What is Mastitis? Symptoms, Causes, & Treatment

What is mastitis?

Mastitis is an inflammation of breast tissue that causes pain, swelling, warmth, and redness. This condition most commonly affects breastfeeding mothers, especially during the first few weeks after giving birth.

Think of mastitis as your breast tissue becoming irritated and inflamed, much like how a cut on your skin might become red and tender. The inflammation can happen with or without an infection, though bacterial infections are often involved.

While mastitis primarily occurs during breastfeeding, it can occasionally affect women who aren't nursing or even men in rare cases. The good news is that mastitis responds well to treatment when caught early.

What are the symptoms of mastitis?

Mastitis symptoms often develop quickly and can make you feel quite unwell. The signs typically appear in one breast, though both breasts can be affected in some cases.

Common symptoms you might experience include:

• Breast pain and tenderness that may worsen during breastfeeding
• Swelling and firmness in part or all of your breast
• Warmth and redness over the affected area
• Fever and chills, often reaching 101°F (38.3°C) or higher
• Fatigue and body aches similar to flu symptoms
• A wedge-shaped area of hardness on your breast

Some women also notice a burning sensation during breastfeeding or small amounts of pus in their breast milk. These symptoms can develop gradually over several days or appear suddenly within hours.

If you're experiencing these symptoms, especially fever and chills, it's important to contact your healthcare provider promptly for proper evaluation and treatment.

What are the types of mastitis?

Healthcare providers typically classify mastitis into two main types based on whether bacteria are involved. Understanding these types can help you better grasp your condition and treatment options.

Infectious mastitis occurs when bacteria enter your breast tissue, usually through small cracks in your nipple or milk ducts. This type often causes more severe symptoms like high fever and requires antibiotic treatment.

Non-infectious mastitis involves inflammation without bacterial infection. This type might develop from milk stasis (when milk builds up in your breast) or from trauma to the breast tissue.

Your doctor can determine which type you have based on your symptoms, examination, and sometimes laboratory tests. Both types are treatable, though the approach may differ slightly.

What causes mastitis?

Mastitis develops when your breast tissue becomes inflamed, and this can happen through several pathways. Understanding these causes can help you recognize risk factors and take preventive steps.

The most common causes include:

• Milk stasis - when breast milk remains in your ducts too long
• Bacterial infection - usually from Staphylococcus aureus or Streptococcus bacteria
• Cracked or damaged nipples that allow bacteria to enter
• Blocked milk ducts that prevent proper milk flow
• Infrequent breastfeeding or sudden changes in feeding schedule
• Poor milk removal during feeding or pumping

Less common causes can include breast trauma from tight clothing or sleeping positions, stress and fatigue that weaken your immune system, or previous breast surgery that affects milk flow.

In rare cases, mastitis can occur in women who aren't breastfeeding due to hormonal changes, certain medications, or underlying breast conditions. The key factor is usually something that either blocks milk flow or introduces bacteria to breast tissue.

When to see a doctor for mastitis?

You should contact your healthcare provider as soon as you notice mastitis symptoms developing. Early treatment can prevent the condition from worsening and help you feel better faster.

Seek medical attention immediately if you experience fever above 101°F (38.3°C), especially when combined with breast pain and redness. These symptoms together strongly suggest mastitis that needs prompt treatment.

Call your doctor urgently if you develop severe symptoms like red streaks extending from your breast, pus or blood in your breast milk, or if you feel extremely unwell with high fever and chills.

Don't wait to see if symptoms improve on their own. Untreated mastitis can progress to a breast abscess, which is more serious and may require surgical drainage.

What are the risk factors for mastitis?

Several factors can increase your likelihood of developing mastitis, though having risk factors doesn't mean you'll definitely get this condition. Being aware of these factors can help you take preventive measures.

The most significant risk factors include:

• First-time breastfeeding mothers, especially in the first few weeks
• Cracked, sore, or damaged nipples
• Infrequent breastfeeding or long gaps between feeds
• Incomplete breast emptying during feeding
• Wearing tight-fitting bras or clothing that puts pressure on breasts
• Previous history of mastitis
• Fatigue and stress that weaken your immune system

Additional risk factors include having a baby with feeding difficulties, using only one feeding position, or having an oversupply of breast milk. Women with diabetes or other conditions that affect the immune system may also have higher risk.

The encouraging news is that many of these risk factors are manageable through proper breastfeeding techniques, adequate rest, and good breast care practices.

What are the possible complications of mastitis?

While mastitis usually responds well to treatment, it's important to understand potential complications so you can recognize warning signs. Most women recover completely without long-term problems when treated promptly.

The most common complication is the development of a breast abscess, which occurs when infection creates a pocket of pus within breast tissue. This happens in about 5-10% of mastitis cases and may require surgical drainage.

Other possible complications include:

• Recurrent mastitis episodes in the same or different areas
• Chronic breast pain that persists after treatment
• Reduced milk supply in the affected breast
• Sepsis (rare but serious blood infection)
• Premature weaning due to pain and discomfort

Very rarely, untreated mastitis can lead to more serious systemic infections. However, with proper antibiotic treatment and supportive care, these severe complications are highly preventable.

The key to avoiding complications is seeking treatment early and following your healthcare provider's recommendations completely, including finishing all prescribed antibiotics even if you feel better.

How can mastitis be prevented?

You can take several practical steps to reduce your risk of developing mastitis. These prevention strategies focus on maintaining good breast health and proper breastfeeding practices.

Effective prevention methods include ensuring proper latch and positioning during breastfeeding, feeding your baby frequently and on demand, and completely emptying your breasts during each feeding session.

Key prevention strategies involve:

• Breastfeeding every 2-3 hours, including during the night
• Alternating feeding positions to drain all areas of your breast
• Keeping your nipples clean and dry between feedings
• Wearing properly fitted, supportive bras without underwire
• Getting adequate rest and managing stress levels
• Treating cracked nipples promptly

If you need to miss a feeding, pump or hand express milk to prevent engorgement. Avoid sudden changes in your feeding schedule when possible, and don't let your breasts become overly full.

Maintaining good nutrition and staying hydrated also supports your immune system and overall breast health during breastfeeding.

How is mastitis diagnosed?

Your healthcare provider can usually diagnose mastitis based on your symptoms and a physical examination of your breasts. The diagnosis process is typically straightforward and doesn't require extensive testing.

During your appointment, your doctor will ask about your symptoms, breastfeeding history, and examine your breasts for signs of inflammation, warmth, and tenderness. They'll also check your temperature and overall health status.

In most cases, no additional tests are needed for diagnosis. However, your doctor might recommend further testing if you have severe symptoms, don't respond to initial treatment, or have recurrent episodes.

Additional tests might include a breast milk culture to identify specific bacteria, blood tests to check for signs of serious infection, or rarely, an ultrasound to rule out an abscess if symptoms are severe.

What is the treatment for mastitis?

Mastitis treatment typically involves antibiotics to fight infection, along with supportive measures to relieve symptoms and promote healing. Most women start feeling better within 24-48 hours of beginning treatment.

Your doctor will likely prescribe antibiotics that are safe during breastfeeding, such as cephalexin or clindamycin. It's crucial to take the full course of antibiotics, usually 10-14 days, even if you feel better sooner.

Treatment approaches include:

• Oral antibiotics to clear bacterial infection
• Pain relievers like ibuprofen or acetaminophen
• Continued breastfeeding or pumping to maintain milk flow
• Warm compresses before feeding to encourage milk flow
• Cold compresses after feeding to reduce swelling
• Adequate rest and increased fluid intake

Your healthcare provider might adjust treatment if you don't improve within 48-72 hours or if complications develop. Some women may need stronger antibiotics or additional interventions.

It's important to continue breastfeeding during treatment, as this helps clear the infection and prevents further milk stasis. The antibiotics prescribed are safe for your baby.

How to take home treatment during mastitis?

Home care measures can significantly help manage mastitis symptoms and support your recovery alongside medical treatment. These strategies focus on comfort, promoting milk flow, and supporting your body's healing process.

Continue breastfeeding or pumping frequently, as this is one of the most important things you can do. Empty your breasts completely during each session, starting with the affected breast if possible.

Effective home care includes:

• Applying warm compresses for 10-15 minutes before feeding
• Using cold packs after feeding to reduce inflammation
• Taking warm showers and gently massaging your breast
• Getting plenty of rest and sleep when possible
• Drinking lots of fluids to stay hydrated
• Taking pain medication as recommended by your doctor

Try different breastfeeding positions to ensure complete breast drainage, and consider gentle breast massage while feeding to help milk flow. Wear loose, comfortable clothing and a well-fitting supportive bra.

Monitor your symptoms closely and contact your healthcare provider if you don't start feeling better within 24-48 hours of starting antibiotics, or if your symptoms worsen.

How should you prepare for your doctor appointment?

Preparing for your doctor's appointment can help ensure you get the most effective treatment and have all your questions answered. A little preparation can make the visit more productive and less stressful.

Before your appointment, write down all your symptoms, when they started, and how severe they are. Note your breastfeeding pattern, including frequency and any recent changes to your routine.

Bring important information including:

• A list of all medications and supplements you're taking
• Your breastfeeding history and any previous breast problems
• Questions about continuing breastfeeding during treatment
• Any concerns about medication safety while nursing
• Information about your baby's feeding patterns and health

Consider bringing your partner or a support person to help remember information and provide emotional support. Don't hesitate to ask questions about treatment options, expected recovery time, and prevention strategies.

If possible, schedule your appointment for a time when you can breastfeed or pump soon after, as this helps with symptom management and demonstrates feeding techniques to your healthcare provider if needed.

What's the key takeaway about mastitis?

Mastitis is a common and very treatable condition that affects many breastfeeding mothers. The most important thing to remember is that early treatment leads to faster recovery and prevents complications.

You can continue breastfeeding safely during treatment, and in fact, maintaining milk flow is an essential part of healing. The antibiotics prescribed are safe for both you and your baby.

With proper treatment, most women feel significantly better within 24-48 hours and recover completely within a week. Don't let fear of mastitis discourage you from breastfeeding - it's a manageable condition with excellent outcomes when treated promptly.

Remember that seeking help early is always the right choice. Your healthcare provider is there to support you through this challenging time and ensure both you and your baby stay healthy.