Mastitis (Breast Infection)

What is mastitis?

Mastitis is the medical term for inflammation of the breast which occurs due to a bacterial infection of the breast tissue. It is characterized by painful breast swelling usually with high fever. The most common bacteria responsible for mastitis is Streptococci and Staphylococcus aureus, however other bacteria may also be responsible. Usually breastfeeding mothers are affected within one to three months of delivery. It can occur in non-pregnant women including after menopause.

Mastitis is women who are breastfeeding is known as lactation mastitis. The most serious complication of untreated mastitis is collection of pus in the breast tissue (abscess) which requires surgical management. Repeated attack of mastitis is quite common in women who have previously suffered from mastitis. Breastfeeding mothers should not discontinue nursing. Mastitis can be effectively treated with antibiotics and painkillers.

Mastitis Location

Breast tissue consists of glands and ducts. The milk produced in the glands is carried by the ducts to the nipple. The dark area just beyond the nipple is the areola beneath which lie the lactiferous ducts. During sucking of baby these ducts are filled with milk and nipple secretes the milk. The infection usually occurs in the ducts and is isolated here. It can spread into the surrounding breast fat if it is left untreated. In most instances only one breast is affected and usually the breast that the baby prefers to feed on in pregnant women. However, sometimes both breasts are infected.

Mastitis Symptoms

In the early stages, breastfeeding mothers may ignore the initial symptoms as the breasts are sore and tender from nursing. However, as the condition progresses, the symptoms are pronounced and should warrant medical investigation. The common symptoms of mastitis includes :

  • Pain and tenderness of the breast.
  • Affected breast appear swollen and warm. Often redness of the affected breast may be seen in a typical wedge pattern.
  • High fever with chill and rigor.
  • Generalized body ache.
  • Weakness.
  • Nausea and vomiting.
  • Pus discharge from the nipple.
  • Painful enlarged glands (lymph nodes) in arm pit on the same side of affected breast.
  • Burning sensation and pain relentlessly or during breast feeding.

Usually mastitis associated with lactation commonly occurs with early months of breastfeeding, however, it can occur during late phases of breast feeding. Lactation mastitis characteristically affects one side of the breast.

Mastitis Complications

Untreated mastitis may become complicated and give rise to :

  • Repeated attacks of mastitis in women with history of mastitis.
  • Milk stasis when milk is not completely emptied from the breast. There may be leakage of milk into the surrounding breast tissue leading to pain, breast lumps and other inflammatory changes in the breast.
  • Delayed or inadequate treatment especially in cases of milk stasis leads to breast abscess due to collection of pus within the breast tissue. It is characterized by persistent high fever with pus discharge from nipples.

Mastitis Causes

Bacteria present in the baby’s mouth or present on the skin of the nipple can enter through cracks on the nipple into the milk-carrying ducts. From the ducts the bacteria can rapidly multiply and infect adjacent breast tissue leading to symptoms of mastitis. Streptococci is commonly responsible for lactation mastitis. Blockage of milk carrying ducts by dead skin or failure to completely empty the breast may also lead to mastitis.

Sometimes superficial infection of the breast may become deep-seated and lead to breast abscess formation. Infection with Staphylococcus aureus is usually responsible for breast abscesses. Chronic mastitis can occur in non-lactating and postmenopausal women. Sometimes a rare form of breast cancer, inflammatory carcinoma, may lead to mastitis.

Risk factors

  • Breastfeeding.
  • Cracked skin of nipple, however mastitis can occur even with intact skin.
  • Failure to completely empty the breast.
  • Tight fitting bra.
  • History of mastitis.
  • Diabetes, HIV/AIDS and other immunocompromised conditions may also increases the risk of mastitis

Mastitis Treatment

Mastitis can be easily treated. It is important that women seek immediate treatment as delaying may lead to complications.

  • Antibiotics are usually prescribed for a 10 to 14 day course. Failure to complete the full antibiotic course predisposes women to repeated attack of mastitis.
  • Analgesics (painkillers) help to manage the pain associated with mastitis.

Other measures that help in the treatment and management includes :

  • Rest and plenty of fluid intake.
  • Complete emptying of breast during feeding Breastfeeding is to be continued.

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