Mastitis is an inflammation and infection in the breast, usually seen in women following childbirth. Bacteria that enter the mother’s breast from the nursing baby’s nose or throat generally cause the infection. The most common bacteria involved strains of Staphylococcus aureus or Streptococcus. It affects about 1% of new mothers. Risk increases if there is an abrasion or crack in the nipple and with breast-feeding. Other contributing factors may include blocked milk ducts from tight-fitting bras, sleeping on the stomach, and prolonged time between feedings.
Symptoms may include:
Symptoms may occur anytime while nursing, but usually begin 3 to 4 weeks after delivery:
Tender, swollen, hard, and hot breast tissue
Fever
Breast lumps
Pus discharge from nipple
Enlarge lymph nodes in armpits of affected breast
What your doctor can do:
Diagnose mastitis by asking about your symptoms and medical history, and by performing a physical exam.
Order laboratory tests such as blood studies, and culture of pus or fluid.
Perform mammography (x-ray of the breast) or a breast biopsy (removal and study of a small amount of tissue) if something other than infection is suspected as a cause.
Prescribe antibiotics to fight bacterial infections.
Perform an incision to drain pus if you have an abscess (a localized area with increasing redness, pain, or tenderness).
Prescribe pain relievers as needed.
What you can do:
Finish the full prescription of antibiotics, even if you start to feel better. This assures complete treatment of the infection.
Apply an ice pack (ice in a plastic bag, covered with a thin towel) on the engorged breast 3 to 6 times a day for 15 to 20 minutes at a time. Do not use ice packs within 1 hour of nursing. Use warm compresses instead.
Wear an uplift bra during treatment.
Continue to breast-feed, even though breasts are infected. Offer the affected breast first to promote complete emptying. Massage the breast with firm pressure from the chest toward the nipple.
If an abscess develops, stop breast-feeding on the affected side, and use a breast pump to empty the affected breast regularly. Continue breast-feeding on the unaffected side.
For minor discomfort, you may use non-prescription drugs such as acetaminophen.
Rest in bed until fever and pain diminish.
Prevention includes washing the nipples before and after nursing, washing hands before touching breasts, and wearing a comfortable bra. When a nipple cracks or fissures, apply lanolin cream or other topical medication as recommended and consider using a nipple guard. DO NOT sleep on your stomach.
Drink extra fluids while you have fever.
DO NOT take any medication without talking to your doctor first. Most medications enter breast milk and may be harmful to your baby.
What you can expect:
Mastitis is usually curable in 10 days with treatment.
Without treatment, or if treatment is not completed, it may lead to a breast abscess.
Contact your doctor if you develop symptoms of mastitis, if your symptoms worsen despite receiving treatment, or if you are having difficulty breast-feeding.
