Mastitis

Overview

Mastitis is an inflammation of breast tissue that can sometimes involve infection. It results in symptoms such as breast pain, swelling, warmth, redness, fever, and chills. Mastitis commonly affects breastfeeding women (lactation mastitis), but it can also occur in women who are not breastfeeding and in men. Symptoms can appear suddenly, including breast tenderness or warmth, swelling, thickening of breast tissue, pain or burning sensation while breastfeeding, skin redness, and a general feeling of illness.

Understanding the disease

Symptoms

The symptoms of mastitis include breast tenderness or warmth to the touch, breast swelling, thickening of breast tissue or breast lump, pain or burning sensation while breast-feeding or continuously, skin redness often in a wedge-shaped pattern, and feeling generally unwell. If the mastitis is caused by an infection, additional symptoms such as fever of 101 F (38.3 C) or greater may be present. It is recommended to see a doctor if you experience breast symptoms that cause concern.

Risk Factors

Risk factors for developing mastitis include:

1. Previous bout of mastitis while breast-feeding
2. Sore or cracked nipples - although mastitis can develop without broken skin
3. Wearing a tight-fitting bra or putting pressure on your breast when using a seat belt or carrying a heavy bag, which may restrict milk flow
4. Improper nursing technique
5. Becoming overly tired or stressed
6. Poor nutrition
7. Smoking

Development

Mastitis can develop due to a blocked milk duct or bacteria entering the breast through a crack in the nipple or milk duct opening. The main cause of mastitis is milk that becomes trapped in the breast, leading to clogged ducts and providing a breeding ground for bacteria. Risk factors for mastitis include a previous bout of mastitis while breastfeeding, sore or cracked nipples, wearing a tight-fitting bra, improper nursing technique, becoming overly tired or stressed, poor nutrition, and smoking. Mastitis symptoms include breast tenderness, swelling, thickening of breast tissue, pain or burning sensations, skin redness, and general feeling of illness. It is essential to see a doctor if you have breast symptoms that concern you.

Assessment and Diagnosis

Triage

You should see a doctor if you have breast symptoms that concern you. These symptoms may include breast tenderness or warmth to the touch, breast swelling, thickening of breast tissue, pain or burning sensation while breast-feeding, skin redness, and feeling generally ill. If you have a fever of 101 F (38.3 C) or higher, it's particularly important to seek medical advice promptly. Early treatment is important to prevent complications such as an abscess.

Diagnosis

To diagnose mastitis, a doctor will typically perform a thorough physical exam and inquire about the patient's symptoms. In some cases, a culture of breast milk may be performed to determine the most effective antibiotic for treatment, especially if the infection is severe. If symptoms persist after completing a course of antibiotics, a biopsy may be necessary to rule out breast cancer.

Management and Treatment

Complications

Potential complications of mastitis include the development of an abscess, which may require surgical drainage. Untreated or improperly treated mastitis can also lead to a buildup of pus, causing breast tissue damage and potentially spreading the infection. Other complications can include breast inflammation, a decrease in milk supply, and difficulty breast-feeding due to pain and discomfort.

Prevention

Mastitis can be prevented by following these tips:

1. Proper breastfeeding technique: Ensure your baby latches on correctly and fully empties one breast before switching to the other during feeding.
2. Changing breastfeeding positions: Switch up the positions you use for breastfeeding at different feedings to encourage the milk to flow properly.
3. Drain the milk completely: Fully drain your breasts while breastfeeding to prevent milk buildup.
4. Avoid tight clothing: Wearing loose-fitting clothing and avoiding tight bras can help prevent pressure on your breasts that may restrict milk flow.
5. Good nutrition and rest: Maintain a healthy diet and get enough rest to help prevent mastitis caused by fatigue and poor nutrition.
6. Seek help from a lactation consultant: Consult a lactation consultant for valuable advice and tips on proper breastfeeding techniques.
7. Avoid smoking: If you smoke, talk to your doctor about quitting smoking to reduce your risk of mastitis. Remember, mastitis can still occur even with preventative measures, so it's essential to be aware of the symptoms and seek medical advice if you experience any of the signs mentioned above.

Treatment

Treatments for mastitis typically involve managing symptoms and addressing the underlying cause. Some common treatment options include:

1. Antibiotics: If your healthcare provider suspects that your mastitis is caused by a bacterial infection, they may prescribe antibiotics to help combat the infection.
2. Warm or cold compress: Applying a warm or cold compress to the affected breast can help alleviate pain and reduce inflammation. You can use a warm or cold pack wrapped in a cloth and apply it to the breast for 15-20 minutes at a time, several times a day.
3. Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help reduce pain and inflammation.
4. Breastfeeding: Continue breastfeeding, even with mastitis. Breastfeeding helps express milk and stimulates the production of antibodies that can fight the infection. If you're experiencing pain during breastfeeding, try to maintain a good latch, use warm compresses, and take pain relievers as needed.
5. Proper latch and positioning: Ensure your baby is latching on correctly and switch between breastfeeding positions to help empty the breast completely.
6. Increase fluid intake: Drinking plenty of fluids, such as water, tea, or milk, can help flush out bacteria and reduce the risk of recurring infections. Remember to follow your healthcare provider's advice and seek medical attention if your symptoms worsen or fail to improve with treatment.

Preparing for medical consultation

To prepare for an appointment for mastitis, you should take note of all your symptoms, even if they seem unrelated to the reason for which you scheduled the appointment. Review key personal information, including major stresses or recent life changes. Make a list of all medications, vitamins, and supplements that you take. Write down questions to ask, noting which are most important to you to have answered. Prepare to discuss your breast-feeding technique and if you have had mastitis previously.