Mastitis is painful swelling and redness in the breast. It is especially common among women who are breastfeeding. While it is most common in just one breast it can occur in both.
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Mastitis is often caused by trapped breast milk in a milk duct. The trapped breast milk can irritate the tissue around it and cause swelling and pain.
Mastitis can also be caused by a bacterial infection in the breast tissue. Milk ducts or cracked skin around the nipple can allow bacteria to enter the breast and cause an infection.
Mastitis often occurs during breastfeeding but, it is possible to get mastitis at other times. This article will focus on symptoms and treatment of lactation-associated mastitis.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Previous mastitisAbrasion or cracking of the breast nippleWearing a bra or clothing that is too tightMissed breastfeeding (causing overdistention of the breast)Irregular breastfeeding
Pressure on the breasts, caused by:
Sleeping on the stomachHolding the breast too tightly during feedingBaby sleeping on the breastExercising (especially running) without a support bra
Anything that causes too much milk to remain in the breast, including:
Baby's teethingUse of artificial nipple or pacifierIncorrect positioning of the baby during feedingsAbrupt weaningYeast infection of the breastLow resistance to infection or immune deficiency disorderPsoriasis
or other skin conditions that affect the nipple
Diabetes mellitusRheumatoid arthritisUse of cortisone drugsPrior breast surgery or implantsSmoking
Symptoms may include:
FeverFatigueNausea or vomitingAches, chills, or other flu-like symptomsRedness, tenderness, or swelling of the breastA burning feeling in the breastA hard feeling or tender lump in the breastPus draining from the nippleSwollen lymph glands in the armpit or above the collar bones
Your doctor will ask about your symptoms and medical history, and perform a physical exam of your breast. If the diagnosis is uncertain, or if mastitis recurs, your doctor may order the following tests:
A culture of your breast milk or nipple discharge
of the affected area
of the breast
Treatment may include:
Relieving the blockage in the milk duct is an effective way to decrease the pain and swelling. To clear blocked breast ducts try:
Breastfeeding frequently—Breastfeeding with mastitis is not harmful to the baby. Talk to your doctor if you are also taking medicines though, to make sure the medicines are not harmful to your baby.Offering the baby the infected breast first (to promote complete emptying of infected breast)Using a breast pump to express milkApplying warm compresses to breasts prior to feeding (to stimulate milk ejection reflex)
To reduce pain and swelling in the breast:
Apply ice compresses to the affected area of your breast after breastfeeding.If your mastitis is not caused by breastfeeding, consider using over-the-counter pain relievers as recommended by your doctor.Be sure to ask your doctor what pain relievers are safe for you and your baby. Taking aspirin is not advised during pregnancy or breastfeeding.Drink lots of fluids.Get plenty of rest.
Antibiotics may be used to treat the infection. They may help cure the infection or reduce the risk of more serious but rare complications such as blood infection. If you are breastfeeding, talk to your doctor about which antibiotics are best for you to take so you can continue to breastfeed.
The bacteria known as
is responsible for many cases of bacterial mastitis. In recent years, some forms of “staph” have become resistant to many of the commonly used antibiotics. So far, the resistant bacteria have been rare in cases of mastitis.
If mastitis does not respond to antibiotics, a localized collection of pus called an abscess might be present. This is usually treated with other antibiotics and a drainage procedure or surgery.
If you are diagnosed with mastitis, follow your doctor's
Strategies to help prevent mastitis include:
Prevent engorgement of the breast with milk by:
Frequent breastfeedingUse of breast pumpWash your hands and breast nipple before breastfeeding.Avoid wearing bras or clothing that is too tight.Avoid sleeping on your breasts, or allowing a baby to sleep on your breasts.If your nipples crack, apply lotion or cream as recommended by your doctor.
American Academy of Pediatrics website. Available at:
Accessed July 20, 2009.
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Last reviewed September 2012 by Andrea Chisholm
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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