Mastitis is a common and painful inflammation of the breast tissue that primarily affects individuals who are lactating. This condition often causes discomfort and raises immediate concerns about the safety of continued milk expression. The answer to whether you can still pump with mastitis is definitively yes; continued and gentle milk removal is a necessary step for recovery and is generally safe for the baby.
Understanding Mastitis: Symptoms and Causes
Mastitis is defined as inflammation in the breast, often presenting as a localized immune response. It can be categorized as non-infectious (inflammatory) or infectious, though both share a common starting point: milk stasis. Milk stasis is inadequate drainage leading to a buildup of milk pressure within the ductal system.
The most common cause is the incomplete removal of milk, often due to missed feedings, a poor latch, or a sudden change in feeding frequency. This milk stasis causes pressure that irritates the surrounding tissue, leading to inflammation. If this inflammation is not resolved, the stagnant milk can become a breeding ground for bacteria, typically entering through a cracked nipple, which then progresses to infectious mastitis.
Symptoms often appear suddenly and can resemble a severe flu, making the lactating person feel unwell quickly. Localized symptoms include breast pain, swelling, and an area of redness or warmth, sometimes presenting in a wedge-shaped pattern. Systemic signs include a fever of 101°F (38.3°C) or higher, chills, and general body aches, indicating significant inflammation or possible infection.
The Critical Role of Continued Milk Removal
Continuing to remove milk from the affected breast is the primary management strategy for mastitis, regardless of whether it is infectious or not. The goal is to clear the underlying milk stasis, which is the root cause of the inflammation and discomfort. Stopping milk removal entirely will exacerbate the condition, leading to engorgement and increasing the risk of complications.
The milk produced during a mastitis episode remains safe for the infant, even if a bacterial infection is present. The baby’s digestive system is equipped to handle the bacteria, and continuing to feed or pump prevents the infection from worsening. The focus has shifted from aggressive draining to gentle, frequent removal aimed at comfort and relief. Excessive or painful pumping can worsen the inflammation and tissue damage.
Frequent, gentle expression helps maintain milk flow through the inflamed ducts, assisting the body in resolving the blockage. This approach is necessary alongside other comfort measures and any prescribed medical treatment. Prioritizing gentle removal reduces swelling and pressure inside the breast without causing further trauma to the irritated tissue.
Practical Pumping and Nursing Strategies During Mastitis
Effective milk removal during mastitis requires prioritizing comfort and gentle flow over complete drainage. The recommended frequency is to nurse or pump as often as possible, typically every two to three hours, to prevent further milk buildup. Pumping duration should be guided by comfort, often meaning shorter sessions aimed at softening the breast rather than emptying it completely.
When using a pump, select the lowest comfortable suction setting to avoid causing additional pain or nipple trauma. Aggressive suction can increase inflammation and worsen the condition rather than helping to clear the blockage. Gentle massage while expressing can encourage flow, using a light, circular motion over the affected area and moving toward the nipple.
Applying warmth to the breast before a pumping or nursing session can help facilitate milk letdown and improve flow. Conversely, applying a cold compress or ice pack after expression is effective for reducing the painful inflammation and swelling. If nursing, positioning the baby so their chin points toward the affected, sore area helps focus the most effective suction on the blocked ducts.
Recognizing Complications and Seeking Medical Care
While home management with frequent, gentle milk removal and pain relief is often effective, recognize signs that require professional medical attention. If symptoms such as a high fever, chills, or localized breast pain persist for more than 12 to 24 hours despite consistent home care, a healthcare provider should be contacted promptly. This duration suggests the inflammation may have progressed to a bacterial infection requiring antibiotics.
Other concerning signs include red streaking extending from the breast, pus or blood in the expressed milk, or the development of a tender, defined lump that does not soften after milk removal. This persistent lump can indicate the formation of a breast abscess, which is a localized collection of pus often requiring drainage by a medical professional. An untreated infection elevates the risk of this complication.
If antibiotics are prescribed, complete the entire course of medication, even if symptoms begin to improve quickly. Discontinuing treatment early can lead to a recurrence of the infection or the development of antibiotic resistance. Consulting with a lactation consultant or doctor early on ensures the correct diagnosis and a safe, effective treatment plan that supports continued milk expression.