Mastitis

Mastitis is inflammation of the breast tissue. It occurs most often in women who are breastfeeding, but it can also affect other women, and sometimes even men. Mastitis will sometimes go away on its own. A health care provider will help determine if medical treatment is needed.

What are the causes?

This condition is usually caused by a bacterial infection. Bacteria can enter the breast tissue through cuts, cracks, or openings in the skin. This usually occurs with breastfeeding because of cracked or irritated nipples.

Sometimes, mastitis can occur when there are no cuts or openings in the skin. This is usually caused by plugged milk ducts. Plugged milk ducts block the flow of milk in the breast.

• Nipple piercing.
• Some forms of breast cancer.

What are the signs or symptoms?

• Swelling, redness, tenderness, and pain in an area of the breast. The area may also feel warm to the touch. These symptoms usually affect the upper part of the breast, toward the armpit region.
• Swelling of the glands under the arm on the same side.
• Discharge from the nipple.
• Fatigue, headache, and flu-like muscle aches.
• Fever and chills.
• Nausea and vomiting.
• Rapid pulse.

Symptoms usually last 2–5 days. Breast pain and redness are at their worst on days 2 and 3, and they usually go away by day 5. If an infection is left to worsen, a collection of pus, or an abscess, may develop.

How is this diagnosed?

• Blood tests to check if your body is fighting an infection from bacteria.
• Mammogram or ultrasound tests to rule out other problems or diseases.
• Fluid tests. If an abscess has developed, the fluid in the abscess may be removed with a needle. The fluid may be checked to see whether bacteria are present.
• Breast milk testing. A sample of breast milk may be tested for bacteria. This is done only when breastfeeding or pumping.

How is this treated?

• Continuing to breastfeed or pump from both breasts to allow adequate milk flow and prevent an abscess from forming.
• Applying hot or cold compresses to the affected area.
• Medicine for pain.
• Antibiotic medicine to treat a bacterial infection.
• Self-care, such as rest and drinking more fluids.
• Using a needle to remove fluid from an abscess if one has developed.

Follow these instructions at home:

Breast care

• Keep your nipples clean and dry.
• If directed, apply heat to the affected area of your breast. Use the heat source that your health care provider or lactation specialist recommends.
• If directed, place ice on the affected area of your breast. To do this:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
  • Remove the ice if your skin turns bright red. This is very important. If you cannot feel pain, heat, or cold, you have a greater risk of damage to the area.

Breastfeeding and pumping tips

• Ask your health care provider or lactation specialist whether you need to change your breastfeeding or pumping routine.
• Avoid using nipple shields for feedings, if possible. Ask a lactation specialist for assistance if needed.
• Alternate the breast you offer first at each feeding to make sure your baby feeds from both breasts equally.
• Offer both breasts to your baby at every feeding.
• Use gentle breast massage during feeding or pumping sessions only as told by your health care provider or lactation specialist.
• Avoid allowing your breasts to become very full with milk (engorged). If your breasts are engorged, you can hand express a small amount of milk for comfort.

• Ask your health care provider or lactation specialist whether you need to change your pumping routine.

Medicines

• Take over-the-counter and prescription medicines as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.

Contact a health care provider if:

• You have pus-like discharge from the breast.
• You have a fever.
• Your symptoms do not improve within 2 days of starting treatment.

Get help right away if:

• Your pain and swelling are getting worse.
• You have pain that is not controlled with medicine.
• You have a red line extending from the breast toward your armpit.

Summary

• Mastitis is inflammation of the breast tissue. It occurs most often in women who are breastfeeding, but it can also affect non-breastfeeding women and some men.
• This condition is usually caused by a bacterial infection.
• This condition may be treated with hot and cold compresses, medicines, self-care, and breastfeeding.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.