• Improving positioning and attachment will help resolve mastitis
• Offering the affected side first, when the baby is more hungry, can help with milk removal
• Expressing and gentle massage are especially important if the baby does not feed well from the affected side
• Paracetamol and ibuprofen (if tolerated) are the most effective medications to relieve pain, pyrexia and inflammation with the least risk to the baby (under 0.6% of the maternal dose of ibuprofen enters the milk)
• Antibiotics (usually Flucloxacillin 250-500mg QDS for at least 7 days, or Erythromycin or Cephalexin if the mother is allergic to penicillin) should be started if there is no obvious improvement in 12 hours, or immediately if the onset of symptoms has been very sudden or there is rapid escalation.
• For more self-help tips for mum, see ‘Breastfeeding and mastitis’ leaflet, at www.breastfeedingnetwork.org.uk