Mastitis

Mastitis is a condition characterized by inflammation of the breast tissue, often accompanied by an infection. This inflammatory response leads to various symptoms, including breast pain, swelling, warmth, redness, and sometimes fever and chills. While mastitis is most commonly associated with lactating women (lactation mastitis), it can also affect women who are not breastfeeding and even men. Lactation mastitis can significantly impact a mother’s well-being and sometimes forces early weaning of the baby. However, it is generally recommended to continue breastfeeding, even while undergoing treatment with antibiotics, as it benefits both the mother and the infant.

Products & Services

Mayo Clinic offers a range of resources and services, including the “Mayo Clinic Family Health Book, 5th Edition,” to provide comprehensive information on health-related topics, including mastitis.

Symptoms

The signs and symptoms of mastitis can manifest suddenly and may include:

• Breast tenderness or warmth to the touch
• Breast swelling
• Thickening of breast tissue or a breast lump
• Continuous pain or a burning sensation, especially during breastfeeding
• Skin redness, often in a wedge-shaped pattern
• General feelings of illness
• Fever of 101°F (38.3°C) or higher

When to See a Doctor

If you experience any breast-related symptoms that concern you, it is advisable to consult with your healthcare provider promptly.

Causes

The primary cause of mastitis is the accumulation of milk in the breast. Other contributing factors include:

• Blocked Milk Duct: Inadequate emptying of the breast during feedings can lead to a blocked milk duct, causing milk to back up and potentially result in breast infection.

• Bacterial Entry: Bacteria from the skin’s surface or the baby’s mouth can enter milk ducts through a nipple crack or milk duct opening. Stagnant milk in an inadequately emptied breast creates an environment conducive to bacterial growth.

Risk Factors

Several risk factors can increase the likelihood of developing mastitis, including:

• Previous Mastitis Episode: A history of previous mastitis while breastfeeding can heighten the risk of recurrence.

• Sore or Cracked Nipples: Although mastitis can develop without broken skin, sore or cracked nipples can contribute to its development.

• Tightfitting Bra or Pressure: Wearing a tight bra or exerting pressure on the breast, such as with a seat belt or carrying a heavy bag, may restrict milk flow.

• Improper Nursing Technique: Incorrect breastfeeding techniques can contribute to mastitis development.

• Fatigue and Stress: Becoming overly tired or stressed can weaken the body’s immune defenses and increase susceptibility to infection.

• Poor Nutrition: Inadequate nutrition can compromise the body’s ability to fight infections effectively.

• Smoking: Smoking has been linked to an increased risk of mastitis.

Complications

Mastitis that remains untreated or is associated with a blocked duct can lead to the formation of a pus-filled collection known as an abscess. Abscesses typically require surgical drainage to resolve. To prevent this complication, it is essential to seek medical attention as soon as symptoms of mastitis appear.

Prevention

Establishing a successful breastfeeding relationship with your infant and minimizing the risk of complications such as mastitis can be achieved by consulting a lactation consultant. These professionals can offer valuable guidance on proper breastfeeding techniques.

To reduce the chances of developing mastitis, consider the following preventive measures:

1. Complete Breast Drainage: Ensure that you thoroughly empty your breasts during breastfeeding sessions.

2. Allow Full Breast Emptying: Let your baby completely empty one breast before switching to the other during feedings.

3. Vary Nursing Positions: Change your breastfeeding positions from one feeding to the next.

4. Correct Latching: Ensure your baby latches on properly during feedings. Seek assistance if needed.

5. Smoking Cessation: If you smoke, consult your doctor about smoking cessation programs to reduce risk factors associated with mastitis.

Diagnosis

Diagnosing mastitis involves a thorough physical examination by your doctor, during which they will inquire about your signs and symptoms. In some cases, a culture of your breast milk may be obtained to assist your doctor in determining the most appropriate antibiotic for treatment, especially in cases of severe infection.

It is important to note that inflammatory breast cancer, a rare form of breast cancer, can cause symptoms such as redness and swelling, which might initially be mistaken for mastitis. Your doctor may recommend a mammogram or ultrasound or both to rule out cancer. If your symptoms persist after completing a course of antibiotics, further evaluation, such as a biopsy, may be necessary to ensure there is no underlying breast cancer.

Treatment

Mastitis treatment typically involves the following:

1. Antibiotics: In cases of infection, a 10-day course of antibiotics is usually prescribed. It is essential to complete the full antibiotic regimen to minimize the risk of recurrence. If symptoms persist after antibiotic treatment, it is advisable to follow up with your doctor.

2. Pain Relievers: Your doctor may recommend over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil), to alleviate pain and discomfort.

It is safe to continue breastfeeding during mastitis, as breastfeeding helps clear the infection. In fact, abrupt weaning can exacerbate symptoms. Your doctor may refer you to a lactation consultant for support and guidance. Adjustments to your breastfeeding techniques can be recommended, including:

• Avoid overfilling the breast with milk before breastfeeding.

• Ensure your baby latches correctly, which can be challenging when your breast is engorged.

• Massage the breast while breastfeeding or pumping to promote milk flow from the affected area.

• Ensure complete breast drainage during feeding sessions. If you have difficulty emptying a portion of your breast, apply warm, moist heat before breastfeeding or pumping milk.

• Breastfeed on the affected side first when your baby is hungrier and has a stronger sucking reflex.

• Vary your breastfeeding positions to promote complete breast emptying.

Lifestyle and Home Remedies

To alleviate discomfort, you can:

• Avoid overfilling the breast with milk before breastfeeding.
• Apply cool compresses or ice packs to the breast after breastfeeding.
• Wear a supportive bra.
• Rest as much as possible.

Preparing for Your Appointment

If you suspect mastitis and are scheduling a healthcare appointment, consider the following preparations:

What You Can Do:

• Document your symptoms, including those that might seem unrelated to your condition.
• Compile a list of all medications, vitamins, and supplements you are currently taking.
• Summarize your medical history and disclose any other existing medical conditions.
• Include personal information, such as recent life changes or sources of stress.
• Prepare a list of questions you want to ask your doctor.

Questions to Ask Your Doctor:

• Will my mastitis resolve without treatment, or is intervention required?
• What home remedies can I use to alleviate my symptoms?
• How will my condition affect my baby?
• Is the medication you are prescribing safe for my baby if I continue to breastfeed?
• How long should I take the prescribed medication?
• What is the likelihood of a recurrence, and how can I minimize that risk?

In addition to your prepared questions, do not hesitate to ask any additional queries that arise during your appointment.

What to Expect From Your Doctor

During your appointment, your doctor will likely inquire about the following:

• The duration of your symptoms and whether they affect one or both breasts.
• The severity of your pain.
• Your breastfeeding techniques.
• Your history of mastitis, if applicable.

Conclusion

Mastitis is a breast condition characterized by inflammation and sometimes infection, primarily affecting lactating women. It can be a painful and distressing experience but is generally manageable with proper treatment, including antibiotics and pain relievers. It is crucial for mothers to understand that continuing breastfeeding, even while undergoing treatment, is beneficial for both mother and baby. Seeking prompt medical attention and consulting with a lactation consultant can help manage and prevent this condition. By adhering to proper breastfeeding techniques and following the guidance of healthcare professionals, women can increase their chances of an enjoyable breastfeeding experience and minimize the risk of mastitis.