|What Is Mastitis?
Mastitis is a breast infection that sometimes affects women who are breastfeeding (lactation mastitis) or who have recently stopped breastfeeding. The condition can leave you feeling exhausted and run down. It can occasionally occur in women who are not nursing (in such instances it is a slightly different type of mastitis called periductal mastitis).
Facts And Statistics
• Some studies show the rate of mastitis in nursing mothers is as high as 33 percent.
• It is most common in the second and third week postpartum (after childbirth).
• It is equally common in the left and right breast.
What Are The Symptoms?
Usually only one breast is affected. Symptoms and signs can appear very suddenly and include:-
• Pain and tenderness in affected breast, particularly in one spot.
• Painful swelling or lump. Any breast lump that does not go away should be checked for the remote possibility of breast cancer.
• Skin redness, usually in a wedge-shaped pattern that points towards the nipple.
• Feeling chilled, nearly always a high fever 101 F (38.3 C) or greater.
• Flu like symptoms, feeling generally unwell.
• Burning sensation, particularly when nursing.
• Swollen lymph glands in the breasts or nearby underarm.
• Abscess (collection of pus). If untreated an abscess can develop under the breast skin. An abscess usually needs surgical drainage.
When To Contact Your Doctor
If you are feeling ill with flu-like symptoms and a red sore area appears on your breast, it is time to contact your doctor.
What Causes It?
Mastitis is a bacterial infection usually caused by the bacteria staphylococcus aureus. This bacteria is normally found on the skin, but if it enters the breast through a crack in the skin (usually on the nipple) it can cause an inflammatory infection. It may enter the cracked nipple from your baby's mouth while feeding. Once inside, the bacteria infects the fatty tissues of the breast causing swelling. This swelling puts pressure on the milk ducts resulting in lumps and pain.
Sometimes engorged breasts (where the milk ducts are blocked) can turn into mastitis. If the breast does not completely empty at the end of feedings, the milk ducts can become clogged causing milk to back up and become stale. This stagnation (called milk stasis) can turn into an infection.
Breast infections can also be caused by other organisms such as candida albicans (associated with yeast infections), streptococcus pneumoniae, group A beta-hemolytic streptococcus, escherichia coli and mycobacterium tuberculosis. These organisms can enter the breast in non-breastfeeding women from a playful love bite for example, a sore nipple or via nipple piercing. Women in their 20s and 30s who smoke are more prone to this type of infection (called periductal mastitis). All breast infections not related to breastfeeding should be investigated immediately for the remote possibility of inflammatory breast cancer.
How Is It Diagnosed?
Your doctor will perform a physical examination, looking for obvious signs and symptoms of mastitis such as inflammation, chills and a painful area in the breast. He will make sure you do not have an abscess, a complication which can occur if the infection is not treated soon enough. Women who are not breastfeeding may be recommended further tests to rule out inflammatory breast cancer. These tests include a diagnostic mammogram and a breast biopsy.
How Is It Treated?
Treatment nearly always involves taking a 10 to 14 days course of antibiotics to kill the offending bacteria. You are likely to feel better within a day or two of taking antibiotics but you should still take the complete course to minimize the risk of a recurrence. In the meantime you can take a mild pain reliever like Tylenol, Motrin IB or Advil to relieve any pain. Having hot showers or applying warm towels to the breast can also help relieve pain. If symptoms do not improve after two days of antibiotics contact your doctor. He will need to rule out a more serious underlying condition.
List Of Oral Antibiotics Prescribed For Mastitis
The following is a list of commonly prescribed antibiotics for breast infections:
875 mg Amoxicillin/clavulanate (Augmentin): Taken twice a day.
500 mg Cephalexin (Keflex): Taken 4 times a day.
500 mg Ciprofloxacin (Cipro): Taken twice a day.
300 mg Clindamycin (Cleocin): 4 times a day.
Can I Still Breastfeed While Taking Antibiotics?
Yes, your doctor will prescribe antibiotics which are considered safe for nursing mothers (all of the above mentioned antibiotics are safe). In the past women were told not to nurse for fear of infecting their baby with the same bacteria. This is no longer the case since subsequent studies have shown that in most instances the bacteria comes from the baby's mouth in the first place. Nursing, even if it is sore, will help to ease pain. Allow your baby to suckle and drain your milk. This will reduce the opportunity for bacteria to multiply.
Are There Any Natural Remedies?
An antibiotic is the only effective way of clearing a breast infection. However, while waiting for the medications to kick in, some women prefer to try herbal remedies to control any pain (instead of taking painkillers).
Make your own poultice by
wrapping the herbs in some gauze.
A herbal poultice applied to the breast (or herbs applied directly) may help. Remedies include:
• Olive oil and elderberry blossom.
• Grated potato.
• Grated fresh ginger.
• Comfrey leaves.
What Are The Risk Factors?
Studies have highlighted the following risk factors:-
• Having cracked nipples.
• Baby suffering from cleft lip or palate.
• Baby has problems latching.
• Missed feedings.
• Using plastic backed breast pads.
• Mother not eating a balanced diet.
• Restriction resulting from wearing a tight bra.
• Use of manual breast pumps.
• Yeast infections.
• Nipple piercing (in non-breastfeeding women).
How To Prevent Mastitis
Sore And Cracked Nipples
Sore or cracked nipples provide an immediate port of entry for bacteria into the breast tissue. In the first few weeks of nursing, nipple damage is often the result of a poor latch. For this reason, asking a lactation consultant for advice on breastfeeding positions may significantly lower your risk of mastitis. Avoid using plastic backed breast pads because they can irritate the nipple by trapping moisture. If your nipples are sore or dry, rub them with expressed milk or purified lanolin.
Blocked Milk Ducts
Blocked milk ducts, caused by inadequate milk removal from one duct, can also lead to infections. Aim to spot the signs of a blocked duct so you can do something about it before it becomes infected. A firm, tender spot on the breast is usually a sign of a blocked duct. Massaging the affected area towards the nipple can help, as well as frequent breastfeeding. There may also be a small white painful bleb (blister) on the nipple. Removing the bleb with a warm cloth or sterile needle can help prevent infections.
Yeast infections can increase the risk of mastitis by causing cracked nipples. A yeast infection may be present if you experience a regular shooting pain which starts in the the nipple and seers through the breast to the wall of your chest. Some mothers can become infected if their baby has suffered oral thrush. If this is the case, treatment of both mom and baby is essential. A topical medication called Mycostatin can be used on both mother and infant or Micatin can be used by mom. Or, you could apply a mixture of 1 percent gentian violet in water as a cheaper but messy alternative (it turns purple). Before feeding the solution is applied with a cotton swab to the part of the baby's mouth that comes into contact with the nipple. After feeding, any area of the nipple that has not turned purple should be swabbed with the solution. Although not approved by the FDA for the treatment of mastitis, the yeast infection drug Diflucan is often prescribed to mother and baby in cases of severe mastitis where a yeast infection is present.
• Breast fibroids are not the same as a breast infection, as cysts rarely form with mastitis.
• Mastitis does not raise your breast cancer risk factors.