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Mastitis
Definition
Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth
and redness. You also might have fever and chills. Mastitis most commonly affects women
who are breast-feeding (lactation mastitis). Mastitis occurs within the first 2-3 weeks after
giving birth, but it can happen later during breast-feeding. The condition can cause the
mother to feel run down, making it difficult to care for the baby.
Mastitis is especially problematic because it may lead to the discontinuation of breastfeeding, which provides optimal infant nutrition.
Optimizing lactation support is essential in women with mastitis.
Breastfeeding in the presence of mastitis generally does not pose a risk to the infant and
should be continued to maintain milk supply.

Things that can cause mastitis

A blocked milk duct. If a breast doesn't completely empty at feedings,
one of the milk ducts can become clogged, causing milk to back up, which leads to breast
infection.
Bacteria entering the breast. Bacteria from the skin's surface and
baby's mouth can enter the milk ducts through a break or crack in the skin of the nipple or
through a milk duct opening. Stagnant milk in a breast that isn't emptied enough provides
a breeding ground for the bacteria. The antibacterial properties of milk help protect the
baby from the infection.
Symptoms of complications
With mastitis, signs and symptoms can appear suddenly and may include:
Breast tenderness or warmth to the touch
Generally feeling ill (malaise)
Breast swelling
Pain or a burning sensation continuously or while breast-feeding
Skin redness, often in a wedge-shaped pattern
Fever of 38.3 C or greater
Although mastitis usually occurs in the first several weeks of breast-feeding, it
can happen anytime during breast-feeding. Mastitis tends to affect only one breast.
Risk factors for mastitis include:
Breast-feeding during the first few weeks after childbirth
Breast engorgement and milk stasis
Sore or cracked nipples, although mastitis can develop without broken skin

Poor breast hygiene infrequent changing of breast pads

Using only one position to breast-feed, which may not fully drain your breast
Wearing a tightfitting bra or putting pressure on your breast from using a
seatbelt or carrying a heavy bag, which may restrict milk flow
Becoming overly tired or stressed
Previous bout of mastitis while breast-feeding
Poor nutrition
If mastitis isn't adequately treated, a collection of pus (abscess) can develop in your
breast and form a breast mass or area of firmness with thickening. An abscess usually
requires surgical drainage. To avoid this complication, recognizing symptoms as soon as
you develop them is important.

Mastitis treatment usually involves:

Antibiotics. Treating mastitis usually requires a 10- to 14-day course of
antibiotics. It's important to take all the pills to minimize the chance of recurrence.
Pain relievers. A mild pain reliever, such as acetaminophen (Tylenol, others) or
ibuprofen (Advil, Motrin IB, others).
Adjustments to breast-feeding technique. Fully empty breasts during
breast-feeding and make sure baby latches on correctly. Referral to a lactation consultant
for help and ongoing support.
Self-care. Rest, continue breast-feeding and drink extra fluids to help the body
fight the breast infection.
If mastitis doesn't clear up after taking antibiotics, it is important to
follow up with a health care provider.
Its safe to continue breast-feeding and it helps clear the infection.
To relieve your discomfort:
Continue to breast-feed as often and as long as baby is hungry
Rest as much as possible
Avoid prolonged overfilling of breast with milk (engorgement) before breastfeeding
Vary breast-feeding positions
Drink plenty of fluids
If there is trouble emptying a portion of the breast, apply warm compresses to
the breast or take a warm shower before breast-feeding or pumping milk
Wear a supportive bra

If breast-feeding on the infected breast is too painful or the baby refuses to

nurse on that breast, try pumping or hand-expressing milk.
To avoid complications like mastitis consider meeting with a lactation consultant. A
lactation consultant can give tips and provide invaluable advice for proper breast-feeding
techniques.
Allow your baby to completely empty one breast before switching to the other
breast during feeding.
Change the position you use to breast-feed from one feeding to the next.
Make sure your baby latches on properly during feedings.
Patient

teaching key points

Wash hands well before breastfeeding
Breast cleanliness frequent breast pad changes
Expose nipples to air as much as possible
Correct latch on and removal from breast
Empty breast
Breastfeed frequently
If extremely painful, start breastfeeding on uninfected side first
Massage distended area as baby breastfeeds
Ice packs and moist heat
Encourage fluid intake
Good fitting bra

Support the mother emotionally and reassure her that she can continue to
breastfeed.

Risk Factors for Mastitis

Cleft lip or palate

Cracked nipples
Infant attachment difficulties
Local milk stasis
Missed feeding
Nipple piercing
Plastic-backed breast pads
Poor maternal nutrition
Previous mastitis
Primiparity
Restriction from a tight bra
Short frenulum in infant
Sore nipples
Use of a manual breast pump
Yeast infection