For most cases of mastitis, your first call should be to your primary care doctor, OB-GYN, or midwife. Any of these providers can diagnose mastitis with a physical exam, prescribe antibiotics if needed, and refer you to a specialist when the situation calls for it. If you’re currently breastfeeding, your OB-GYN is often the most natural starting point since they already know your postpartum history.
Your Primary Care Doctor or OB-GYN
Mastitis is typically diagnosed through a physical exam and a review of your symptoms. Your doctor will look for the hallmark signs: a red, warm, wedge-shaped area of swelling on the breast, pain, and fever. No blood work or imaging is usually needed for a straightforward case. If infection is suspected, the standard treatment is a 10- to 14-day course of oral antibiotics targeting the bacteria most commonly involved.
Alongside antibiotics, the Academy of Breastfeeding Medicine recommends ice packs (applied every hour if needed) and over-the-counter anti-inflammatory pain relievers to bring down swelling and ease discomfort. These simple measures can make a significant difference while the antibiotics take effect.
If your symptoms don’t improve after a full course of antibiotics, your doctor may order a mammogram or ultrasound to rule out an abscess or, in rare cases, request a biopsy to exclude breast cancer, which can occasionally mimic mastitis.
Lactation Consultants for Breastfeeding-Related Causes
Mastitis in breastfeeding parents often starts with a poor latch, incomplete milk drainage, or blocked ducts. A doctor can treat the infection, but fixing the underlying breastfeeding mechanics is what prevents it from coming back. That’s where an International Board Certified Lactation Consultant (IBCLC) comes in.
An IBCLC can assess your baby’s latch, adjust positioning, and help you develop a feeding or pumping routine that keeps milk flowing. They can also identify issues like nipple blebs (small white bumps that block a milk duct opening) and guide you on treatment. Lactation consultants don’t prescribe medication, so they work alongside your doctor rather than replacing them. Many hospitals, birthing centers, and pediatrician offices have IBCLCs on staff, and your OB-GYN can refer you to one.
Telehealth as a Faster Option
If you’re breastfeeding and recognize the symptoms of mastitis, a telehealth visit can get you a diagnosis and prescription in as little as 15 minutes. Several platforms now offer asynchronous consultations where you fill out a health questionnaire, and a board-certified provider reviews it and sends a treatment plan without a video call. This option works well for uncomplicated lactational mastitis, where the symptoms are clear-cut: breast pain, warmth, tenderness, and fever in someone who is currently nursing.
Telehealth is not the right fit if you notice pus or blood draining from the breast, red streaks extending toward your chest or arms, or signs of a worsening infection. Those situations need an in-person exam.
When You Need a Breast Surgeon
About 3 to 11 percent of mastitis cases progress to a breast abscess, a pocket of pus that forms inside the breast tissue. If your doctor suspects an abscess, you’ll likely be referred for an ultrasound to confirm it, followed by a referral to a breast surgeon or general surgeon for drainage. In most cases, the surgeon can drain the abscess using a needle guided by ultrasound, a minimally invasive procedure that avoids a larger incision. Chronic or recurring abscesses sometimes require traditional surgical drainage.
You may also be referred to a surgeon if mastitis keeps coming back despite proper antibiotic treatment. Recurrent infections can signal an underlying issue like a blocked or damaged milk duct that needs further investigation, including possible biopsy to rule out other conditions.
Non-Lactational Mastitis
Mastitis doesn’t only happen during breastfeeding. Periductal mastitis, which involves inflammation around the milk ducts, can occur in women who aren’t nursing, and breast infections (though rare) can also affect men. In these cases, a primary care doctor is still the right first stop, but the referral pathway looks a little different.
Because non-lactational mastitis can be caused by a wider range of bacteria and sometimes mimics other breast conditions, your doctor will likely want imaging early on. The infection may involve organisms not typically seen in breastfeeding-related mastitis, which can change the choice of antibiotic. If an abscess forms or the diagnosis is uncertain, you’ll be referred to a breast surgeon or breast medicine specialist. For men experiencing breast tissue infection, the same pathway applies: primary care first, then a breast clinic or surgical oncologist if the case is complex or doesn’t respond to initial treatment.
When to Go to the ER
Most mastitis can wait for a same-day or next-day appointment with your regular doctor. But certain symptoms signal a more dangerous situation that needs immediate attention:
- A persistent fever over 101.5°F that isn’t coming down
- Dizziness, confusion, or fainting
- Nausea or vomiting severe enough that you can’t keep antibiotics down
- Pus or blood draining from the breast
- Red streaks spreading from the breast toward the chest or arms
Signs of sepsis from a breast infection include vomiting, diarrhea, slurred speech, and extreme confusion. This is a medical emergency. If you or someone around you notices these symptoms, go to the emergency room immediately.