What is mastitis?

Causes and Symptoms

Mastitis is usually caused by a staphylococcal infection of the breast.
The bacteria may enter the breast through a sore or crack in the
nipple, although some patients do not report having sore or cracked nipples.
Generally, mastitis occurs in women who are breastfeeding, but women who are not breastfeeding may also
experience the disease. Onset of the infection is often associated with stress,
reduced immunity, or missed or increased intervals between feedings of a breastfed
baby. Milk stasis, or the inefficient removal of milk from the breast, is a common
cause of noninfectious mastitis and may be due to ineffective infant suckling,
poor latching of the infant at the breast, blockage of the milk ducts, or
restricted duration or frequency of feedings. Between 3 to 20 percent of lactating
women are reported to develop mastitis.

Common symptoms of mastitis are swelling, redness, hotness, tenderness, an area of
hardness, and pain in part or all of the infected breast. In some cases, there is
a localized area of soreness in the breast, while in other cases, the entire
breast may be inflamed. The victim typically has flulike symptoms, such as
tiredness, aches, chills, fever, and fatigue. These feelings often occur prior to
breast soreness. Blocked ducts usually resolve themselves naturally within
twenty-four to forty-eight hours, although a blocked duct may sometimes lead to
mastitis.

Treatment and Therapy

Continued breastfeeding using both breasts is considered safe during mastitis.
Increased milk expression from the affected breast can help ease discomfort.
Alternate hot and cold packs applied to the sore area of the infected breast help
reduce the inflammation and pain and provide comfort. Gently massaging the tender
area increases circulation and helps loosen any plugged ducts. Fever can be
treated with acetaminophen or ibuprofen without any harm to a breastfeeding baby.
Patients should also drink plenty of fluids. For nursing mothers, unless the pain
is too intense, breastfeeding should be continued during the treatment of
mastitis. If breastfeeding is discontinued, then the breast should be drained
regularly with manual expression or a breast pump.

Once a diagnosis of mastitis is made, proper antibiotics should be administered if
symptoms do not improve after twelve to twenty-four hours of effective milk
removal. Once they are administered, the soreness usually starts to disappear
within two to five days. Redness may continue for up to a week or more.
Lactobacilli probiotics are associated with lower recurrence
rates and decreased pain compared to antibiotic therapy in women with infectious
mastitis. Bed rest helps relieve stress and builds up the immune system. If not
treated properly and in a timely manner, mastitis can lead to a breast abscess
that requires surgical draining.

Perspective and Prospects

Mastitis is most common among nursing mothers during the first three months
postpartum. The most important preventive measure against mastitis for these women
is regular breastfeeding. Recurrent mastitis is associated with irregular
breastfeeding patterns, fatigue, and stress. Frequent breastfeeding and lifestyle
changes that promote good health and a strengthened immune system are key
ingredients for reducing the occurrence of mastitis. If antibiotics are prescribed
for treatment, it is important that the full course be taken even though the
patient improves quickly; otherwise, the risk of mastitis returning increases.

Bibliography

Arroyo, R., et al. "Treatment of Infectious
Mastitis during Lactation: Antibiotics versus Oral Administration of
Lactobacilli Isolated from Breast Milk." Clinical Infectious
Diseases 50.12 (2010): 1551–8. Print.

Colson, Jenni Lynn,
ed. Breastfeeding Sourcebook. Detroit: Omnigraphics, 2002.
Print.

Hunt, K. M., et al.
"Mastitis is Associated with Increased Free Fatty Acids, Somatic Cell Count,
and Interleukin-8 Concentrations in Human Milk." Breastfeeding
Medicine 8.1 (2013): 105–10. Print.

Icon Health.
Mastitis: A Medical Dictionary, Bibliography, and Annotated
Research Guide to Internet References. San Diego: ICON Health,
2004. Print.

Jahanfar, S., et al.
"Antibiotics for Mastitis in Breastfeeding Women." The Cochrane
Database of Systematic Review 2 (2013).

Marz, Russell B.
Medical Nutrition from Marz. 2nd ed. Portland: Quiet
Lion, 1999. Print.

Reddy, Pavani.
“Postpartum Mastitis and Community-Acquired Methicillin-Resistant
Staphylococcus aureus.” Emerging Infectious
Diseases 13.2 (2007): 298. Print.

Swenson, Deborah E.
Telephone Triage for the Obstetric Patient: A Nursing
Guide. Philadelphia: Saunders, 2001. Print.