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Mastitis, particularly poorly-managed mastitis, has a major impact on breastfeeding duration. Effective management and prevention of re-occurrence requires adequate understanding of the different causes of mastitis and knowledge of appropriate strategies and therapies. Contrary to popular belief, mastitis is not synonymous with infection. In many cases there is no infection, hence the importance of appropriate clinical management that allows for a distinction between infective mastitis and other causes of inflammation of lactating breast tissue. Careful management can avoid the use of unnecessary antibiotic exposure. Herbal medicine can play an important role in the treatment and prevention of mastitis. However, it is imperative that clinicians have clear understanding of their limits of therapy, effectively follow-up, and have good referral pathways to ensure that women are supported by health professionals with an adequate understanding of breastfeeding.