Managing mastitis for mums of multiples

mastitis with multiples tips

Author: Melissa Hays, Cocoon & Cradle

Managing mastitis for mums of multiples – (I think that’s enough m’s)!

Oh mastitis – what a literal pain. If you are a mum of twins or triplets that wants to avoid mastitis or has mastitis and wants to know what to do next, you’ve come to the right place!

While mastitis is quite common (affecting up to 20% of breastfeeding mums), it is definitely not normal. But before we dive into all of the ins and outs, you may be asking yourself, what even is mastitis?

You may immediately think infection when you think of mastitis, but did you know that mastitis literally means inflammation of the breast. This may or may not involve a bacterial infection.

It’s likely that it goes like this:

Engorgement -> Non-infective Mastitis -> Infective Mastitis -> Breast Abscess

Common signs include a tender, hot and swollen wedge shaped area of breast, which may be associated with a temperature and flu like symptoms.

sore breast twins

Possible causes of mastitis with multiples

Well, it’s a long list. Including:

  • Damaged nipples
  • Infrequent or scheduled breastfeeds
  • Missed breastfeeds
  • Poor attachment or weak suck
  • Illness in mum or baby’s
  • Oversupply of milk
  • Rapid weaning
  • Pressure on the breast (e.g., tight bra)
  • Blocked nipple pore or duct (milk blister/bleb)
  • Stress and fatigue
breastfeeding multiples with mastitis

Mastitis with multiples management

If you are a mum of twins or triplets with mastitis, the most important thing to remember is to keep your breasts as close to empty as possible! The best treatment is frequent and effective milk removal.

This means feeding your little one’s more often, starting on the breast with mastitis if feeding one at a time. Position your baby’s with their chin or nose pointing to the reddened area as this will help with drainage.

After you have fed your twins or triplets, you may also express breastmilk by hand or pump depending on how empty your breasts feel.

Other important measures include focusing on rest, fluids and nutrition. That may mean utilising family, friends, or if possible paid help, so you can actually rest. Raising multiple little one’s is hard enough without adding mastitis to the mix, so please seek all of the support you can get.

You can also use heat, such as a shower or hot pack, just prior to feeding to help with your let-down, and use cold packs after feeding to help reduce swelling. Anti-inflammatory pain relief, such as ibuprofen (brand name Nurofen), can also help. Pain can stop your let-down reflex, and we don’t want that!

sore breast triplets breastfeeding

What about antibiotics?

The Academy of Breastfeeding Medicine (ABM) state that if symptoms are mild and have been present for less than 24 hours, effective milk removal and supportive measures may be enough. However, if symptoms are not improving within 12–24 hours or if you are feeling unwell, antibiotics should be started. Discuss with your doctor the best course of action for your individual circumstances.

Prevention of mastitis with multiples

Don’t want to get mastitis in the first place or don’t want it again? Focus on preventing breast engorgement! Check your twins or triplets attachment and positioning to the breast and never restrict feeds. Feeding on demand is perfect!

If you do find that your breasts get overly full and you are not able to breastfeed at the time, express by hand or with a pump until you are comfortable again. Check your breasts regularly for lumps, pain or redness too.

mastitis expressing twins

Mastitis is a literal pain, so please get support early. If you haven’t already, find yourself a breastfeeding bestie, aka. International Board Certified Lactation Consultant (IBCLC), to support you through this time. We are the leading experts in breastfeeding support and care, and love supporting mums of multiples, just like you.

Cocoon and Cradle Twins

Melissa Hays is an International Board Certified Lactation Consultant (IBCLC), Holistic Sleep Coach, Paediatric Nurse & Midwife

Instagram & Facebook: @cocoonandcradle



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