Mastitis

Mastitis is an infection of breast tissue that most often occurs in women who breastfeed. It can happen any time during breastfeeding, but usually occurs within the first 3 months after giving birth. Usually only one breast is affected.

What causes mastitis?

Mastitis is commonly caused by bacteria that enter through a break or crack in the skin on the nipple. It can also happen if a milk duct becomes plugged because the breast has not been completely emptied. If you have had mastitis before, you are more likely to have it again.

What are the signs and symptoms of mastitis?

• Chills and fever
• Breast swelling, redness, warmth, and tenderness
• Tenderness under your arm
• Fatigue and body aches

How is mastitis diagnosed and treated?

Your healthcare provider will examine you. He or she will also ask about your symptoms, and if you have had mastitis before. You can continue to breastfeed your baby while you are being treated for mastitis. Breastfeeding when you have mastitis may help speed your recovery. You may need any of the following:

• Antibiotics help treat or prevent a bacterial infection.
• Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
• NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
• Incision and drainage may be needed if the swelling does not go away and an abscess forms. Your healthcare provider will make a small incision in your breast to drain the pus.

How can I manage my symptoms?

• Continue to breastfeed from the affected breast. This will help to prevent an abscess from forming. Breastfeed your baby on the affected side first. Apply a warm, wet cloth on your breast or take a warm shower before you feed your baby. This can help increase your milk flow. If it is painful when you breastfeed from the affected breast, feed your baby from the other breast first. Pump the affected side to completely drain your breast after breastfeeding, if needed. You may save the pumped milk to feed your baby.
• Use different positions to breastfeed. Change the position of your baby during feedings. This may help to relieve your discomfort.
• Apply heat on your breast for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain.
• Apply ice after feedings. Apply ice on your breast for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
• Massage your breast. Gently massage your breast before and during breastfeeding to help drain your milk.
• Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you.
• Rest as needed. Do not sleep on your stomach until your infection is gone.

How can I prevent mastitis?

• Breastfeed every 2 or 3 hours to prevent engorgement. Breast engorgement develops when too much milk builds up in your breast. Take your time when you breastfeed to allow your baby to empty your breast. Try not to switch breasts too early. Express or pump after you breastfeed if your baby is not emptying your breasts when he or she feeds.
• Prevent sore and cracked nipples. A good latch prevents sore and cracked nipples. If you have sore nipples after breastfeeding, your baby may not be latched on properly. Gently break suction and reposition if your baby is only sucking on the nipple. Talk to a lactation consultant if you need help with your baby's latch.
• Care for your breasts. Keep your nipples clean and dry between feedings. Check them for cracks, blisters, or other irritated areas. Ask a lactation specialist or your healthcare provider how to treat sore and cracked nipples. Wash your hands before and after you breastfeed your baby or pump your breasts. Wear a comfortable nursing bra that supports your breasts but is not too tight.

When should I contact my healthcare provider?

• Your symptoms do not get better within 2 days.
• You have a painful lump in your breast.
• You have swollen and tender lymph nodes in your armpit on the same side as the affected breast.
• You have questions or concerns about your condition or care.