Mastitis is an infection in the tissue of one or both of the mammary glands inside the breasts. Mastitis usually affects women who are producing milk and breast-feeding.
The patient often feels a hard, sore spot inside the breast. Mastitis can occur as a result of a blocked milk duct, or bacteria entering the breast through a break in the skin.
Mastitis, also known as lactation mastitis, is thought to affect approximately 10 percent of all breast-feeding mothers. However, study results vary significantly, from a very small percentage of cases up to 33 percent.
The condition tends to emerge during the first three months after giving birth, but it can occur up to 2 years later.
Some mothers mistakenly wean their babies when they develop mastitis. In most cases, breast-feeding can continue during mastitis.
In the vast majority of cases, only one breast is affected. Sometimes, mastitis can affect women who are not lactating, but it is uncommon. In very rare cases, it can affect men.
Contents of this article:
Fast facts on mastitis
Here are some key points about mastitis. More detail and supporting information is in the main article.
- Mastitis rarely affects more than one breast at a time
- In very rare cases, mastitis can affect males
- Mastitis often occurs because of a blocked milk duct
- Symptoms can include chills, fatigue, and a swollen breast.
Symptoms of mastitis
Mastitis occurs in around 10 percent of breast-feeding mothers.
Signs or symptoms may develop rapidly, and could include:
- An area of the breast becomes red and swollen
- The affected area of the breast hurts when touched
- The affected area feels hot when touched
- A burning sensation in the breast that may be there all the time, or only when breast-feeding
The following symptoms are occasionally present:
- Anxiety, feeling stressed
- Chills and shivering
- Elevated body temperature
- General aches and pains
- A feeling of malaise
Causes of plugged duct
Mastitis is usually because of a blocked, or plugged, duct which causes milk stasis (milk is produced, but then remains in the breast, rather than coming out during feeding). Milk stasis may be caused by:
- The baby not attaching to the breast properly during feeding
- The baby having difficulties sucking the milk out of the breast
- The baby being breast-fed infrequently
- Milk ducts being blocked because of pressure on the breast caused by, for example, tight clothing
Anything that stops the milk from being properly expressed will usually result in milk stasis, which often leads to milk duct blockage.
Causes of mastitis
Bacteria do not generally thrive in fresh human milk. However, if the milk ducts are blocked, and the milk stagnates, the likelihood of infection grows. Experts believe that bacteria, which exist on the surface of breast skin, enter the breast through small cracks or breaks in the skin. They also suggest that bacteria in the baby's mouth may get into the mother's breast during a breast-feed.
Mastitis in women who are not lactating
Women who are not lactating (not producing milk, not breast-feeding) may develop mastitis - this is not common and is referred to as periductal mastitis. Those who do develop non-lactating infectious mastitis tend to be regular smokers and in their late 20s to early 30s.
Experts believe that smoking may damage the milk ducts, making them more susceptible to infection.
Mastitis after nipple piercing
Nipple piercing that is carried out by non-professional, unregistered piercing studios may raise the risk of mastitis occurring.
Diagnosis of mastitis
Mastitis is fairly easy to diagnose. A doctor will perform a physical examination and ask the patient questions about her symptoms.
When symptoms are severe, or if the woman does not respond to treatment, the doctor may take a small sample of breast milk for testing. Tests will usually determine whether there is a bacterial infection, as well as the type of bacteria. Identifying the type of bacteria helps the doctor select the most targeted treatment.
If the physician believes the mastitis is caused by a breast-feeding problem, the patient may be asked to demonstrate how she breast-feeds. It is important that the mother does not feel she is being blamed or judged. Breast-feeding often requires some practice.
Treatments for blocked duct
Self-care techniques can often resolve a blocked duct:
- The mother needs to make sure she is drinking plenty of liquids and resting.
- Symptoms of pain and fever can be alleviated with acetaminophen (Tylenol). Some of it will pass through the breast milk, but not enough to harm the baby. Do not take Aspirin while breast-feeding.
- Feed the baby more frequently.
- If an individual cannot feed the baby more frequently, expressing the milk more often can be helpful.
- During a feed, start with the affected breast. This ensures that it is drained more regularly.
- After a feed, gently express any leftover milk.
- Ask a healthcare professional whether the baby is attaching to the breast properly.
- Try different feeding positions until one is found that is more effective at draining the breast fully.
- Warming the breast before a feed can sometimes make it easier for the baby to get the milk out.
- Some stroking techniques can help with milk flow.
- Wearing very loose-fitting clothes until the mastitis has gone. When it has gone, avoid tight-fitting clothes.
If the problems persist, there are a range of support groups, which include certified lactation consultants and La Leche League meetings.
Treatments for mastitis
Treatments for mastitis usually include an antibiotic, as well as the techniques listed above for blocked duct. The antibiotic may be passed through the breast milk to the baby. The baby might produce runny stools and become restless. Doctors say this does not affect the baby, and the effects will disappear as soon as treatment is completed.
If the mastitis does not get better, the individual should see a doctor again.
Complications of mastitis
Recurrence - women who have had mastitis are more likely to get it again, compared with other women. In most cases, recurrence is due to late or inadequate treatment.
Abscess - if the mastitis is not treated properly, there is a risk that a collection of pus (abscess) can develop in the breast. Abscesses usually require surgical draining.