mastitis

What is mastitis?

Mastitis is a condition in which a woman’s breast tissue becomes abnormally swollen or inflamed. It is usually caused by infection of the mammary ducts. It occurs almost exclusively in women who are breastfeeding.

Mastitis can occur in the presence or absence of infection. As it progresses, mastitis can lead to the formation of a breast abscess. This is a localized collection of pus in the breast tissue. Severe cases of mastitis can be fatal if left untreated.

Types of mastitis

Mastitis can be infected or non-infected. If the inflammation occurs without infection, it is usually due to milk stasis. Milk stasis is the accumulation of milk in the breast tissue of lactating women. However, inflammation caused by milk stasis typically progresses to inflammation with infection. This is because stagnant milk provides an environment where bacteria can grow.

Mastitis caused by infection is the most common form. Sometimes a break in the skin or nipple may occur. According to the American Cancer Society, it is usually Staphylococcus aureus bacteria enter this break and infect the breast tissue. To fight infection, the body releases a number of chemicals that cause inflammation.

What are the symptoms of mastitis?

The most common mastitis symptoms are:

  • swelling or breast enlargement
  • redness, swelling, tenderness, or feeling of warmth in the breast
  • itching in breast tissue
  • tenderness under your arm
  • a small cut or sore on the nipple or skin of the breast
  • fire

What causes mastitis?

Causes of mastitis include:

bacterial infection

Bacteria are normally found on the skin. It’s in everyone’s hands and normally harmless. However, if the bacteria can leave the skin, they can cause an infection. If bacteria enter the breast tissue, they can cause mastitis due to a break in the skin near or around the nipple.

Obstruction of the milk duct

Milk ducts carry milk from the mammary glands to the nipple. When these ducts become blocked, milk builds up inside the breast and causes inflammation and can lead to infection.

Who is at risk of mastitis?

The following may increase your risk of developing mastitis:

  • breastfeeding for the first few weeks after birth
  • sore or cracked nipples
  • using only one position to breastfeed
  • wearing a tight-fitting bra
  • previous episodes of mastitis
  • extreme tiredness or weakness

In such cases, there is a risk of milk accumulation in one or both breasts or infection of the breast tissue.

How is mastitis diagnosed?

Most cases of mastitis are diagnosed clinically. A doctor will ask you questions about the condition and then give you a physical exam.

The doctor may ask when you first saw the inflammation and how painful it was. They will also ask about other symptoms if you are breastfeeding and if you are taking any medications.

After a physical exam, your doctor will likely be able to tell if you have mastitis. If you have a severe infection or if the infection does not respond to treatment, your doctor may order a breast milk sample. The clinic will test the sample to detect the exact bacteria that caused the infection. This will allow your doctor to give you the best medicine possible, according to an article in American Family Physician.

Inflammatory breast cancer can mimic mastitis symptoms. If you are being treated for mastitis and symptoms do not improve, your doctor may test for cancer.

How is mastitis treated?

Treatment of mastitis ranges from antibiotics to minor surgical procedures. Some common treatments for mastitis include:

  • Antibiotics: Some antibiotics can clear up the bacterial infection that causes mastitis. You should not take any antibiotics that have not been prescribed by your doctor.
  • Ibuprofen: Ibuprofen is an over-the-counter medication that can be used to reduce pain, fever, and swelling associated with mastitis.
  • Acetaminophen: Acetaminophen can also be used to reduce pain and fever.

Antibiotic therapy usually cures the infection completely. Nursing mothers can still breastfeed during treatment. The infection is in the breast tissue and not in the milk. Breastfeeding can also speed up the healing process.

Your doctor may recommend that you have a surgical procedure called an incision and drainage. During this procedure, the doctor will make a small incision to help drain abscesses caused by infection.

Prevention

The following measures can help prevent mastitis:

  • taking care to avoid irritation and cracking of the nipple
  • frequent breastfeeding
  • using a breast pump
  • using an appropriate breastfeeding technique that ensures she is well latched on by the baby
  • weaning the baby for several weeks instead of suddenly stopping breastfeeding

Resources:

Breast inflammation. (2016, 21 April)

Mayo Clinic Staff. (2015, 12 June). Breast inflammation. received

Spencer, J. (2008, September 15). Treatment of mastitis in lactating women. American Family Practice, 78 (6), 727-731

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