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Mastitis

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. If you have mastitis, you might also experience fever and chills. Mastitis most commonly affects women who are breast-feeding (lactation mastitis), although sometimes this condition can occur in women who aren't breast-feeding.

In most cases, lactation mastitis occurs within the first three months after giving birth (postpartum), but it can happen later during breast-feeding. The condition can leave you feeling exhausted and run-down, making it difficult to care for your baby.

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

Symptoms Causes Risk factors Complications Prevention

With mastitis, signs and symptoms can appear suddenly and may include:

  • Breast tenderness or warmth to the touch
  • Generally feeling ill (malaise)
  • 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 breast-feeding, it can happen anytime during breast-feeding. Lactation mastitis tends to affect only one breast — not both breasts.

When to see a doctor

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.

Mastitis may be caused by:

  • A blocked milk duct. If a breast doesn't completely empty at feedings, one of your milk ducts can become clogged, causing milk to back up, which leads to breast infection.
  • Bacteria entering your breast. Bacteria from your skin's surface and baby's mouth can enter the milk ducts through a break or crack in the skin of your nipple or through a milk duct opening. Bacteria can multiply, leading to infection. These germs aren't harmful to your baby — everyone has them. They just don't belong in your breast tissues.

Risk factors for mastitis include:

  • Breast-feeding during the first few weeks after childbirth
  • Sore or cracked nipples, although mastitis can develop without broken skin
  • Using only one position to breast-feed, which may not fully drain your breast
  • Wearing a tightfitting bra, which may restrict milk flow
  • Becoming overly tired (fatigued)
  • Previous bout of mastitis while breast-feeding — if you've experienced mastitis in the past, you're more likely to experience it again

When mastitis isn't adequately treated, or it's related to a blocked duct, a collection of pus (abscess) can develop in your breast. An abscess usually requires surgical drainage. To avoid this complication, talk to your doctor as soon as you develop signs or symptoms of mastitis.

To get your breast-feeding relationship with your infant off to its best start — and to avoid complications such as mastitis — consider making an appointment with a lactation consultant. A lactation consultant can give you tips and provide invaluable advice for proper breast-feeding technique.

Minimize your chances of getting mastitis by following these tips:

  • Fully drain 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 for only 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 feeding.
  • Change the position you use to breast-feed from one feeding to the next.
  • Make sure your baby latches on properly during feedings.
  • 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.
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