Mastitis

Mastitis means inflammation (injury from infection or irritation) of the breast tissue. Mastitis may occur in up to a third of women who are lactating (forming breast milk) after giving birth and is then called lactation mastitis. When lactation mastitis is due to an infection, it is usually caused by bacteria, although fungal (yeast) infections can also be the cause. Most cases of lactation mastitis occur during the first 3 months postpartum (after giving birth), but it may occur any time as long as a woman is breastfeeding. When mastitis is severe, an abscess (collection of pus from an infection) may develop in the breast. The April 2, 2003, issue of JAMA includes an article about lactation mastitis.

SYMPTOMS
Malaise (feeling tired and unwell)
Fever
Reddened area of the breast, usually wedge-shaped
Warmth or tenderness of the breast
Pain with nursing (can also be caused by sore or cracked nipples without mastitis)

POSSIBLE RISK FACTORS

Mastitis after a previous pregnancy
Nipple cracks or sores
Using only one position to breastfeed so the entire breast does not empty
Tight-fitting bra that obstructs milk flow

TREATMENT
Continue nursing and use different feeding positions
Complete, frequent emptying of the affected breast
Warm compresses or warm shower
Increase fluid intake
Bed rest
Pain medication
Antibiotics if prescribed by your doctor
Drainage of any abscess that may form

If you think you have mastitis, see your doctor. In most cases, mastitis is easily treated. Continuing to breastfeed while you have mastitis will not hurt your baby.

Mastitis can occur in older women who are not lactating. This form of mastitis is called periductal mastitis. The milk ducts near the nipple become inflamed, causing breast pain. There may also be a breast mass near the nipple, retraction of the nipple, or discharge. Because breast cancer can also cause these symptoms, it is important to see your doctor if you have any of them. Treatment of periductal mastitis may include antibiotics or surgery if the periductal mastitis is severe.

There is a form of breast cancer called inflammatory breast cancer that can be confused with mastitis. Because inflammatory breast cancer is fast-growing, aggressive, and deadly, it is important to detect it early. Fever usually occurs with mastitis but rarely occurs with inflammatory breast cancer.

Adapted from Journal of the American Medican Association