Mastitis


Original Article:http://www.mayoclinic.com/health/mastitis/DS00678

Definition

Mastitis is an infection of the breast tissue that causes pain, swelling and
redness of the breast. Mastitis most commonly affects women who are
breast-feeding, although in rare circumstances this condition can occur
outside of lactation.

Often, mastitis occurs within the first six weeks after birth (postpartum),
but it can happen later during breast-feeding. The condition can leave you
feeling exhausted and rundown, making it difficult to care for your baby.

Sometimes mastitis leads a mother mistakenly to wean her baby before she
intends to. But you can continue breast-feeding while you have mastitis.

Symptoms

http://www.mayoclinic.com/images/nav/clear.gifWith mastitis, signs and
symptoms can appear suddenly and may include:

* Breast tenderness or warmth to the touch
* General malaise or feeling ill
* Swelling of the breast
* Pain or a burning sensation continuously or while breast-feeding
* Skin redness, often in a wedge-shaped pattern
* Fever of 101 F (38.3 C) or greater

Although mastitis usually occurs in the first several weeks of nursing, it
can happen any time during breast-feeding. Mastitis tends to affect only one
breast – not both breasts.

Causes

Mastitis occurs when bacteria enter your breast through a break or crack in
the skin of your nipple or through the opening to the milk ducts in your
nipple. Bacteria from your skin’s surface and baby’s mouth enter the milk
duct and can multiply – leading to pain, redness and swelling of the breast
as infection progresses.

Risk factors

Things that put you at increased risk of mastitis include:

* Sore or cracked nipples, although mastitis can develop without
broken skin.
* A previous bout of mastitis while breast-feeding – if you’ve
experienced mastitis in the past, you’re more likely to experience it again.
* Using only one position to breast-feed, which may not fully drain
your breast.
* Wearing a tightfitting bra, which may restrict milk flow.

When to seek medical advice

In most cases, you’ll feel ill with flu-like symptoms for several hours
before you recognize that there’s a sore red area on one of your breasts. As
soon as you recognize this combination of signs and symptoms, it’s time to
contact your doctor.

Your doctor will probably want to see you to confirm the diagnosis. Oral
antibiotics are usually very effective in treating this condition. If you’ve
had mastitis before, your doctor may prescribe antibiotics over the phone.
If your signs and symptoms don’t improve after the first two days of taking
antibiotics, see your doctor right away to make sure your condition isn’t
the result of a more serious problem.

Tests and diagnosis

Your doctor diagnoses mastitis based on a physical examination, taking into
account signs and symptoms of fever, chills and a painful area in the
breast. Another clear sign is a wedge-shaped area on the breast that points
toward the nipple and is tender to the touch. As part of the examination,
your doctor will make sure you don’t have a breast abscess – a complication
that can occur when mastitis isn’t treated promptly.

Complications

Complications that may arise from mastitis include:

* Recurrence. Once you’ve had mastitis, you’re more likely to get it
again, either breast-feeding the same infant or a future child. Delayed or
inadequate treatment is usually to blame for mastitis recurrence.
* Milk stasis. When the milk isn’t completely drained from your breast
during breast-feeding, milk stasis can occur. This causes increased pressure
on the ducts and leakage of milk into surrounding breast tissue, which can
lead to pain and inflammation.
* Abscess. When mastitis is inadequately treated, or if it’s related
to milk stasis, a collection of pus (abscess) can develop in your breast. An
abscess usually requires surgical draining. To avoid this complication, talk
to your doctor as soon as you develop signs or symptoms of mastitis.

Treatments and drugs

Mastitis treatment usually involves:

* Antibiotics. Treating mastitis usually requires a 10- to 14-day
course of antibiotics. You may feel well again 24 to 48 hours after starting
antibiotics, but it’s important to take the entire course of medication to
minimize your chance of recurrence.
* Self-care remedies. Resting, continuing breast-feeding and drinking
extra fluids can help your body overcome the breast infection.

If your mastitis doesn’t clear up after taking antibiotics, check back with
your doctor. A rare form of breast cancer – inflammatory breast cancer – can
also cause redness and swelling that could initially be confused with
mastitis. You may need a biopsy to make sure you don’t have breast cancer.

Prevention

Minimize your chances of getting mastitis by fully draining the milk from
your breasts while breast-feeding. Allow your baby to completely empty one
breast before switching to the other breast during feeding. If your baby
nurses only for a few minutes on the second breast – or not at all – start
breast-feeding on that breast the next time you feed your baby.

Alternate the breast you offer first at each breast-feeding, and change the
position you use to breast-feed from one feeding to the next. Make sure your
baby latches on properly during feedings. Finally, don’t let your baby use
your breast as a pacifier. Babies enjoy sucking and often find comfort in
suckling at the breast even when they’re not hungry.

Lifestyle and home remedies

If you have mastitis, it’s safe to continue breast-feeding. Breast-feeding
helps your breast clear the infection.

To relieve your discomfort:

* Maintain your breast-feeding routine.
* Avoid prolonged engorgement before breast-feeding.
* Use varied positions to breast-feed.
* Drink plenty of fluids.
* If you have trouble emptying a portion of your breast, apply warm
compresses to the breast or take a warm shower before breast-feeding or
pumping milk.
* Wear a supportive bra.
* While waiting for the antibiotics to take effect, take a mild pain
reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil,
Motrin, others).

If breast-feeding on the infected breast is too painful, try pumping or
hand-expressing milk.

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