By Sally Robertson, BSc
Mastitis is an infection of the breast tissue that causes inflammation and pain. The condition usually affects women who are within their first three months of breastfeeding, although it can also be an issue later on in breastfeeding. The condition affects around 10% of women who choose to breastfeed.
In women who are breastfeeding, the condition may also be referred to as lactation mastitis or puerperal mastitis. In women who are not breastfeeding, the condition may be referred to as periductal mastitis. Among breastfeeding women, mastitis is usually caused by a build-up of milk within the breast tissue, a condition referred to as milk stasis. This happens ifmilk fails to be properly removed from the breast while the baby is feeding, which may happen for several reasons, including:
- Missed or infrequent feeding episodes if a baby sleeps through the night, for example
- The baby may not be attaching to the nipple properly during feeding,
- The baby may be having problems sucking. This can happen if a baby has a condition called tongue-tie, where the piece of tissue that connects the underside of the tongue to the floor of the mouth is too short.
- Favouring one breast over the other for feeding. If one nipple is feeling sore, a mother may use the other breast, leaving the original breast at risk of becoming blocked with accumulated milk.
- A knock or blow to the breast may damage the milk ducts in the breast.
- Pressure placed on the breast by tight fitting garments or even a seat belt can lead to mastitis.
In some cases, the accumulated milk becomes infected with bacteria, in which case the term infective mastitis applies. If non-infective mastitis does not get treated, it can turn into infective mastitis.
Among women who are not breastfeeding, the most common reason for mastitis to develop is infection of the breast caused by a damaged nipple. This may happen if the nipple is pierced or has become cracked or sore, for example. This form of mastitis usually affects females aged 20 to 40 years and is more common among smokers than non-smokers. Occasionally, the cause of mastitis in women who are not breastfeeding is duct ectasia, which occurs when the milk duct behind the nipple becomes shorter and wider as a woman ages. This condition is usually only found in women who are approaching the menopause.
Sometimes, mastitis causes women to wean their baby off breast milk earlier than they originally intended to, but women can continue to breastfeed while they have this condition. In fact, although feeding may be uncomfortable when a woman has mastitis, continuing to breastfeed can be helpful because it removes any blocked breast milk. This helps to alleviate symptoms more quickly and prevents the condition from becoming any more serious.
The symptoms of mastitis often develop suddenly and usually only affect one breast. Some examples of symptoms include:
- Tenderness in the breast
- Warmth in the breast
- Swelling in the breast
- A burning or painful sensation that may be continuous or only occur when the baby tries to feed from the affected breast
- Reddening of the breast skin, often in a wedge shape
- Fever of 38.3˚C or higher
- Chills and body ache
- A hardening or lump in the breast tissue
- The nipple may be red, swollen and painful to touch
- Nipple discharge
- A general feeling of malaise
In the majority of cases, women begin to develop flu-like symptoms such as chills, body ache and fever before they develop other symptoms such as a redness across the breast or a lump. This condition usually responds well to a course of oral antibiotics, with symptoms often starting to improve a couple of days into taking this medication.
If mastitis is not treated appropriately, a collection of pus called an abscess may develop in the breast. This can require surgical drainage and any signs or symptoms of mastitis should be treated as early a possible to avoid this complication.
Sometimes, mastitis causes women to wean their baby off breast milk earlier than they originally intended to, but women can continue to breast feed while they have this condition. In fact, although feeding may be uncomfortable when a woman has mastitis, continuing to breastfeed can be helpful because it removes any blocked breast milk. This helps to alleviate symptoms more quickly and prevents the condition from becoming any more serious.
Last Updated: Nov 5, 2014