Can infants still breastfeed with their mother when she has mastitis?

Breastfeeding with Mastitis

Yes, infants can and should continue to breastfeed when their mother has mastitis, as continued breastfeeding is an essential component of treatment that facilitates milk removal and does not pose a risk to the infant. 1

Why Continued Breastfeeding is Recommended

Continued breastfeeding during mastitis is beneficial for several important reasons:

1. Facilitates recovery: Regular milk removal is crucial for mastitis treatment and helps resolve the infection more quickly 1

2. Prevents complications: Continued breastfeeding helps prevent breast abscess formation, which occurs in approximately 10% of mastitis cases 1, 2

3. Safe for infant: Breastfeeding with mastitis does not pose health risks to the infant 1

4. Prevents worsening: Discontinuing breastfeeding can worsen engorgement and slow recovery 1

5. Maintains breastfeeding relationship: Stopping during mastitis treatment may contribute to early cessation of breastfeeding altogether 1

Management Recommendations

For the Mother

• Continue regular breastfeeding from the affected breast, as this is essential for treatment 1
• Optimize breastfeeding technique with proper infant latch 1, 3
• Encourage physiologic breastfeeding rather than pumping when possible 1, 3
• Pain management with pregnancy-safe analgesics such as acetaminophen or ibuprofen 1
• Conservative measures for 1-2 days including NSAIDs, ice application, and minimizing pumping 3
• Antibiotics if symptoms persist beyond 24-48 hours, typically those effective against Staphylococcus aureus (e.g., dicloxacillin, cephalexin) 1, 2

What to Avoid

• Excessive pumping to empty the breast, as this may worsen the condition 3
• Heat application and aggressive breast massage, which can increase inflammation 3
• Stopping breastfeeding, which can lead to milk stasis and worsen symptoms 1

Special Considerations

• Breast abscess: If a breast abscess develops, surgical drainage or needle aspiration may be needed, but breastfeeding can usually continue even with a treated abscess 2
• Monitoring the infant: Some infants may experience mild gastrointestinal effects such as diarrhea, although this is uncommon 1
• Risk for premature infants: The risk of necrotizing enterocolitis increases in premature infants if breast milk is temporarily replaced with formula, emphasizing the importance of continued breastfeeding 1

Follow-up and Monitoring

• Complete antibiotic course if prescribed 1
• Monitor for recurrence or complications 1
• Consider ultrasound if symptoms worsen despite antibiotics to evaluate for abscess formation 1, 3

The Academy of Breastfeeding Medicine, American Academy of Pediatrics, and World Health Organization all support continued breastfeeding during mastitis treatment as it is beneficial for both mother and infant 1.