What is mastitis?
Mastitis is a painful condition that is caused by an infection of the breast tissue that results in breast swelling, warmth, and redness. It usually affects pumping or breastfeeding women (lactation mastitis), but it can also occur in individuals who aren’t lactating. Because breastfeeding is painful and can lead to some breastfeeding moms weaning earlier than they hoped, it is crucial to understand how to recognize, prevent, and treat mastitis.
Though it is most commonly seen in breastfeeding women it can also affect non-lactating women and, rarely, men. Mastitis inflammation is usually caused by stagnant breast milk due to blockage or engorgement, making it essential to empty the breasts regularly by nursing or pumping. However, more severe cases of mastitis can be due to an infection, usually caused by bacteria entering the breast tissue through a cracked or sore nipple.
What causes mastitis?
Exactly what causes a mastitis breast infection can be challenging to pinpoint. However, it is usually due to either milk stasis, bacteria, or a combination. Milk stasis simply means a build-up of milk within the breast tissue. Sometimes, it can feel like a firm area of tissue in the affected area or a distinguishable breast lump. Milk typically becomes stagnant due to blocked milk ducts.
Clogged milk ducts are usually a result of irregular or infrequent emptying of the breasts. However, difficulty breastfeeding, such as not being able to get a good latch, can also contribute to a clogged duct. Some lactating mothers experiencing engorgement may restrict milk flow by wearing tight-fitting bras, carrying heavy bags that cross the chest, or wearing a seatbelt. All of which can put pressure on the breast and contribute to inflammatory mastitis.
Regardless, blocked milk can be a breeding ground for bacteria, which can come from various sources.
Bacteria from the skin’s surface, the baby’s mouth, or breast pump parts can enter the milk ducts through cracks in the nipple. When bacteria multiply within the breast, infection can occur, often referred to as bacterial mastitis.
What are the symptoms of mastitis?
Recognizing the signs of mastitis early can help you seek timely treatment and prevent complications. Early signs of mastitis often come on quickly instead of gradually. Symptoms include:
- Breast Pain: A localized pain in one area of the breast. Usually, mastitis occurs in only one and not both breasts.
- Swelling: The affected breast may become swollen and hard, causing the skin to become tight and shiny.
- Redness and Warmth: The skin over the infected area might be red and warm to the touch.
- Fever and Chills: Mastitis can cause flu-like symptoms, including fever, chills, and body aches.
- Fatigue: General feelings of tiredness and malaise.
- Swollen lymph nodes: Mastitis can occur almost anywhere on the breast, from the areola upward. If it begins to spread from the breast, it can cause swelling in the lymph nodes under the armpit and neck.
How is mastitis treated?
Catching the symptoms of mastitis and treating it early is essential for alleviating symptoms and preventing complications. Mild cases of mastitis can often be managed at home. However, reaching out to your doctor at the first signs of mastitis is critical. Ensuring the breasts are emptied regularly through frequent breastfeeding, or pumping can help relieve symptoms.
Specific breastfeeding techniques like dangle feeding may help unblock clogged ducts. Applying a warm compress to the affected area can ease pain and improve milk flow. Soaks, in which you lean forward and place the breast into a basin of warm water, can also encourage milk flow. While you have symptoms of mastitis, be sure to drink plenty of fluids and get lots of rest to help your body fight the infection.
If symptoms do not improve and a bacterial infection is suspected, your doctor may prescribe antibiotics for mastitis. Over-the-counter anti-inflammatory medications, like ibuprofen or a pain reliever like acetaminophen, may also be recommended to help reduce swelling and relieve pain.
What are the complications of mastitis?
If left untreated, mastitis can lead to more severe complications. If breastfeeding becomes painful and difficult or milk cannot be adequately expressed, a decrease in milk supply is possible, which can affect breastfeeding outcomes. More serious complications include chronic mastitis, in which recurrent episodes lead to chronic inflammation of the breast or a breast abscess in the breast tissue, which usually requires drainage and antibiotics.
Can mastitis be prevented?
Prevention is the best approach to managing mastitis, and there are a few ways to reduce your risk.
First, ensure your baby has a proper latch to avoid nipple trauma and ensure effective milk removal. Breastfeeding or pumping frequently is essential to preventing milk stasis. Alternating breastfeeding positions can also help ensure all areas of the breast are emptied effectively. In between nursing sessions, change your nursing pads frequently and wash your hands before breastfeeding or pumping to maintain good hygiene.
It’s also important to take care of your nipples with lanolin-based creams that moisturize them to prevent cracking. Unless advised by a doctor, be wary of supplements that can increase milk production, which could lead to oversupply.
Wearing loose-fitting bras and avoiding tight clothing can prevent constriction of the milk ducts. If you do experience clogged ducts, cracked nipples, or pain while breastfeeding, consult a lactation consultant or your healthcare provider for guidance.
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Mastitis FAQs
Can you breastfeed with mastitis?
It is usually safe to breastfeed with mastitis. Nursing or pumping can help remove the clog and drain the stagnant milk from the breast.
Can mastitis go away on its own?
Sometimes, mild cases of mastitis can go away on their own with prompt and thorough home treatment, such as expressing milk every two hours and warm compresses or soaks. However, because serious complications can occur, prompt assessment and treatment by your doctor are always recommended.
How common is mastitis?
Lactation mastitis is a common breastfeeding condition, affecting as many as 10% of breastfeeding women in the United States. It most commonly occurs during the first three weeks postpartum.
Sources:
Mastitis and sore breasts
https://llli.org/breastfeeding-info/mastitis
Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022
https://www.bfmed.org/assets/ABM%20Protocol%20%2336.pdf
Mastitis: What Breastfeeding Parents Need to Know
https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Mastitis.aspx
Acute Mastitis
https://www.ncbi.nlm.nih.gov/books/NBK557782/#:~:text=mastitis.%5B7%5D-,Go%20to:,the%20first%205%20years%20postpartum.
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