Your doctor diagnoses mastitis based on a physical exam, taking into account signs and symptoms such as fever, chills and breast pain. Another clear sign is a wedge-shaped area of redness on the breast that points toward the nipple and is tender to the touch.
Your doctor will make sure you don't have a breast abscess — a complication that can occur when mastitis isn't treated promptly. A culture of your breast milk might help guide your doctor in determining the best antibiotic for you, especially if your infection is severe.
A rare form of breast cancer — inflammatory breast cancer — also can cause redness and swelling that could initially be confused with mastitis. Your doctor may recommend a diagnostic mammogram. If your signs and symptoms persist even after you complete a course of antibiotics, you may need a biopsy to make sure you don't have breast cancer.
Mastitis treatment usually involves:
- Antibiotics. Treating mastitis usually requires a 10- to 14-day course of antibiotics. You may feel well again 24 to 48 hours after starting antibiotics, but it's important to take all the pills to minimize your chance of recurrence.
- Pain relievers. Your doctor may recommend a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
- Adjustments to your breast-feeding technique. Make sure that you fully empty your breasts during breast-feeding and that your infant latches on correctly. Your doctor may review your breast-feeding technique with you or may refer you to a lactation consultant for help and ongoing support.
- Self-care. Rest, continue breast-feeding and drink extra fluids to help your body fight the breast infection.
If your mastitis doesn't clear up after taking antibiotics, it is important to follow up with your doctor so he or she can decide if you need further testing.
Lifestyle and home remedies
If you have mastitis, it's safe to continue breast-feeding and it helps clear the infection.
To relieve your discomfort:
- Continue to breast-feed as often and as long as your baby is hungry
- Rest as much as possible, preferably in bed with your baby, which will encourage frequent feedings
- Avoid prolonged overfilling of your breast with milk (engorgement) before breast-feeding
- Vary your breast-feeding positions
- Drink plenty of fluids
- If you have trouble emptying a portion of your breast, apply warm compresses to the breast or take a warm shower before breast-feeding or pumping milk
- Wear a supportive bra
If breast-feeding on the infected breast is too painful or your infant refuses to nurse on that breast, try pumping or hand-expressing milk.
Preparing for your appointment
For mastitis, your first appointment will likely be with your regular obstetrician-gynecologist, family doctor or nurse practitioner. For problems related to breast-feeding, you may be referred to a lactation consultant.
What you can do
To prepare for your appointment:
- Note all your symptoms, even if they seem unrelated to the reason for which you scheduled the appointment.
- Review key personal information, including major stresses or recent life changes.
- List all medications, vitamins and supplements you take regularly.
- Write down questions to ask your doctor.
For mastitis, some basic questions to ask include:
- Will my infection clear on its own or do I need treatment?
- What can I do at home to relieve my symptoms?
- How might my condition affect my baby?
- Should I stop breast-feeding my baby?
- If I continue to breast-feed, is the medication you're prescribing safe for my baby?
- How long will I have to take the medication?
- What are the chances that the infection will recur? How do I minimize my risk of recurrence?
What to expect from your doctor
Your doctor may ask you questions about:
- How long you've had symptoms
- Whether you have breast pain and how severe it is
- Whether symptoms occur in one or both breasts
- Your breast-feeding technique
- Whether you've had previous breast infections