What is mastitis?

Mastitis, which is a breast tissue infection, can occur at any time, even for women who have never been pregnant. Most often, though, it shows up during early breastfeeding, usually within the first two months, before a nursing infant has fully settled into a regular feeding pattern with a healthy latch.

What causes mastitis?

Most cases of mastitis are caused by bacteria entering the body through the nipple – often through nipples that are cracked or sore from breastfeeding. Working to make sure to only handle dry or cracked nipples with hands that have been washed with hot water and soap can help cut down on infections this way. The other reason a breast might become infected would be due to a blocked milk duct, which can happen when breasts aren’t fully emptied during or after a feeding.

Several factors lead to an increased risk of mastitis, including:

  • Previous cases of mastitis
  • Engorgement from skipping or putting off breastfeeding or pumping, especially if this happens often
  • Cracked or irritated nipples, especially irritation caused by trouble with latching
  • Anemia, which can lower the immune system and, thus, resistance to infections like mastitis
  • Only breastfeeding in one position, which can lead to breasts not being fully emptied
  • Pressure on breasts from tight bras, seatbelts, or carrying a heavy bag
  • Illness or infection in the mother or baby

What does mastitis look like?

Mastitis usually only affects one breast, which may be red, swollen, or painful. Mastitis is also often accompanied by fever, chills, and other flu-like symptoms, which may show up before visible symptoms like breast swelling or redness do. Pain or a burning sensation during breastfeeding is also a symptom of mastitis. Early signs include slight swelling or redness of the breast.

How is mastitis treated? 

When mastitis symptoms are detected, it’s always a good idea to have them checked out by a doctor, since, when left untreated, mastitis can develop into a breast abscess, which often needs to be treated surgically. Caught early, though, a doctor will generally make a diagnosis based on an exam, and prescribe antibiotics, which should begin to relieve symptoms in the first two days or so. It’s important to keep taking antibiotics for the full 10 to 14 day course, even if the symptoms seem better, to cut down on the chances of the mastitis returning. If the antibiotics prescribed don’t start to have an effect in a few days, the doctor may recommend testing to find out what kind of infection is causing the mastitis.

While recovering from mastitis, acetaminophen and ibuprofen-based pain relievers are both safe to use during breastfeeding. It’s also important to get plenty of fluids and rest. Using cold packs can also reduce pain and pressure from inflammation in the infected breast. Before breastfeeding, it can help to massage the breast, and to use a heat pack or a warm, wet washcloth to help with milk-flow.

Can I nurse with mastitis? 

Breastfeeding with mastitis is not only safe for both you and baby, but it can actually help clear up the infection as it increases blood-flow and the flow of milk through the breast, helping to clear out blocked ducts. However, some babies won’t nurse at a breast that’s infected with mastitis, and in those cases, hand-expressing or using a breast pump works just as well.

  • Healthwise Staff. “Mastitis While Breastfeeding.” University of Michigan Health System. Regents of the University of Michigan, May 30 2016. Web.
  • Mayo Clinic Staff. “Mastitis.” Mayo Clinic. Mayo Clinic, June 12 2015. Web.
  • Bonnie Tilson. “Mastitis–Plugged Ducts and Breast Infections.” Leaven. 29(2): 19-21. Web. March-April 1993.
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