Breast mastitis is an infection that commonly affects women who are breast-feeding (especially during the first two months after childbirth) but can occur in all women at any time. Mastitis is a benign (non-cancerous) condition that can usually be treated successfully with antibiotics. Signs of mastitis include red, hot, painful, or inflamed breasts and other flu-like symptoms such as headache, nausea, high temperature (101 degrees Fahrenheit, 38.4 degrees Celsius or greater), or chills. Women with symptoms of mastitis should see a physician. Breast-feeding with mastitis is generally not harmful to the baby and may actually help speed up recovery.
Mastitis during breast-feeding can be caused by:
Mastitis most commonly occurs when the breasts are not fully emptied of milk. The milk overflows from the breast glands and engorges the breasts. Breast engorgement (swelling) can occur any time the breasts produce more milk than the amount being removed by breast-feeding, pumping, or manual (hand) expression. Breast engorgement increases the risk of infection. If bacteria enter the breast through an opening in the nipple or a break in the skin, the breast tissue becomes infected.
When bacteria enters the breast ducts, it grows and attracts inflammatory cells. Inflammatory cells release substances to fight the infection (mastitis) but also cause the breast tissue to well and increases blood flow. Nasopharyngeal organisms from the infant's mouth, sinuses and other air passages are usually the source of breast infections in breast-feeding women. Though women may be inclined to stop breast-feeding if they have mastitis, continued breast-feeding actually helps to clear the infection. Breast-feeding with mastitis is usually not harmful to the baby.
Mastitis may be prevented by breast-feeding, pumping, or manually (hand) expressing milk frequently to avoid engorgement. Improper positioning during breast-feeding, such as leaning over the baby, can lead to mastitis. Women are encouraged to use two to three different breast-feeding positions each day and to avoid tight or binding bras while breast-feeding. When weaning the baby, do so gradually to avoid engorgement and mastitis.
Mastitis is typically diagnosed by a physician based on signs such as swollen, red, and painful breasts and flu-like symptoms. If a physician is unsure whether a patient has mastitis, he or she may order a laboratory culture of the breast milk. Approximately 10% of women with mastitis develop abscesses in the infected breast area. An abscess is a benign (non-cancerous) closed pocket containing pus (a creamy, thick, pale yellow or yellow-green fluid). Abscesses are usually drained with needles. A particularly large abscess may need to be cut open to drain. Usually, the area I numbed with a local anesthesia and covered with gauze after the procedure.
Mastitis usually requires treatment. Treatment for mastitis may require the following:
Updated: June 29, 2008