Mastitis is a breast infection - the infection of the breast tissue. Mastitis is a bacterial infection that occurs when harmful bacteria infiltrate the breast tissue through a breached area of the nipple skin such as a scratch and/or cracks, then multiply within the fatty tissue of the breast. The bacteria may also enter the breast tissue through the small holes in nipple’s milk ducts. In most cases the source of harmful bacteria (Staphylococcus aureus) is the surface of skin or the mouth of baby. After the bacteria infiltrate the body, it is multiplied causing redness and localized swelling of the breast and pain.
Mastitis usually only affects one breast and the symptoms often develop quickly.
Mastitis can occur when bacteria commonly found on the skin enter the nipple through small cracks.
The bacteria then multiply in the fatty tissue of the breast surrounding the milk ducts, causing swelling, warmth, or pain. The swelling can press on the milk ducts and block them.
Mastitis occurs most commonly in women who are breast-feeding. However, it may occur in women who are not breast-feeding as well. Staphylococcus aureus is the bacterium that is most often associated with this type of infection.
The infection can also occur after milk plugs one of the many milk ducts within the breast, trapping bacteria within the tissue. In this way, a blocked milk duct may also result in a breast infection.
Mastitis symptoms in most cases are pretty severe. Most women with mastitis would experience breast pain, fever and weakness. These are the most typical symptoms observed during mastitis:
- breast tenderness, redness, enlargement, or sensitivity;
- warm and/or hot painful area in breast tissue;
- burning pain in the breast that may be continuous or may only occur when you are breastfeeding;
- breast itchiness;
- breast hardness;
- liquid or pus discharge from nipple;
- changes in sensation of the breast;
- fever (sometimes pretty high);
- swollen lymph node on same side as affected breast;
- lump in affected breast.
Some women with mastitis could experience flu-like symptoms such as:
- high temperature up to 38-40C;
- shivering and chills;
Severe infections could lead to pus-filled cysts called “abscess” within the breast tissue. In these cases the surgery interventions could be needed.
The most alarming symptom of mastitis is the presence of a breast lump. The lump is composed of swollen and inflamed breast tissue, which may develop into a breast abscess. As most women associate breast lumps with cancer, the initial reaction to a mastitis lump or breast abscess often includes anxiety and fear.
MASTITIS risk factors
Smoking can increase the risk of breast mastitis (especially during breast-feeding). Smoking hinders the breasts' milk ejection reflex, raising the risk of breast engorgement and plugged milk ducts. Fatigue, anemia, and stress all increase a woman's chance of developing a breast infection during lactation.
Breast anatomical defects and surgical scars (after any surgery) may also increase the risk of breast infection during lactation. Surgical scarring from a breast biopsy, cosmetic surgery, breast tumor removal, cyst removal, or breast abscess scars may all interfere with milk flow. Women with fibrocystic breast disease may have a slightly higher risk of breast mastitis than those with "normal" breasts.
Diagnosis of mastitis is easy and obvious. It started fast during breast-feeding – severe pain, redness and other typical symptoms are becoming very disturbing. Simple observation and breast exam can discover mastitis. No tests are usually required for breast-feeding women.
However, if you are not breast-feeding, your doctor may request certain tests to better understand your condition. These may include mammography or a biopsy.
Recommendations for breast-feeding women with mastitis:
- get plenty of rest;
- apply a warm, moist cloth to the affected area several times a day;
- breast-feed frequently and use different breast-feeding positions to help unplug the affected milk duct.
Antibiotics could be recommended if mastitis symptoms continue for more than 24 hours despite rest, heat, and frequent nursing. If antibiotics are prescribed, completing the antibiotic treatment is crucial to preventing a recurrence of the infection.
If mastitis symptoms do not improve within a day of starting antibiotics, it is possible the breast infection is a yeast infection, and not caused by bacteria. Yeast infections may pass to the breast from the mother's skin, or from a thrush infection in the baby's mouth.
Mothers who are breast- feeding are typically encouraged to continue nursing their babies while receiving treatment for mastitis. Breast-feeding can help clear plugged ducts, which will reduce the accumulation of milk and help the infant maintain proper nursing techniques. In general, mothers do not have to worry about harming the health of their baby as the antibiotics used to treat these infections are usually safe for breast-feeding.
Many mothers with mastitis worry about passing the infection to their infant. It is important to understand that breast milk contains many antibacterial components that protect the infant from infection.
During mastitis women need special self-care - applying a moist hot compress to the affected breast for fifteen to twenty minutes four times a day can help reduce mastitis pain. Some women gain relief from breast infection pain by expressing milk in a hot shower.
The main risk/complication of mastitis is breast abscess – only severe cases of mastitis (breast infection) could develop into the breast abscess. Breast abscess is an area of infected breast tissue filled with pus, dead cells and fluid. Breast abscess can press upon milk ducts, causing lactation problems and pain.
Breast abscess can be treated by draining the abscess with a fine needle. If necessary, the abscess can be surgically removed through a breast incision. Women planning future pregnancies should be aware that surgical scarring increases the risk of mastitis during future pregnancy, lactation and breastfeeding.
Recurrent mastitis is possible during present breast-feeding period and during future pregnancy and lactation. Recurrent mastitis can increase the risk for breast abscess.
In some cases, ceasing breastfeeding and ending lactation may be necessary to prevent further breast infection. Some doctors treat chronic breast infection during breastfeeding with prophylactic antibiotics. In other cases, breastfeeding women watch carefully for signs of plugged milk ducts and/or flu-like symptoms, and report such symptoms promptly.
Mastitis prevention includes the following:
- Practice very good hygiene during breast feeding;
- Keep your skin clean and wash your baby’s mouth before breast-feeding;
- Wipe down your breasts with a sanitizing wipe and then wipe your breasts down with a sterile damp cloth to remove the alcohol;
- Use only sterile materials during breast cleaning;
- All materials you use for breast cleaning should be sterile;
- Don’t forget that most breast infections are caused by germs in their baby’s mouth;
- Try wearing well-fitted bras because wrong bra could create more problems;
- Breast-feed your baby frequently to keep milk ducts from plugging;
- Avoid carrying heavy items over your shoulders (e.g., a purse, diaper bags, etc.), and use several different positions while breast-feeding to help drain different areas of the breast.
MASTITIS when not breastfeeding
Mastitis rarely develops outside of lactation. Women who do develop breast infection or abscess symptoms when not breastfeeding may require breast biopsies to rule out a rare type of breast cancer than mimics mastitis symptoms. Women who are breastfeeding usually do not undergo biopsy tests during mastitis or abscess diagnosis, but may require skin biopsies if antibiotic and antifungal treatments prove ineffective.