Mastitis: Causes, Symptoms, Diagnosis, Prevention, and Treatment
What is Mastitis?
Mastitis is an inflammatory condition of the breast tissue, often accompanied by infection. It most commonly affects women who are breastfeeding, though it can also occur in women who are not lactating and, in rare cases, even in men.
Mastitis can cause pain, swelling, redness, and warmth in the affected breast. It may also lead to fever and chills. If left untreated, mastitis can develop into an abscess requiring surgical drainage. Early diagnosis and treatment are essential to manage symptoms and prevent complications.
Types of Mastitis
1. Lactational Mastitis (Puerperal Mastitis):
Occurs during breastfeeding, usually within the first 6-12 weeks postpartum. It is the most common type and is often caused by milk stasis or bacterial infection.
2. Non-Lactational Mastitis:
This type occurs in women who are not breastfeeding. It may result from trauma, duct ectasia, or infections, and is more common in smokers and women with diabetes.
3. Periductal Mastitis:
Involves inflammation of the subareolar ducts. Often seen in non-lactating women and associated with smoking.
Causes of Mastitis
1. Milk Stasis
Milk stasis refers to the accumulation of milk in the breast, often due to:
• Infrequent breastfeeding
• Poor latching by the baby
• Skipped feedings
• Tight clothing or pressure on the breasts
2. Bacterial Infection
Cracked or sore nipples can allow bacteria (usually Staphylococcus aureus) from the skin or baby’s mouth to enter the breast tissue, leading to infection.
3. Blocked Milk Ducts
A clogged milk duct can lead to milk accumulation, inflammation, and eventually infection.
4. Weaning
Abrupt weaning can result in milk buildup and increase the risk of mastitis.
5. Poor Breastfeeding Techniques
Improper latching, ineffective suckling, or using only one breast can contribute to milk stasis.
6. Nipple Trauma
Cracked, sore, or bleeding nipples create a direct entry point for bacteria.
7. Smoking and Other Risk Factors
Non-lactational mastitis is more common in smokers and individuals with weakened immune systems or diabetes.
Signs and Symptoms of Mastitis
Recognizing the symptoms of mastitis early is critical for prompt treatment. Common signs include:
Breast-related Symptoms
• Swelling or engorgement
• Redness or warmth in the affected area
• Pain or burning sensation during breastfeeding
• A hard lump or area of thickened tissue
• Tenderness in one localized region of the breast
Systemic Symptoms
• Fever (often > 38.5°C or 101.3°F)
• Chills
• Fatigue or general malaise
• Body aches
• Flu-like symptoms
• Nipple-related Symptoms
• Cracked or sore nipples
• Pus or blood-stained nipple discharge (in some cases)
Diagnosis of Mastitis
Healthcare providers typically diagnose mastitis through clinical evaluation, but additional tests may be required in certain situations.
1. Physical Examination
The doctor will examine the breast for swelling, redness, and tenderness and check for the presence of a lump.
2. Medical History
A thorough history including breastfeeding habits, recent illnesses, nipple trauma, or weaning practices will help identify risk factors.
3. Breast Milk Culture
In cases of recurrent mastitis or persistent infection, a milk sample may be sent for culture to identify the causative bacteria and determine antibiotic sensitivity.
4. Ultrasound
If an abscess is suspected, a breast ultrasound can confirm the presence of fluid collection.
5. Mammogram or Biopsy (Rarely)
In non-lactational mastitis or when symptoms do not improve, further tests may be done to rule out inflammatory breast cancer or other underlying conditions.
Prevention of Mastitis
Preventing mastitis involves both good breastfeeding practices and general breast care. Here are some effective strategies:
1. Ensure Proper Latching
A good latch ensures complete drainage of the breast and prevents milk stasis. Consult a lactation expert if latching issues persist.
2. Breastfeed Regularly and Completely
Feed your baby on demand and allow the baby to empty one breast before switching to the other.
3. Alternate Breasts
Start breastfeeding on the opposite breast each time to ensure even milk drainage.
4. Avoid Tight Bras or Clothing
Tight garments can compress milk ducts and lead to blockages.
5. Care for Nipples
Use lanolin or breast milk to moisturize sore nipples and avoid harsh soaps that cause dryness..
6. Practice Good Hygiene
Wash hands before touching breasts or pumping milk. Keep feeding equipment and pump parts clean and sterile.
7. Treat Engorgement Promptly
If your breasts become engorged, express milk either manually or using a pump.
8. Avoid Skipping Feedings
Skipping feeds or long gaps between feedings increases the risk of milk stasis.
Treatment of Mastitis
1. Self-Care and Home Remedies
• Continue Breastfeeding: Frequent feeding helps drain the breast and relieve symptoms.
• Warm Compresses: Apply warm compresses to the affected area before breastfeeding to improve milk flow.
• Cold Packs: After feeding, cold packs can help reduce inflammation and pain.
• Rest and Fluids: Adequate rest and hydration support recovery.
• Massage: Gentle massage of the breast towards the nipple during feeding or pumping helps clear blockages.
2. Medications
• Antibiotics: If symptoms do not improve within 24 hours, a doctor may prescribe antibiotics such as dicloxacillin, cephalexin, or clindamycin.
• Pain Relievers: Over-the-counter medications like ibuprofen or acetaminophen can relieve pain and reduce inflammation.
3. Treatment of Breast Abscess
• If a breast abscess develops (a pus-filled lump), it may require:
• Needle Aspiration: Draining pus using a needle guided by ultrasound.
• Surgical Drainage: In severe cases, an incision and drainage procedure may be necessary.
4. Lactation Support
A lactation consultant can help identify underlying breastfeeding issues, improve technique, and prevent recurrence.
Complications of Untreated Mastitis
• Breast Abscess: A localized collection of pus in the breast that may need surgical intervention.
• Recurrent Mastitis: Untreated or poorly managed mastitis can come back repeatedly.
• Premature Weaning: Pain and discomfort may lead some mothers to stop breastfeeding earlier than planned.
• Sepsis (Rare): If infection spreads, it can cause a severe systemic response requiring emergency care.
Mastitis vs. Other Breast Conditions
Condition Key Features
• Mastitis Pain, redness, fever, occurs during lactation
• Breast Abscess Localized pus, swelling, fever
• Plugged Milk Duct Tender lump, no fever
• Engorgement Full, hard breasts, no infection
• Inflammatory Breast Cancer Persistent redness, swelling, peau d’orange appearance, often no pain
When to See a Doctor
• Seek medical attention if:
• Symptoms persist or worsen after 24–48 hours
• Fever exceeds 38.5°C (101.3°F)
• Pus or bloody discharge appears
• You notice a hard, painful lump that does not resolve
• You experience symptoms of an abscess (severe pain, localized swelling)
Frequently Asked Questions (FAQs)
1. Can I continue breastfeeding if I have mastitis?
Yes. In fact, continuing to breastfeed or express milk helps drain the breast and speed up recovery. It’s safe for the baby even if you’re on antibiotics.
2. Is mastitis contagious?
No. Mastitis is not contagious and cannot be passed to the baby through breastfeeding.
3. How long does mastitis last?
With proper treatment, most cases of mastitis resolve within 3–5 days. Severe or complicated cases may take longer.
4. Can mastitis occur without infection?
Yes. Inflammation due to milk stasis can cause non-infectious mastitis, but it may lead to infection if not treated early.
5.What foods help prevent Mastitis?
Hydrating foods, Omega 3 rich sources (like fish), and foods high in Vitamin C, Zinc and antioxidants help boots immunity and reduce inflammation.
Conclusion
Mastitis is a painful but treatable condition that commonly affects breastfeeding mothers. Early identification and treatment are crucial to avoid complications like abscess formation. Ensuring good breastfeeding techniques, regular feeding schedules, and proper nipple care can help prevent mastitis.
If you experience persistent pain, fever, or swelling in your breast, seek medical help promptly. With the right care, most women recover quickly and can continue breastfeeding successfully.
This article is for informational purposes only and does not substitute professional medical advice. Consult your healthcare provider for a personalized diagnosis and treatment plan.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)