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OVERVIEW

What is mastitis?

Mastitis is an inflammation of the breast.  It is usually caused by an infection. It often happens while a woman is breastfeeding, especially during the first 6 weeks. Having mastitis does not raise your risk of developing breast cancer.

SYMPTOMS

What are the symptoms of mastitis?

Women who have mastitis feel generally ill. They may feel run down or achy. In addition to an inflamed breast, they may feel like they have the flu. Other symptoms include:

• Breast pain
• Breast swelling
• A tender, red, wedge-shaped area on the breast
• A breast that is warm or hot to the touch
• A burning sensation while breastfeeding
• Discharge from the nipple
• Fever
• Chills
• Nausea or vomiting

Mastitis usually affects one breast, not both breasts.

CAUSES

What causes mastitis?

Mastitis is usually caused by germs (bacteria) that are found on the skin or in your baby’s mouth. These bacteria can enter your breast through a milk duct opening or a crack in the nipple.

Infection is more likely to happen when milk is trapped in the breast. Stagnant milk sitting in the breast makes bacteria grow, which leads to infection. Trapped milk can happen due to inexperience or poor technique in breastfeeding. Sometimes a milk duct can get blocked, causing milk to back up in the breast.

You may be at higher risk of developing mastitis if you:

• Have sore or cracked nipples
• Use only one position to breastfeed (using different positions helps make sure you completely drain the breast)
• Wear a tight-fitting bra or put pressure on your breasts (which can restrict milk flow)

DIAGNOSIS & TESTS

How can my healthcare provider tell if I have mastitis?

Your healthcare provider will ask you about your symptoms and examine the affected breast. They will check for swelling, tenderness and a painful, wedge-shaped area on the breast that is a tell-tale sign of mastitis.

If you are not breastfeeding and you have symptoms of mastitis, your healthcare provider may order other tests. These could include a breast ultrasound, MRI, mammogram, or biopsy.

PREVENTION

Can mastitis be prevented or avoided?

Below are some basic breastfeeding techniques to lower your risk of developing mastitis.

• Your baby should latch onto the nipple with their mouth open wide.
• Allow your baby to empty one breast before switching to the other breast.
• Change your baby’s position from one feeding to the next to help empty all the areas of the breast.
• If you need to stop a feeding, break the suction using your finger.
• Don’t wear tight-fitting bras or breast pads that cause your nipples to stay moist after breastfeeding.
• Air your nipples out when possible.
• Tell your healthcare provider or lactation consultant if you have nipple pain during nursing.

TREATMENT

How is mastitis treated?

Sometimes breast infections go away on their own. If you notice you have symptoms of mastitis, try the following:

• Breastfeed on the affected side every 2 hours, or more frequently. This will keep your milk flowing and prevent your breast from getting too full of milk.
• Massage the area. Start behind where it is sore and use a circular motion toward the nipple.
• Apply warm, moist compresses to the sore area.
• Wear a supportive, well-fitting bra. Make sure it isn’t too tight. You don’t want to constrict your milk ducts.

Your healthcare provider will likely prescribe antibiotics to clear up the infection. You should start to feel better a few days after starting the antibiotics. But make sure you take all the antibiotics your healthcare provider prescribes to prevent antibiotic resistance.

Over-the-counter pain medicines such as acetaminophen (one brand name: Tylenol) or ibuprofen (one brand name: Advil) can help relieve pain. Warm showers can also help relieve the pain.

Although it may be painful, it is important to keep breastfeeding when you have mastitis. Your breast milk will not be bad for your baby, even if you have mastitis, although some infants may not like the taste. If you stop breastfeeding, germs can spread in the milk that is left in your breast, and your infection can get worse. If you cannot nurse your baby, you should pump your breasts to remove the milk.

Getting enough rest and drinking extra fluids can help you feel better faster. Contact your healthcare provider if your symptoms get worse.

Living with mastitis

If mastitis isn’t treated properly, an abscess (collection of pus) may develop. This could form a mass in your breast. Abscesses are usually painful. They normally must be drained surgically.

Call your healthcare provider right away if you notice any of the following symptoms:

• Infection in both breasts
• Pus or blood in your breastmilk
• Red streaks near the affected area
• Symptoms came on severely and suddenly
• A painful lump that might be an abscess

To prevent these types of complications, contact your healthcare provider when you first notice symptoms of mastitis.