Patient information from BMJ

Mastitis: breastfeeding advice

Last published:Aug 05, 2021

If you have developed mastitis, you've probably already been breastfeeding for at least a few weeks.

Some health professionals think that mastitis often happens because babies aren't breastfeeding properly, but we don't know this for sure.

But you might find it helpful to look at how your are breastfeeding, either to check if there's anything you could change that might help, or just to reassure you that you're doing nothing wrong.

Here we describe what position you and your baby should be in when breastfeeding, and the signs that tell you that your baby is feeding properly. To read more about mastitis and its treatment, see the leaflet Mastitis in breastfeeding women.

The first thing you need to do is get into a comfortable position. Make sure you’re sitting down with enough room to stretch your arms out to the elbows. Use cushions if you need extra back support. Remember you’ll be in this position a lot, and maybe for a long time.

Once you’re comfortable you need to get your baby in a good position for feeding:

• Hold your baby close to you with their body facing your chest

• Your baby’s head and body should be in a straight line

• Make sure your baby’s arm does not get in the way

• Keep your baby’s head and neck well supported but leave enough room to tilt their head back

• Hold your baby so their nose is level with your nipple and close enough to get a big mouthful of breast

• Keep your baby’s nose free for breathing (do not push it into your breast)

• You may find it helps to hold your breast from underneath, by making a C-shape with your thumb and forefinger.

The next thing you need to do is to get your baby to latch onto your breast. Your baby might do this without you having to do anything. But if your baby seems reluctant, then you may need to encourage them.

Try teasing your baby’s lips with the nipple to get them to open their mouth. As your baby opens their mouth, push your breast towards it with your nipple facing towards the roof of their mouth. If your baby does not want to feed, then stop and try again a bit later.

When your baby is properly attached you should notice the following:

• Your baby’s mouth is wide open

• You can see the coloured skin around the nipple. You should see more of this above your baby’s mouth and less underneath their chin

• Your baby’s chin is touching your breast

• Your baby’s lower lip is rolled down

• Your baby’s nose is free.

It's normal to feel some discomfort when you start to breastfeed. Your nipples may be sore and your breasts may feel very heavy and full, especially when your milk first comes in. This usually happens about three days after you give birth. But you shouldn't be in a lot of pain. If you are, ask a health professional about it.

There are certain signs that will tell you that your baby is feeding properly:

• You should be able to hear and see your baby swallowing

• Your baby should have a rhythmic suck

• Your baby’s arms and hands should be relaxed

• Your baby’s mouth should be moist

• Your baby should have regular soaked and heavy nappies

• Your breast should feel softer as your baby feeds

• Breastfeeding your baby should make you feel relaxed and even sleepy.