MASTITIS

Mastitis is inflammation of tissue in one

or both mammary glands inside the
breast. Mastitis usually affects lactating
women - women who are breastfeeding,
producing milk. Hence, it is often
referred to as lactation mastitis. The
patient feels a hard, sore spot inside the
breast. Mastitis can occur as a result of
an infection or a blocked milk duct.

Two types of mastitis

Non-infectious mastitis - this is usually caused
by breast milk staying within the breast tissue
- milk stasis - because of a blocked milk duct
or a breastfeeding problem. If left untreated,
the milk left in the breast tissue can become
infected, leading to infectious mastitis.
Infectious mastitis - this is caused by bacterial
infection. It is important to receive treatment
immediately to prevent complications, such as
an abscess in the breast.

What are the symptoms of mastitis?

In the vast majority of cases only one breast is affected.
The following signs or symptoms, which may develop
rapidly, could be present (a symptom is something the
patient feels or reports, while a sign is something other
people, including the doctor identify): An area of the
breast becomes red.
The affected area of the breast hurts when touched.
The affected area feels hot when touched.
A burning sensation in the breast which may be
there all the time, or only when breastfeeding.

What are the causes of mastitis?

Causes of non-infectious mastitis
Non-infectious mastitis is usually caused by milk stasis (milk
is produced, but then remains in the breast, rather than
coming out during feeding). Milk stasis may have the
following causes:
The baby is not attaching to the breast properly during
feeding.
The baby has difficulties suckling the milk out of the
breast.
The baby is being breastfed infrequently.
Milk ducts may be blocked because of pressure on the
breast caused by, for example, tight clothing.

 Causes of infectious mastitis

Bacteria do not generally thrive in fresh human
milk. However, if the milk ducts are blocked and
the milk stagnates the likelihood of infection
grows. Experts believe that bacteria which exist
on the surface of breast skin enter the breast
through small cracks or breaks in the skin. They
also suggest that bacteria in the baby's mouth
may get into the mother's breast during a
breastfeed. However, nobody is completely sure
how bacteria get into the breast.

 Infectious mastitis in women who are not

lactating
Women who are not lactating (not producing
milk, not breastfeeding) may develop infectious
mastitis - this is not common. Those who do
develop non-lactating infectious mastitis tend to
be regular smokers in their late 20s to early 30s.
Experts believe that smoking may damage the
milk ducts, making them more susceptible to
infection.

How is mastitis diagnosed?

Mastitis is fairly easy to diagnose. A GP
(general practitioner, primary care physician)
will carry out a physical examination and ask
the patient questions about her symptoms.
When symptoms are severe, or if the
woman does not respond to treatment, the
doctor may take a small sample of breast
milk for testing. Tests will usually determine
whether there is a bacterial infection, as well
as the type of bacteria. Identifying the type
of bacteria helps the doctor select the most
targeted treatment.

How is mastitis diagnosed?

If the health care professional believes the mastitis is
caused by a breastfeeding problem, the patient may
be asked to demonstrate how she breastfeeds. It is
important that the mother does not feel she is being
blamed or judged. Breastfeeding sometimes requires
some practice.
Inflammatory breast cancer, a rare form of breast
cancer, can also have similar symptoms of redness
and swelling. In some rare cases a biopsy may be
taken to rule out breast cancer.

What are the treatment options for mastitis?

Non-infectious mastitis - some self-care techniques
usually resolve non-infectious mastitis. These include:
The mother needs to make sure she is drinking plenty
of liquids.
The mother needs to make sure she is resting enough.
Symptoms of pain and/or fever can be alleviated with
OTC (over the counter) acetaminophen (paracetamol,
Tylenol). Some of it will pass through the breast milk,
but not enough to harm the baby. Do not take Aspirin
while breastfeeding.
Feed the baby more frequently.
If you cannot feed the baby more frequently, express
the milk more often if the breasts feel full.
During a feed, start with the affected breast. This will
drain it more.
After a feed gently express any leftover milk.

What are the treatment options for mastitis?

Infectious mastitis - treatment includes an
antibiotic , as well as the techniques listed
above for non-infectious mastitis. The
antibiotic may be passed on through the
breast milk to the baby. The baby may
produce runny stools and become restless.
This does not damage the baby, and the
effects will disappear as soon as treatment is
completed.

What are the complications of mastitis?

Recurrence - women who have had mastitis are
more likely to get it again, compared to other
women. In most cases recurrence is due to late or
inadequate treatment.
Abscess - if the mastitis is not treated properly there
is a risk that a collection of pus (abscess) can
develop in the breast. Abscesses usually require
surgical draining.