Mastitis

Mastitis is an inflammation of the breast tissue that can cause pain, swelling, and redness. Although it is most common in breastfeeding women (lactational mastitis), it can also occur in women who are not nursing (nonlactational mastitis). Untreated mastitis can sometimes lead to a breast abscess, a collection of pus that may need to be drained. 

Common causes

  • A clogged milk duct: When milk isn't fully drained from a breast, a milk duct can become blocked, causing milk to back up. This can create a breeding ground for bacteria.

  • Bacteria entering the breast: Bacteria from the skin's surface or a baby's mouth can enter the milk ducts through a small crack or sore on the nipple.

  • Improper nursing technique: An incorrect latch or poor positioning can prevent a breast from fully emptying during a feeding.

  • Wearing a tight bra: Pressure on the breast from a tight-fitting bra or restrictive clothing can hinder milk flow.

  • Oversupply of milk: If you produce more milk than your baby can take in, it can lead to milk backing up in the breasts.

  • Fatigue or stress: Being overly tired or stressed can also be a contributing factor.

  • Other factors: Nonlactational mastitis can be associated with factors like nipple piercings, smoking, diabetes, or a weakened immune system. 

Signs and symptoms

Symptoms of mastitis can appear suddenly and may resemble the flu. 

  • Breast pain, swelling, and warmth.

  • A wedge-shaped area of redness on the breast. This may be harder to see on darker skin.

  • A hard lump in the breast tissue.

  • Fever and chills.

  • A general feeling of being unwell or fatigue.

  • A burning sensation during breastfeeding. 

Diagnosis

A doctor can often diagnose mastitis with a physical breast exam and by discussing your symptoms. In most cases, further lab tests are not needed. 

  • Breastmilk culture: In severe or unusual infections, or if the mastitis doesn't respond to initial treatment, a doctor may take a sample of breastmilk to identify the bacteria causing the infection.

  • Ultrasound: An ultrasound may be performed if a breast abscess is suspected or if the infection does not improve after a few days of treatment.

  • Biopsy: For women who are not breastfeeding and do not respond to antibiotics, a doctor may order a biopsy to rule out a rare form of breast cancer that mimics mastitis. 

Treatment

Treatment for mastitis can involve a combination of self-care and medical intervention. 

  • Medication: If an infection is present, a 10 to 14-day course of antibiotics is often prescribed. Over-the-counter pain relievers, such as ibuprofen, can help manage pain and reduce inflammation.

  • Continued breastfeeding: Unless advised otherwise by a doctor, it is important to continue breastfeeding. This helps clear the milk ducts and can speed up recovery.

  • Home care: Applying warm compresses before feeding and cold compresses afterward can help relieve pain and inflammation. Resting, staying hydrated, and massaging the affected area can also help improve symptoms.

  • Abscess treatment: If an abscess develops, it will likely require surgical drainage. 

Important: If you experience mastitis symptoms, especially fever, it is important to contact a healthcare provider for a proper diagnosis and treatment plan. 

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