MASTITIS… and a hangry baby! — what to look out for and practical tips from Clifton Hill Physiotherapy

The dreaded “M” word

What is mastitis?


  • Defined as “inflammation of the breast”. The term is generally used in reference to the lactating breast.
  • Is thought to occur when pressure within the ducts is greater than the surrounding tissue. This causes milk products to leak into surrounding tissue and the body produces a dramatic inflammatory response.
  • This in turn can cause painful, red, hot and inflamed breast tissue.
  • Incidence of mastitis has been reported to be as high as 1 in 3 women post partum, with the highest incidence occurring 2-3 weeks post partum. Mastitis is the most common reason to wean in the first 12 weeks post partum (Wöckel et al 2008).

Symptoms may include:

  • Breast tissue feeling tender
  • Increased temperature of the breast tissue
  • Redness in a wedge-shaped or striped pattern on the breast tissue
  • Chills, ache and flu-like symptoms, similar to a systemic illness
  • The inflammation may or may not involve a bacterial infection (the only way to rule out a true infection is by doing a milk sample testing – but this step is often skipped as it takes a long time)

“A tender, hot, swollen, wedge-shaped area of breast associated with increased temperature, chills, ‘flu-like’ aching and systemic illness. The inflammation may or may not involve a bacterial infection” (Amir 2014).

Risk factors and things to avoid:

  • A previous episode of mastitis
  • A sudden change in number of feeds (ie. infant sleeping longer overnight, skipped feeds)
  • Switching to 2nd breast before 1st breast is finished
  • Suckling replaced by pacifiers or bottles
  • Compression- including flange of expressing pump, tight bra/garment
  • Positioning and attachment problems (eg. from tongue tie, nipple damage)
  • Pendulous large breast tissue
  • A direct blow to the breast


Here, at Clifton Hill Physio, we have a great team of Women’s Health Physiotherapists, including: Adriane, Issy, Kiera, Ali, Clare, Jane, Jen and Sal.


Our physio’s can help you with:


  • Diagnosis and advice- including appropriate referral
  • Treatment:
  • Therapeutic Ultrasound can be very effective in the management and treatment of mastitis. This will likely form part of your treatment and will be explained by your physiotherapist.
  • Education regarding manual handling of your breast: This must always be gentle. Respect your pain.
  • Self-management techniques: Effleurage or draining massage, breast rotating/breast lifting techniques. 
  • Kinesiotape can be very helpful in facilitating lymphatic drainage of swelling. Your physiotherapist will show you how to apply this if necessary.
  • Positioning advice:

It is important to have a number comfortable positions to rely on for feeding.

Recumbent or ‘laid back feeding’, football hold and side lying hold.

Special extra tips:


  • If possible try to bring you baby with you as it is helpful to have your baby feed immediately after the session.
  • Develop the habit of feeling each breast after each feed to highlight any areas of tension.
  • Always maintain adequate hand hygiene and breast pad hygiene.
  • If it is safe to do so, Non-Steroidal Anti-Inflammatory medications (NSAIDs) may be recommended.
  • It is almost always ok for your baby to continue feeding if comfortable.
  • Avoid over-stimulating the breast tissue
  • Ensure the duration between feeds is short enough so breasts do not feel uncomfortably full.
  • Expressing must be comfortable and/ or relieving.
  • Take care that the flange does not compress the breast
  • Avoid wearing tight compressive garments, ie, tight bra/flange of expressing pump. Garments should not indent skin.
  • Catch it early: look out for early signs to prevent the condition from becoming debilitating or a more serious health problem that might threaten yours and the baby’s well-being.


At Inner North Physiotherapy, we understand how distressing mastitis can be and will always try our best to book you in as early as possible.

Our physio’s will strive to fit you in within the day to help reduce your symptoms and provide you and the baby with some relief as quickly as possible.





  • If your symptoms are persisting
  • If you have a nipple infection
  • If you have signs of thrush
  • If you require a breast ultrasound (as advised by your physiotherapist)
  • If you become acutely unwell

Adriane Kabulyuk





The Australian Breastfeeding Association

The International Breastfeeding Journal

Positioning advice:



-Amir, L., (Revised March 2014). Clinical Protocol #4: Mastitis. The Academy of Breastfeeding Medicine Protocol Committee ABM.

-Cooper, M., (2015) The lactating breast for physiotherapists. Course Notes – Continence & Women’s Health Physiotherapy Australia Group, Australian Physiotherapy Association.

Struebe, A., & Schwartz, E., (2010). The risks and benefits of infant feeding practices for women and their children.Journal of Perinatology, 30, 155-162

– Wöckel, A., Abou-Dakn, M., Beggel, A., Arck (2008). Inflammatory breast diseases during lactation: health effects on the newborn – a literature review. Mediators of Inflammation, Article ID 298760, 7 pages doi: 10,1155/2008/298760.