Mastitis and antibiotic therapy; do you need antibiotics?

Research has shown that there is no correlation between the levels of bacteria in breast milk and symptoms of mastitis. In fact healthy women without any mastitis at all had a similar pathogenic profile to those who did have mastitis.

What does this mean for antibiotic use during an episode of mastitis? More research is needed, but bacterial counts are not a factor indicative of a need for antibiotics. The criteria for prescribing an antibiotic is that there have been no improvements in symptoms within 12-24hours of the commencement of care interventions. Reports of antibiotic use in mastitis indicates that it is prescribed frequently, yet research does not support such extensive use.

As a breastfeeding mother, the important take home point here is that you do not necessarily need antibiotics to treat your mastitis. If you have a fever and have seen no improvement in symptoms within 12 hours of clearing your blockage then it is time to contact your GP. Otherwise, as long as there is improvement, mastitis can be effectively managed with simple at home techniques. It can still take a week for a lump to clear completely and all pain and fatigue to resolve.

How to know if you have mastitis

Any breastfeeding mother who feels as if she has the flu should always be suspicious of mastitis. If you feel unwell, have a good feel for any lumps.

Mastitis however doesn’t always cause flu symptoms, other indications include a red inflamed area on your breast tissue, or pain. Remember you may not have a red area, you may not have pain, you may not have fever, but any of these symptoms individually or combined can indicate mastitis. The first sign for some mothers of mastitis can be their toddler jumping on them and feeling agony in their breasts.


Prevention is always better than cure. Staying well rested, getting good nutrition, and overall self care go a long way to preventing mastitis. This is obviously challenging for a new mother; mastitis risk is just one of many great reasons to seek outside support from family and friends.

It is also important that your baby is latching well, poor latch can cause nipple damage, this increases your risk of developing an infection. Additionally poor latch means poor milk transfer, and that leads to an increased chance of milk stasis.

If you have oversupply, get on top of it. You are much more likely to have milk left in your breast at the end of a feed if you have too much.

Bundle of Care can provide assistance with correcting latch and oversupply, as well as help prevent a recurrence of infection. You can use the online booking form to make an appointment.


Treating mastitis is really just a matter of clearing the blockage, and getting good milk flow and clearance going. This sounds simpler than it really is, some blocks are very difficult to clear. Simple strategies include:

  • Continue to feed your baby. Alternatively, express from the effected side if it is too painful, or if baby is refusing to nurse from that side.
  • Get in the shower. Hot water is very effective in assisting you remove a stubborn blockage. It is also soothing.
  • Use hot packs or a warm washer. Apply it before every feed; this will increase the chance of your baby being able to remove the blockage.
  • Don’t wear restrictive clothing or bras. Take your bra off for the day, or wear one that is too big.
  • Take an anti-inflammatory. Ibuprofen is safe during breastfeeding and is a very effective over the counter medication that not only brings relief, but helps you recover.
  • REST! Your body really needs lots of rest to recover from mastitis without resorting to antibiotic therapy. This is challenging. Many women find it helpful to sleep when the baby does, and enlist the help of family or a close friend.