Mastitis occurs when breast tissue becomes inflamed and leads to infection. When an infection occurs, it causes breast pain, swollen breast, tenderness, redness, fever, and chills.
Generally, mastitis commonly affects women during breastfeeding (also known as lactation mastitis). Sometimes, it can happen in those not currently breastfeeding, and even in men.
Patients with lactation mastitis tend to feel tired and run down, causing difficulty caring for their babies. It is better for the mother and baby to continue with breastfeeding while taking a course of antibiotics for the mastitis.
Symptoms
Symptoms tend to appear suddenly as follows:
- Breast tenderness
- Swollen breast
- Breast tissue becomes thickening or known as a breast lump
- Pain or a burning sensation during breastfeeding
- Skin redness
- Tends to feel ill
- Fever 38.3 C or higher
When to consult a doctor
The patient should seek medical attention if they experience any breast symptoms that concern them.
Causes
The leading cause of mastitis is milk that has become trapped in the breast; other causes are as follows:
- Blocked milk ducts – If the breast can’t be adequately emptied, there could be blockage in the milk ducts, raising the risk of breast infection.
- Bacteria enter the breast - Bacteria from the baby's mouth and skin can enter the milk ducts through a nipple skin crack. It can also enter through dilated milk duct. Inadequate excretion of breast milk could contribute to increased risk of bacterial infection.
Factors that increase the risk of mastitis are as follows:
- Previous mastitis while breastfeeding.
- Sore or cracked nipples.
- Too much pressure on the breast from a tight seat belt, tight fitting bra, or toting a heavy backpack restricting the flow of milk.
- Improper nursing technique
- Feeling too tired or too stressed.
- Poor nutrition
- Smoking cigarettes
Complications
If left untreated, mastitis could lead to a blocked milk duct, resulting in a breast abscess. When this happens, surgical drainage is required. To avoid abscess formation, patients should discuss this with their doctors as soon as they detect any mastitis symptoms.
How to prevent mastitis
The patient should consider discussing with a lactation consultant to avoid mastitis. A lactation consultant will be able to give the patient tips and provide devices for proper breastfeeding.
These tips can help minimize the chances of developing mastitis:
- Try to completely drain the milk from the breasts with each breastfeeding.
- Allow the baby to empty one breast before switching to the other breast.
- Try different breastfeeding positions to find the most comfortable one.
- Make sure your baby is supported properly during feedings.
- Smokers should ask their doctor how to quit the habit.
Diagnosis
The doctor will perform a physical examination and check out the patient's symptoms. A breast milk culture may be sent to determine the right antibiotic for the patient, especially in severe cases.
Inflammatory breast cancer may present with redness and swollen breasts that can be confused with mastitis. However, this type of cancer is very rare. The doctor may suggest the patient undergo a mammogram or ultrasound examination or both if the symptoms continue even after taking many courses of different antibiotics. A breast biopsy may be obtained to ensure there is no breast cancer.
Treatment
- Antibiotics – The doctor will prescribe a 10-day course of antibiotics for the infection. The course of medication should be fully finished to reduce the chance of recurrence. Follow up with the doctor If the symptom doesn’t improve after the antibiotic treatment.
- Pain relievers – The doctor will recommend pain relievers, such as acetaminophen or ibuprofen, to help relieve the pain.
Breastfeeding can be continued even with mastitis, as breastfeeding can help clear the infection. Weaning the baby from breastfeeding in the middle of mastitis could worsen the symptoms.
The doctor may refer the patient to a breastfeeding specialist for guidance and support. Suggestions for proper breastfeeding techniques are as follows:
- Avoid leaving an overfilled breast untapped for an extended period before the subsequent breastfeeding.
- Make sure the baby latches properly — This may be difficult if there are blocked milk ducts. Expressing some breast milk manually first before each breastfeeding may help.
- Massaging the breast while pumping the milk – Focusing on the area under the nipple.
- Ensure the breast is adequately emptied with each breastfeeding – Apply warm and moist heat to the breast before pumping out the milk if the patient has trouble draining out the milk.
- Breastfeeding is on the problematic side first when the baby is hungry and sucking vigorously.
- Change breastfeeding positions.
Lifestyle changes and tips for self-care at home
- Avoid build-up of breast milk for an extended period before subsequent breastfeeding
- Apply ice packs to the breast after breastfeeding
- Wear a supportive bra
- Rest as much as you can
Preparing for the doctor’s appointment
If mastitis is suspected, the doctor may consult with an obstetrician-gynecologist or a breastfeeding specialist.
- List down all symptoms, even if unrelated to mastitis.
- List all medications, vitamins, and supplements the patient is currently taking.
- List down all key medical information, including other health conditions.
- List all key personal information, including any recent significant life changes or stresses.
- Note down questions to ask the doctor.
Questions to ask the doctor
- Do I need treatment, or will the mastitis recover on its own?
- How can I care for myself at home to relieve the symptoms?
- Is it possible for the symptoms to be passed on to the baby, and how?
- Is the medication prescribed safe for the baby if I continue to breastfeed?
- Must I take medication to treat mastitis; how long do I have to take it?
- Are there any chances for recurrences? How can I prevent it?
Questions the doctor may ask you
The doctor will most likely ask the patient several questions as follows:
- How long has the patient experience the symptoms? Are these just on one side or in both breasts?
- How severe is the pain?
- What breastfeeding technique do you use?
- Have you ever had mastitis before?
