Mastitis

Mastitis means inflammation (injury from infection or irritation) of the breast tissue Mastitis may occur in up to a third of women who are lactating (forming breast milk) after giving birth and is then called lactation mastitis When lactation mastitis is due to an infection, it is usually caused by a bacteria, although fungal (yeast infections) can also be the cause Most cases of lactation mastitis occur during the first three months postpartum (after giving birth), but it may occur at any time as long as a woman is breast feeding When mastitis is severe, an abscess (collection of pus from an infection) may develop in the breast.

SYMPTOMS OF LACTATION MASTITIS

  • Malaise (feeling tired and unwell)
  • Fever
  • Reddened area of the breast, usually wedge shaped
  • Warmth or tenderness of the breast
  • Pain with nursing (can also be caused by sore or cracked nipples without mastitis)

POSSIBLE RISK FACTORS FOR DEVELOPING MASTITIS

  • Mastitis after a previous pregnancy
  • Nipple cracks or sores
  • Using only one position to breastfeed so the entire breast does not empty
  • Tight fitting bra that obstructs milk flow
  • Incomplete emptying of breasts (milk stasis)

TREATMENT OF MASTITIS

  • Continue nursing and use different feeding positions (Positioning the infant at the breast with the chin or nose pointing to the blockage)
  • Complete, frequent emptying of the affected breast (If pain interferes with the let-down, begin nursing on the unaffected breast until let-down is achieved and then switch breasts)
  • Warm compresses or warm shower just prior to nursing (Once breasts are emptied, ice packs can be applied to relieve pain and swelling)
  • Massaging the breast during the feed with an edible oil or non-toxic lubricant on the fingers may facilitate milk removal. Massage should be directed from the blocked area moving toward the nipple
  • After feeding, expressing milk by hand or pump may augment milk drainage and hasten resolution of the problem
  • Increase fluid intake
  • Bed rest
  • Pain medication (Ibuprofen)
  • Antibiotics if prescribed by your doctor
  • Drainage of any abscess that may form

If you think you have mastitis, call the office In most cases, mastitis is easily treated Continuing to breastfeed while you have mastitis will not hurt your baby.

Mastitis can occur in older women who are not lactating This form of mastitis is called periductal mastitis The milk ducts near the nipple become inflamed, causing breast pain There may also be a breast mass near the nipple, retraction of the nipple, or discharge Because breast cancer can also cause these symptoms, it is important to see your doctor if you have any of them Treatment of periductal mastitis may include antibiotics or surgery if the periductal mass is severe

There is a form of breast cancer called inflammatory breast cancer that can be confused with mastitis Because inflammatory breast cancer is fast-growing, aggressive, and deadly, it is important to detect it early Fever usually occurs with mastitis, but rarely occurs with inflammatory breast cancer.

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*adapted from JAMA Patient Page -- April 2, 2003 (not copyrighted)