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Recurrent Mastitis


Refer to  Blocked Duct and Mastitis pages for definitions. 

30% of women will develop mastitis in the first 3 weeks after delivery.

30% of those women will develop a second mastitis. 

If you have developed a recurrent mastitis, find out why. 


Here are the most common reasons why women get recurrent mastitis: 

1. Milk left in the breast for a longer time than the breast wants it to be.

  • skipping a feeding,
  • sleeping longer at night,
  • skipping feedings at night (someone else is feeding the baby so you can sleep)
  • high milk production that the baby cannot remove,
  • baby with a cold so doesn’t feed well

2. Open wound on the nipple (see Nipple Scab article)


3. Pressure on the breast

  • tight bra,
  • seatbelt,
  • sleeping on stomach,
  • baby carrier
  • backpack/ heavy purse
  • baby sleeping on your chest
  • massage

4. Milk blister, bleb, inflamed duct.  See Bleb article.



Once a duct gets inflamed, it is at higher risk for getting blocked and reblocked.  If you have a “bleb” or inflamed duct, make sure you drain the breast well at every feeding.

  • Massage the breast during the feeding/pumping,
  • If your baby did not feed well for some reason, pump after that feeding to fully drain

5. Incomplete treatment during the first mastitis

  • Incorrect type of antibiotic (dicloxacillin, cephalexin and clindamycin are all first line antibiotic choices). 
  • Incorrect antibiotic dosage (verify dosage with pharmacy)
  • Short treatment course (a 10 to 14 day course may be needed)



Recommended antibiotic therapies for mastitis: speak with your doctor about antibiotic choices


Dicloxacillin 500mg every six hours if you don’t have a penicillin allergy. 


If you are allergic to penicillin but can take cephalosposins, take cephalexin 500mg every 6 hours for 10 days. 

If you are allergic to penicillin and have never taken cephalosporins, take clindamycin 300mg every six hours for 10 days. 

Zithromax is not a first choice antibiotic for mastitis and may not be effective for mastitis. 

**If you have recurrent mastitis in the same breast, speak with your doctor about getting a culture done to identify the bacteria causing the infection. 

**If you have recurrent mastitis in the same spot each time, speak with your doctor about getting an ultrasound to evaluate the area.