Mastitis: What’s Changed, What’s Wrong, and What Still Gets Missed
Mastitis isn’t just an infection. And the way we’ve been treating it… might be making things worse.
In this episode, Katie and Joh unpack mastitis through a more current lens — moving away from the idea of “blocked ducts” and towards understanding inflammation as the key driver.
They explore the early signs many women miss — including the flu-like symptoms that can appear before any visible breast changes — and why recognising these early can change the entire trajectory of the condition.
The conversation also challenges long-standing advice around heat, massage, and increased feeding, explaining why these approaches may worsen inflammation rather than resolve it. Instead, they introduce a more physiologically aligned approach focused on rest, anti-inflammatories, cold therapy, and maintaining normal feeding patterns.
Importantly, they discuss what happens when mastitis doesn’t fully resolve — including subclinical presentations, changes in milk supply, and the impact on baby behaviour. The episode also highlights the emotional and practical realities for mothers navigating mastitis, and the need for clinicians to remain flexible, transparent, and responsive when protocols don’t fit the individual.
In This Episode We Cover
- Early “boob flu” symptoms and why mastitis can present before breast changes
- The shift from “blocked ducts” to inflammation-based understanding
- Why heat and massage may worsen symptoms
- How cold therapy and anti-inflammatories may support recovery
- When to manage at home vs when to seek medical review
- Subclinical mastitis and recurring symptoms
- Changes in milk taste and baby feeding behaviour
- Maintaining milk supply when baby refuses one breast
- The role of clinical judgement beyond protocol
- Transparency and trust in complex lactation care
Want More From Katie and Joh?
Check out our courses for professionals:
Decoding the Suck: Gentle support for babies with sucking difficulties
Breastfeeding & Lactation: The Fundamentals
Pregnant or a new mum or parent? Find more support from Katie:
The Feeding Couch® – Breastfeeding SOS – for new mums and parents
Instagram
Katie: @katiejameslactation
Johanna: @milkandmotherhood
YouTube
The Latch Revolution
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Medical Disclaimer
Disclaimer: The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content.
Keywords
mastitis breastfeeding, mastitis inflammation vs infection, blocked ducts myth, mastitis treatment cold therapy, lactation mastitis protocol, breastfeeding pain inflammation, milk supply mastitis, baby refusing breast mastitis, subclinical mastitis, lactation consultant education
