Mastitis

Definition

Mastitis is an infection of the breast. It usually only occurs in women who are breastfeeding their babies.

Description

Breastfeeding is the act of allowing a baby to suckle at the breast to drink the mother's milk. In the process, unaccustomed to the vigorous pull and tug of the infant's suck, the nipples may become sore, cracked, or irritated. This creates a tiny opening in the breast, through which bacteria can enter. The presence of milk, with high sugar content, gives the bacteria an excellent source of nutrition. Under these conditions, the bacteria are able to multiply, until they are plentiful enough to cause an infection within the breast.

Mastitis usually begins more than two to four weeks after delivery of the baby. It is a relatively uncommon complication of breastfeeding mothers, occurring in only approximately 3% to 5% of nursing women.

Causes and symptoms

The most common bacteria causing mastitis is called Staphylococcus aureus. In 25-30% of people, this bacteria is present on the skin lining normal, uninfected nostrils. It is probably this bacteria, clinging to the baby's nostrils, that is available to create infection when an opportunity (crack in the nipple) presents itself.

Usually, only one breast is involved. An area of the affected breast becomes swollen, red, hard, and painful. Other symptoms of mastitis include fever, chills, and increased heart rate.

Diagnosis

Diagnosis involves obtaining a sample of breast milk from the infected breast. The milk is cultured, allowing colonies of bacteria to grow. The causative bacteria then can be specially prepared for identification under a microscope. At the same time, tests can be performed to determine what type of antibiotic would be most effective against that particular bacteria. Sometimes, women and their physicians confuse mastitis with breast engorgement, or the tenderness and redness that appears when milk builds up in the breasts. Mastitis often can be distinguished if symptoms are accompanied by fever.

Treatment

A number of antibiotics are used to treat mastitis, including cephalexin, amoxicillin, azithromycin, dicloxacillin, and clindamycin. Breastfeeding usually should be continued, because the rate of abscess formation (an abscess is a persistent pocket of pus) in the infected breast goes up steeply among women who stop breastfeeding during a bout with mastitis. Most practitioners allow women to take acetaminophen while nursing, to relieve both fever and pain. As always, breastfeeding women need to make sure that any medication they take is also safe for the baby, since almost all drugs they take appear in the breastmilk. Warm compresses applied to the affected breast can be soothing.

Prognosis

Prognosis for uncomplicated mastitis is excellent. About 10% of women with mastitis will end up with an abscess within the affected breast. An abscess is a collection of pus within the breast. This complication will require a surgical procedure to drain the pus.

Prevention

The most important aspect of prevention involves good handwashing to try to prevent the infant from acquiring the Staphylococcus aureus bacteria in the first place. Keeping the breast clean before breastfeeding also helps prevent infection. Keeping the breasts from becoming engorged may help prevent mastitis by preventing plugging of milk ducts.

Resources

PERIODICALS

Hager, W. David. "Managing Mastitis: Antibiotics Can Prove Invaluable in the Treatment of Mastitis, but Before You Prescribe Them, It's Important to Distinguish Breast Engorgement from Infectious Mastitis." Contemporary OB/GYN January 2004: 32-41.

ORGANIZATIONS

La Leche League International. 1400 N. Meacham Rd., Schaumburg, IL 60173-4048. (800) 525-3243. 〈http://www.lalecheleague.org〉.

Mastitis

Mastitis is a common infection among breastfeeding women. The infection causes the breast to become tender, red, and hot. The woman also experiences flu-like symptoms, such as fever, tiredness, and sometimes nausea and vomiting. Breast infections can occur when the milk ducts become plugged or when the nipples become cracked. In rare cases, the connective tissues of the breast may become infected.

Mastitis usually affects only one breast, and is treatable with antibiotics . Women with mastitis are encouraged to continue to breastfeed, or to pump the milk from both breasts, to prevent the breasts from becoming abscessed. Mastitis is not dangerous to the infant, since the milk is not infected.

see also Breastfeeding.

Delores C. S. James

Bibliography

Worthington-Roberts, Bonnie, S., and Rodwell Williams, Sue (1993). Nutrition in Pregnancy and Lactation, 6th edition. Madison, WI: Brown & Benchmark.

Internet Resources

Tilson, Bonnie. "Mastitis." Available from <http://www.lalecheleague.org>

mastitis , inflammation of the breast. Mastitis most commonly occurs in nursing mothers between the first and third weeks after childbirth, usually of the first child. It is an infection that results when bacteria enter through cracked nipples; the organisms may already be in the body and attack breast tissue weakened by injury. The breast becomes swollen and painful and a high fever may be present. Mastitis is usually easily treated with antibiotics . In severe cases, when an abscess forms within the breast, the suckling baby must be weaned completely. Chronic cystic mastitis is a common, noninfectious but often painful condition in women between 30 and 50 years old, in which cystic nodules develop in the breasts, giving them a lumpy appearance. It sometimes results from a hormonal imbalance. Biopsy may be necessary to distinguish the condition from breast cancer. Another type of mastitis may occur during puberty, and another is associated with other infectious diseases, e.g., mumps and tuberculosis.

mastitis (mas-ty-tis) n. inflammation of the breast, usually caused by bacterial infection via damaged nipples. cystic m. chronic mastitis in which the breast feels lumpy due to the presence of cysts. puerperal m. acute mastitis that develops during the period of breast-feeding.