MASTITIS

General Information

DEFINITION--Inflammation and infection in the breast of a woman who has recently given birth. It occurs in about 1% of new mothers and is more likely in women who are breast-feeding. An abscess is a collection of pus that may follow if the mastitis is not treated.

BODY PARTS INVOLVED--Breasts.

SEX OR AGE MOST AFFECTED--Females of childbearing age.

SIGNS & SYMPTOMS--

Symptoms may occur anytime while nursing, but usually begin 3 to 4 weeks after delivery. Common symptoms include:

• Fever.
• Tender, swollen, hard, hot breast(s).
• A localized area with increasing redness, pain, tenderness and fluctuance (feels like pushing on an inflated inner tube) indicates an abscess.

CAUSES--Infection from bacteria that enter the mother's breast from the nursing baby's nose or throat. The most-common germs are Staphylococcus aureus and beta-hemolytic streptococcus. Infection with the mumps virus is another cause.

RISK INCREASES WITH

• Abrasion of the nipple.
• Blocked milk ducts from wearing too-tight bras, sleeping on the stomach or waiting too long between feedings.
• Use of an electric or manual breast pump.

HOW TO PREVENT

• Wash nipples before nursing. Wash hands before touching breasts.
• Wear a comfortable bra that is not too tight.
• If a nipple cracks or fissures, apply lanolin cream or other topical medication recommended by your doctor.
• Don't sleep on your stomach.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and a culture of breast milk.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Surgery to drain an abscess (rare).

POSSIBLE COMPLICATIONS--It may be necessary to discontinue breast-feeding if the infection is severe enough to require treatment with antibiotics.

PROBABLE OUTCOME--Usually curable in 10 days with treatment.

How To Treat

GENERAL MEASURES--

• Apply an ice pack (ice in a plastic bag, covered with a thin towel) to the engorged breast 3 to 6 times a day. Use for 15 to 20 minutes at a time. Don't use ice packs within 1 hour of nursing--use warm compresses instead.
• Massage nipples with cocoa butter or a cream recommended by the doctor.
• Wear an uplift bra during treatment.
• Continue to breast-feed, even though breasts are infected. Offer the affected breast first to promote complete emptying.
• If an abscess develops, stop breast-feeding on the affected side. Use a breast pump to empty the infected breast regularly, and continue breast-feeding on the unaffected side.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection. Finish the prescription, even if symptoms subside quickly.
• Pain relievers. For minor discomfort, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--Rest in bed until fever and pain diminish.

DIET--No special diet. Drink extra fluids if you have fever.

Call Your Doctor If

• You have symptoms of mastitis.
• Symptoms recur or worsen despite treatment.