Overview

Mastitis is inflammation of the breast and is seen almost exclusively in women. It is especially common among women who are breastfeeding. Mastitis usually affects only one breast, but may affect both breasts.

Title
Mastitis

Types

There are 2 types of mastitis:

Non-infective mastitis symptoms

With non-infective mastitis, patients will feel generally well and:

  • the breast feeling hot and sore mainly in one area of the breast
  • the symptoms are gradual, not sudden
  • only one breast will be affected

Infective mastitis symptoms

With infective mastitis, the breast may feel tender, hot and swollen.

Other symptoms may include:

  • a fever or high temperature (38 degrees Celsius or higher)
  • chills
  • flu-like symptoms (aches and pains all over the body)
  • a tender, hot, swollen area of the breast

generally feeling unwell

Symptoms

Symptoms may include: fever ; fatigue; nausea or vomiting; aches, chills, or other flu-like symptoms; redness, tenderness, or swelling of the breast; a burning feeling in the breast; a hard feeling or tender lump in the breast; pus draining from the nipple; swollen lymph glands in the armpit or above the collar bones.

Causes

Mastitis occurs when a milk duct in the breast becomes blocked, or the skin around the breast nipple becomes cracked. Both of these situations allow bacteria to enter and infect the breast tissue. Causes of mastitis include pregnancy, breastfeeding, tuberculosis, skin rashes, or, rarely, breast cancer.

Diagnosis

Diagnosis is based on symptoms and medical history, and exam of the breast. If the diagnosis is uncertain, or if mastitis recurs, the following tests might be ordered: a culture of your breast milk or nipple discharge; a biopsy of the affected area; a breast ultrasound; a mammogram, or x-ray of the breast.

Treatment

Antibiotics are generally used to treat the infection and there is evidence that they may reduce the duration of symptoms. Whether antibiotics are necessary for a cure or to reduce the risk of more serious, but rare complications such as bloodstream infection, is unknown.

If mastitis does not respond to antibiotics, a localized collection of pus called an abscess might be present. This is usually treated with antibiotics and a drainage procedure or surgery.

Clearing Blocked Breast Ducts
Methods to clear block breast ducts include:

  • Breastfeeding frequently (Breastfeeding with mastitis is not harmful to the baby when treatment involves antibiotics such as cephalexin, amoxicillin, or erythromycin. The use of some other antibiotics may dictate caution, especially when breastfeeding an infant under eight weeks of age.
  • Using a breast pump
  • Applying warm compresses to breasts prior to feeding (to stimulate milk ejection reflex)
  • Offering the baby the infected breast first (to promote complete emptying of infected breast)

Pain Relief
To reduce pain and swelling in the breast:

  • Apply ice compresses to the affected area of your breast after breastfeeding.
  • If mastitis is not caused by breastfeeding, consider using over-the-counter pain relievers as recommended by your doctor.
  • If mastitis is caused by pregnancy or breastfeeding, be sure to ask health professionals what pain relievers are safe 
  • Drink lots of fluids.

Get plenty of rest.

Prevention

Strategies to help prevent mastitis include:

  • Prevent engorgement of the breast with milk by:
    • Frequent breastfeeding
    • Use of breast pump
  • Wash hands and breast nipple before breastfeeding.
  • Avoid wearing bras or clothing that is too tight.
  • Avoid sleeping on breasts, or allowing a baby to sleep on breasts.

If nipples crack, apply lotion or cream as recommended by health professionals

Complications

In more severe cases of infectious mastitis, an abscess can develop in the breast.

Risks

Risk factors include:

  • Previous mastitis
  • Abrasion or cracking of the breast nipple
  • Wearing a bra or clothing that is too tight
  • Missed breastfeeding
  • Irregular breastfeeding
  • Pressure on the breasts, caused by:
    • Sleeping on the stomach
    • Holding the breast too tightly during feeding
    • Baby sleeping on the breast
    • Exercising (especially running) without a support bra
  • Anything that causes too much milk to remain in the breast, including:
    • Baby's teething
    • Use of artificial nipple or pacifier
    • Incorrect positioning of the baby during feedings
    • Abrupt weaning
  • Low resistance to infection or immune deficiency disorder
  • Psoriasis or other skin conditions that affect the nipple
  • Diabetes mellitus
  • Rheumatoid arthritis
  • Use of cortisone drugs
  • Prior breast surgery or implants

Smoking

Recovery
Living with
Self-help