What Is Mastitis?
Mastitis is a condition in which a woman’s breast tissue
becomes abnormally swollen or inflamed. It is usually caused by an infection of
the breast ducts. It occurs almost exclusively in women who are breastfeeding.
According to the World Health Organization, mastitis can
occur with or without the presence of infection (WHO, 2000).
As it progresses, mastitis can cause the formation of a breast abscess. This is a localized collection of pus within breast
tissue. Severe cases of mastitis can be fatal if left untreated.
Types of Mastitis
Mastitis can occur either with or without infection. If the
inflammation occurs without infection, it is usually caused by milk stasis (WHO, 2000).
Milk stasis is the buildup of milk within the breast tissue of lactating women.
However, inflammation caused by milk stasis typically
progresses to inflammation with infection. This is because the stagnant milk
provides an environment in which bacteria can grow.
Mastitis caused by an infection is the most common form.
Sometimes, a break in the skin or nipple can develop.
Bacteria (usually Staphylococcus aureus)
enter this break and infect the breast tissue (American
Cancer Society, 2012). To fight the infection, the body releases a host of
chemicals, which cause inflammation.
What Causes Mastitis?
The causes of mastitis include:
- Bacterial infection: Bacteria are normally found
on the skin. Everyone has them, and they are normally harmless. But if bacteria
are able to break through the skin, they can cause an infection. If bacteria
enter the breast tissue, due to a break in the skin near or around the nipple, they
may cause mastitis.
- Obstruction of a milk duct: Milk ducts carry milk
from the breast glands to the nipple. When these ducts are blocked, milk builds
up within the breast and causes inflammation and may result in infection.
Who Is at Risk for Mastitis?
The following may increase your risk of developing mastitis:
- breastfeeding for the first few weeks after childbirth
- sore or cracked nipples
- using only one position to breastfeed
- wearing a tight fitting bra
- previous episodes of mastitis
- extreme tiredness or fatigue
In these situations, you are at risk for the buildup of milk
within one or both breasts, or at risk for an infection of the breast tissue.
What Are the Symptoms of Mastitis?
The most common symptoms of mastitis are:
- swelling or breast enlargement
- redness, swelling, tenderness, or a sensation of
warmth on the breast
- itching over the breast tissue
- tenderness under your arm
- a small cut or wound in the nipple or on the
skin of the breast
How Is Mastitis Diagnosed?
Most cases of mastitis are diagnosed clinically. A doctor
will ask you questions about the condition and then give you a physical exam.
The doctor may ask when you first noticed the inflammation
and how painful it is. He or she will also ask about other symptoms, whether
you are lactating, and whether you are on any medications.
After the physical exam, your doctor will probably be able to
tell if you have mastitis. If you have a severe infection, or if the infection
does not respond to treatment, then your doctor may ask for a sample of breast
milk. The clinic will test the sample to identify the exact bacteria causing
the infection. This will allow your physician to give you the best possible
medication (Spencer, 2008).
Inflammatory breast cancer
can mimic the symptoms of mastitis. If you are being treated for mastitis
and the symptoms do not improve, your doctor may test for cancer.
How Is Mastitis Treated?
Treatment for mastitis ranges from the use of antibiotics to
undergoing a minor surgical procedure. Some common treatments for mastitis
- Antibiotics: Certain antibiotics can eradicate
the bacterial infection causing mastitis. (You should not take any antibiotics
that have not been prescribed by your physician.)
- Ibuprofen: Ibuprofen is an over-the-counter drug
that can be used to decrease the pain, fever, and swelling associated with
- Acetaminophen: Acetaminophen can also be used to
decrease pain and fever.
Antibiotic treatment usually completely resolves the
Breastfeeding mothers are still able to breastfeed during
treatment. The infection is in the breast tissue and not in the milk.
Breastfeeding may also help speed the treatment process.
Your doctor may recommend that you undergo a surgical
procedure called incision and drainage. During this procedure, the doctor will
make a small incision to help drain any abscesses that have formed due to the
The following measures may help prevent mastitis (PubMed Health, 2009):
- taking care to prevent irritation and cracking
of the nipple
- frequent breastfeeding
- using a breast pump
- using a proper breastfeeding technique that
allows for good latching by the infant
- weaning the baby over several weeks, instead of
suddenly stopping breastfeeding