions and avoid carrying bags on the shoulder that press against breasts

Lifestyle and Self-Care

• Get adequate rest: Fatigue weakens your immune system, making you more susceptible to infection
• Stay hydrated: Drink plenty of fluids to support milk production and overall health
• Maintain proper nutrition: Eat a balanced diet to support your immune system
• Manage stress: High stress levels can impact your immune function and milk flow
• Address blocked ducts immediately: If you notice a plugged duct, work to clear it through massage, warm compresses, and frequent nursing before it progresses to mastitis

When Weaning

• Wean gradually: Sudden weaning can lead to engorgement and increase mastitis risk
• Reduce feedings slowly: Drop one feeding at a time over several days or weeks
• Express milk if needed: If experiencing fullness during weaning, express just enough milk to relieve discomfort

Frequently Asked Questions

How quickly do mastitis symptoms develop?

Mastitis symptoms can develop rapidly, often within a few hours. You may notice breast tenderness and warmth initially, followed quickly by more severe symptoms like fever, intense pain, and visible redness. Some women report feeling completely fine in the morning and experiencing full-blown mastitis symptoms by afternoon.

Can I continue breastfeeding if I have mastitis?

Yes, you should continue breastfeeding even with mastitis. Continuing to nurse actually helps resolve the condition by draining the affected breast and clearing the infection. The infection is typically localized to breast tissue and doesn’t contaminate the milk. Your baby is not at risk from nursing on the infected breast.

Is mastitis contagious?

No, mastitis itself is not contagious and cannot be transmitted to your baby through breast milk or to other people through casual contact. However, if the infection is caused by bacteria, basic hygiene practices should still be maintained to prevent spreading bacteria to other parts of your body or to others.

Can mastitis occur in women who aren’t breastfeeding?

Yes, though less common, mastitis can occur in non-lactating women and even rarely in men. This type, called periductal mastitis, typically affects women of reproductive age who smoke. It involves inflammation of the ducts beneath the nipple and may be related to bacteria entering through the nipple or to duct damage.

How long does mastitis last?

With proper treatment, mastitis symptoms typically improve within 24-48 hours and resolve completely within 7-10 days. However, without treatment, symptoms may worsen and complications such as breast abscess can develop. If symptoms don’t improve within 24 hours of starting treatment, you should contact your healthcare provider.

When should I see a doctor for mastitis symptoms?

You should contact your healthcare provider if you experience breast pain accompanied by fever, if you notice pus or blood in your breast milk, if symptoms worsen despite home care measures, or if a red area on your breast becomes increasingly painful or enlarged. Immediate medical attention is needed if you develop a high fever above 101.5°F (38.6°C), feel severely ill, or notice red streaks spreading from the affected area.

Can mastitis lead to serious complications?

While most cases of mastitis resolve without complications when treated promptly, untreated mastitis can lead to a breast abscess—a collection of pus that may require drainage. In rare cases, severe infection can lead to sepsis, a serious bloodstream infection. This is why recognizing symptoms early and seeking appropriate care is important.

Are certain women more prone to developing mastitis?

Yes, first-time mothers are at higher risk due to inexperience with breastfeeding techniques. Women with previous mastitis episodes, those with cracked or damaged nipples, mothers experiencing extreme stress or fatigue, and women who wear tight-fitting bras are also at increased risk. Having a baby with tongue-tie or other anatomical issues affecting latch can also increase susceptibility.

References:

• Mayo Clinic – Mastitis: Symptoms and Causes
• World Health Organization – Mastitis
• Centers for Disease Control and Prevention – Mastitis
• NHS – Mastitis
• MedlinePlus – Mastitis