Breastfeeding and Mastitis

April 23, 2019

Breastfeeding 101: Let’s start at the beginning.

 It is day 3/4/5 or whenever your milk develops (we used to say “comes in” but this is technically incorrect, as the pregnant body produces colostrum before delivery). Your perhaps previously small breasts have suddenly jumped up a few cup sizes and now resemble large blue bowling balls; this is called engorgement. You’ve been giving this feeding thing a good go for the past few days, and baby is (hopefully) latching well. It can take time to perfect the latch, so persevere and it’ll get quicker and easier for both you and bub.



Get Comfortable

  • Make yourself comfortable, take a big breath and try to relax
  • Be patient with yourself and with your baby. As the baby will pick up on your emotions and any stress around feeding or their attachment; particularly in the early days when their other senses are heightened until their vision develops
  • Contrary to what you're told about breastfeeding not causing pain, there may be an initial moment of discomfort as baby latches. Once correctly attached, there should be minimal pain and only an odd prickling sensation for some women when the let-down occurs.


If you do experience discomfort it may be due to cracked or damaged nipples. Try to modify the position for feeding so the baby takes the areola in their mouth and not just the nipple. Alternatively you may wish to try a nipple shield. Speaking with a lactation consultant can be useful as there may be able to advise on modifying your baby’s latching technique. Some women find Lanolin cream applied before and after a feed helpful. Gently hand expressing a small amount of breastmilk which can be rubbed over the nipple after a feed (this is just one of the many amazing ways breast milk promotes healing!).



Engorgement… Ouch!!

Engorgement occurs when the breasts produce more milk than they can hold (common when your milk matures) or if a feed is missed. This causes the brea sts to feel hard and uncomfortably full. If this occurs and is left untreated, blocked ducts or mastitis may develop. Blockages and mastitis can also develop as a result of a tight bra or clothing, pressure from nursing pads or trauma to the breast/nipple. As tired as you probably are, if a thoughtful relative or friend offers to watch baby while you nap. Try to set an alarm and make sure they’re back in time for the next feed. If you nap on the couch, make sure your nursing bra/singlet isn’t too tight, this can cause compression of breast tissue. Going bra-less or “free-boobing” is often good for the girls!



Mastitis; what is it?

Red, angry, sore patches on the breast, sometimes accompanied by streaks and shiny skin, and often a feeling of general malaise; as if you’re getting the f lu. It is caused by milk being pushed into the surrounding tissue. Possible due to bra / hand compression or increased force through duct due engorgement. Your body is well trained to recognise anything out of the norm (like this backflow). So inflammatory markers are released to ‘protect’ you from these foreign cells. Clever body! The only down side is that while you’re fighting this inflammation, your body isn’t functioning at full capacity. It is your body’s way of saying you’ve overdone it and need to rest.


If detected early, it is relatively easy to reduce and recover from symptoms of Mastitis. Firstly, REST! Leave the housework – call upon your partner or family members to help. Your priority is looking after yourself so that you can better look after baby.


Drink plenty of fluids, and make sure you're eating well and enough

A hot shower or warm washcloth applied to the breast before a feed can help soften areas of tension and may assist with clearing any blockages

An ice pack applied after feeding can assist with reducing heat and inflammation. Some women also apply cold cabbage leaves to the breast or soak the breast in warm water and Epsom salts

Have a break from feeding off this breast for a feed to allow some recovery provided engorgement is not an issue.

If you feel the need to express, do so gently as we do not want to promote an oversupply or cause further inflammation



Can a Physiotherapist help?

A Pelvic Health physiotherapist may use therapeutic ultrasound on the affected area to reduce pain and swelling. Massaging towards the armpit to promote lymphatic drainage is helpful. But, please do not use a comb to aggressively massage lumps out of your breast. There is a school of thought that this is beneficial, but it may in fact worsen symptoms. Massage gently with the pads of your fingers, but not to the point of pain.


Your Physio will cover massage techniques. They will also be able to make recommendations of feeding positions, appropriate clothing for adequate support. They will provide advice on reducing the risk of subsequent episodes of Mastitis. Seek treatment from a GP for advice and pharmacological intervention if your symptoms do not improve.



More from the blog

Why Does My Child Have 'Sneaky Poos'? (Encopresis Explained for Parents)

By Nicola Andreacchio • May 18, 2026
Encopresis is when a child regularly soils their underwear after the age they would usually be toilet trained. For many children, this happens because of long-term constipation, stool withholding, or reduced awareness of the body’s signals that tell them they need to do a poo. When stool builds up in the bowel over time, the rectum can stretch and become less sensitive. This means children may not feel the urge to go, and softer stool can leak around the blockage without them realising. This can be frustrating and upsetting for both children and parents, but it is very common and treatable. Pelvic health physiotherapy can play an important role in helping children manage encopresis by improving bowel habits, supporting healthy toileting routines, and helping the bowel return to normal function. Treatment may include: Education for both parents and children about how the bowel works and why soiling happens Helping children develop regular toilet routines, especially after meals when the bowel is naturally more active Improving toilet posture, including correct foot support and positioning, to make bowel motions easier to pass Teaching breathing and relaxation strategies to reduce straining, fear, or withholding behaviours Supporting children to better recognise body signals and respond to the urge to open their bowels Addressing pelvic floor muscle tension or coordination difficulties that may affect bowel emptying Working through sensory challenges, toileting anxiety, or distractions that may contribute to accidents Pelvic health physiotherapy is gentle, supportive, and child-focused. Appointments are designed to help children feel safe and comfortable while also giving parents practical strategies to use at home. The goal is to reduce accidents, improve bowel emptying, and make toileting a less stressful experience for the whole family. With patience and the right support, children can regain confidence and work toward long-term healthy bowel habits.

Bedwetting and alarms

By Kylie Conway • May 14, 2026
Bedwetting, also known as nocturnal enuresis, is very common in children. It is rarely intentional and is usually part of normal development, especially when children sleep very deeply and do not wake to bladder signals. There are a few reasons this can happen. Some children produce more urine overnight, some have a smaller bladder capacity, and others are still developing the brain–bladder connection needed to recognise and respond to a full bladder during sleep. It can also run in families, so a family history of bedwetting is common. A bedwetting alarm is one of the most effective treatment options. It works by detecting moisture as soon as wetting starts and then sounding or vibrating to wake the child. The aim is for the child to wake, stop urinating, and finish in the toilet. Over time, this helps train the brain to respond earlier to bladder signals during sleep. In the beginning, many children do not wake fully to the alarm and may need a parent to help them get up and use the toilet. With consistent use, this response usually improves, and children gradually start waking on their own. It is important that bedwetting is managed with patience and reassurance. It is not a behaviour issue, and children are not doing it on purpose. Pressure or punishment can make things more stressful and does not help with progress. Alongside alarm use, simple bladder habits can support progress, such as regular daytime toileting, good fluid intake earlier in the day, and managing constipation if present, as this can impact bladder function. Pelvic health physiotherapy can also provide support. A pelvic health physio can help set up and explain how to use a bedwetting alarm, making sure families feel confident from the start. We guide you on where to place the sensor, how to respond when it goes off, and what steps to follow overnight to build consistency. We also help troubleshoot common challenges and adjust the plan if needed, to improve the chances of success. Alongside this, we provide education and a structured plan tailored to the child and family, helping to support progress and confidence over time.

The Pelvic Floor and Sexual Function in Men

By Kylie Conway • April 20, 2026
Sexual health is an important part of overall wellbeing, yet it is something many men find difficult to talk about. One factor that is often overlooked is the role of the pelvic floor in sexual function. The pelvic floor is a group of muscles at the base of the pelvis. In men, these muscles help support the bladder and bowel, and they also play a key role in erections, ejaculation, and sexual sensation. When these muscles are not functioning well - whether they are too tight, too weak, or not coordinating properly - it can contribute to sexual difficulties. Some men may experience erectile dysfunction, difficulty maintaining an erection, changes in ejaculation, reduced sensation, or discomfort during or after sex. These concerns can occur at any stage of life and are more common than many people realise. There are a range of factors that can affect pelvic floor function. Stress and anxiety can increase muscle tension, while surgery (such as prostate surgery), prolonged sitting, or chronic pelvic pain can also play a role. Often, it is a combination of factors rather than a single cause. It is also important to recognise the role of the mind-body connection. Stress, performance anxiety, and emotional wellbeing can all influence sexual function. Addressing both the physical and psychological aspects of health often leads to the best outcomes. Pelvic health physiotherapy can help identify how the pelvic floor is functioning and guide treatment. This may include exercises to improve strength or relaxation, breathing techniques, and strategies to reduce tension and improve coordination. Education and small changes can often make a meaningful difference. Sexual dysfunction in men is common, and support is available. Understanding the connection between the pelvic floor and sexual health can be an important step toward improving confidence, comfort, and overall wellbeing.

Pelvic Health Is For Everyone

By Kylie Conway • March 18, 2026
Pelvic Health Is for Everyone Pelvic health is often talked about as a women’s issue, but in reality it affects people of all genders across every stage of life. The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles also play a role in sexual function and everyday movements like lifting, bending, coughing, or laughing. Because they are involved in so many aspects of daily life, looking after pelvic health is important for everyone. Pelvic health concerns can show up in many different ways. Some people experience bladder leakage, urgency, constipation, or changes in bowel habits. Others may experience pelvic girdle pain, including discomfort around the sacroiliac joints, pubic symphysis, or coccyx (tailbone). Pelvic pain can also occur in the lower abdomen or in the genitals and may affect comfort with sitting, exercise, or sexual activity. These symptoms can affect people of any gender, yet they are often not openly discussed. Pelvic floor challenges can appear at different stages of life. Children may experience constipation, bedwetting, or daytime bladder accidents. Adolescents and adults may notice pelvic pain, bladder urgency, or bowel changes. Men may experience pelvic pain or bladder symptoms, including leakage, particularly after prostate surgery. Older adults may notice changes in bladder or bowel control or pelvic comfort as the body changes with age. While these experiences are common, many people are surprised to learn that help is available. Hormones also play an important role in pelvic health for people of all genders. Changes in hormone levels; during puberty, pregnancy, menopause, or as part of gender-affirming hormone therapy, can influence tissue health, bladder control, sexual function, and comfort in the pelvic region. Understanding these changes and supporting the body with the right care can make a meaningful difference. Pelvic health physiotherapy offers practical support, education, and treatment for many of these concerns. Physiotherapists can help people better understand their pelvic floor, improve bladder and bowel habits, manage pelvic girdle or pelvic pain, and support comfortable movement in daily life. Often, small changes can make a big difference to daily comfort and confidence. Pelvic health isn’t limited to one gender or one stage of life. By talking about it more openly and recognising the many ways it can affect the body, we can make it easier for everyone to seek support and care for their pelvic health.