Do I need antibiotics if I have mastitis?

If you’ve been hit with the burning, aching, feverish beast that is mastitis—first of all, I’m so sorry. It’s brutal. But let’s clear up one of the biggest myths I still hear:

You do NOT need to pump and dump if you’re on antibiotics for mastitis.

That milk? Still safe. Still liquid gold. Still full of antibodies your baby can benefit from.

According to the Academy of Breastfeeding Medicine’s Protocol #36 on Mastitis (updated version!), here’s what you really need to know:

1. Keep removing milk—just not too little or too much.

🥛 Moving milk frequently helps reduce inflammation and protect your supply.

🥛BUT aggressively trying to “empty the breast” over and over can create oversupply, which keeps the inflammation party going longer.

🥛Aim for a “just right” approach: Feed or pump on your normal schedule unless otherwise advised, and monitor how you feel.

2. Antibiotics can usually be avoided, but if needed, they’re breastfeeding-safe.

💊First line antibiotics for mastitis (dicloxacillin, flucloxacillin, or cephalexin) are compatible with nursing.

💊You don’t need to pause breastfeeding or pumping.

💊They may cause some gut changes in you or your baby (like looser stools or mild tummy upset), but that’s typically short-term. You can support gut health with probiotics, fiber, and hydration.

3. Mastitis is inflammatory, not just infectious.

🩺Newer research shows it’s not just about clogged ducts—it’s about dysbiosis, tissue stress, and sometimes immune imbalance.

🩺That’s why ABM recommends a whole-body approach: Rest, fluids, anti-inflammatories (like ibuprofen), and strategic milk removal—not overdoing it, not underdoing it.

If you’ve been hit with the burning, aching, feverish beast that is mastitis—first of all, I’m so sorry. It’s brutal. But let’s clear up one of the biggest myths I still hear:

You do NOT need to pump and dump if you’re on antibiotics for mastitis.

That milk? Still safe. Still liquid gold. Still full of antibodies your baby can benefit from.

According to the Academy of Breastfeeding Medicine’s Protocol #36 on Mastitis (updated version!), here’s what you really need to know:

1. Keep removing milk—just not too little or too much.

🥛 Moving milk frequently helps reduce inflammation and protect your supply.

🥛BUT aggressively trying to “empty the breast” over and over can create oversupply, which keeps the inflammation party going longer.

🥛Aim for a “just right” approach: Feed or pump on your normal schedule unless otherwise advised, and monitor how you feel.

2. Antibiotics can usually be avoided, but if needed, they’re breastfeeding-safe.

💊First line antibiotics for mastitis (dicloxacillin, flucloxacillin, or cephalexin) are compatible with nursing.

💊These same antibiotics can be given directly to baby if they have an infection, at higher doses than

💊They may cause some gut changes in you or your baby (like looser stools or mild tummy upset), but that’s typically short-term. You can support gut health with probiotics, fiber, and hydration.

3. Mastitis is inflammatory, not just infectious.

🩺Newer research shows it’s not just about clogged ducts—it’s about dysbiosis, tissue stress, and sometimes immune imbalance.

🩺That’s why ABM recommends a whole-body approach: Rest, fluids, lymphatic massage/breast gymnastics, ice and anti-inflammatories (like ibuprofen), and strategic milk removal—not overdoing it, not underdoing it. Usually by managing mastitis with these first, antibiotics can be avoided

You don’t need to suffer through mastitis alone. And you definitely don’t need to waste your milk.

If you’re not sure how often to pump or feed, or you’re on round two of mastitis and feeling burned out, email me to lalactation@gmail.com and let’s talk through it.