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What is Mastitis?
Breast mastitis is an infection that commonly affects women who are breast-feeding
(especially during the first two months after childbirth) but can occur in all women at
any time. Mastitis is a benign (non-cancerous) condition that can usually be treated
successfully with antibiotics. Signs of mastitis include red, hot, painful, or
inflamed breasts and other flu-like symptoms such as headache, nausea, high body temperature
(101 degrees Fahrenheit, 38.4 degrees Celsius or greater), or chills. Women with
symptoms of mastitis should see a physician. Breast-feeding with mastitis is
generally not harmful to the baby and may actually help speed up
recovery.
How Does Mastitis Occur?
Mastitis during breast-feeding can be caused by:
- Breast engorgement (swelling)
- A blocked milk duct
- Cracked or damaged skin or tissue around the nipple
Mastitis most commonly occurs when the breasts are not fully emptied of milk. The
milk overflows from the breast glands and engorges the breasts. Breast engorgement
(swelling) can occur any time the breasts produce more milk than the amount being removed
by breast-feeding, pumping, or manual (hand) expression. Breast engorgement
increases the risk of infection. If bacteria enter the breast through an opening in
the nipple or a break in the skin, the breast tissue becomes infected.
When bacteria enters the breast ducts, it grows and attracts inflammatory cells.
Inflammatory cells release substances to fight the infection (mastitis) but also cause the
breast tissue to well and increases blood flow. Nasopharyngeal organisms from the
infant's mouth, sinuses and other air passages are usually the source of breast infections
in breast-feeding women. Though women may be inclined to stop breast-feeding if they
have mastitis, continued breast-feeding actually helps to clear the infection.
Breast-feeding with mastitis is usually not harmful to the baby.
How is Mastitis Prevented?
Mastitis may be prevented by breast-feeding, pumping, or manually (hand) expressing
milk frequently to avoid engorgement. Improper
positioning during breast-feeding, such as leaning over the baby, can lead to
mastitis. Women are encouraged to use two to three different breast-feeding
positions each day and to avoid tight or binding bras while breast-feeding. When
weaning the baby, do so gradually to avoid engorgement and mastitis.
How is Mastitis Diagnosed?
Mastitis is typically diagnosed by a physician based on signs such as swollen, red, and
painful breasts and flu-like symptoms. If a physician is unsure whether a patient
has mastitis, he or she may order a laboratory culture of the breast milk.
Approximately 10% of women with mastitis develop abscesses in the infected breast area.
An abscess is a benign (non-cancerous) closed pocket containing pus (a creamy,
thick, pale yellow or yellow-green fluid). Abscesses are usually drained with
needles. A particularly large abscess may need to be cut open to drain.
Usually, the area I numbed with a local anesthesia and covered with gauze after the
procedure.
How is Mastitis Treated?
Mastitis usually requires treatment. Treatment for mastitis may require the
following:
- Antibiotics are usually prescribed by a
physician to help clear up the infection. Women with mastitis
should schedule an appointment with a doctor.
- Use warm water on the infected area of the
breast before breast-feeding to help stimulate let-down (the milk
ejection reflex).
- Breast-feed or pump frequently, using both
breasts. Lactation consultants recommend first breast-feeding from the
unaffected breast until let-down (milk ejection reflex) occurs and then
switch to the breast with mastitis.
- Breast-feed only until the breast is soft.
- Apply icy compresses to the breasts after
breast-feeding to relieve pain and swelling.
- Drink fluids and get enough rest.
- Ask a physician about whether over the counter pain relievers such as acetaminophen
(Tylenol) or ibuprofen are safe to reduce pain.
Additional Resources and References
Updated: August 15, 2007
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