What is mastitis?

Mastitis is an inflammation of the breast. It occurs most often in women who are breastfeeding, but it can affect any woman. Mastitis can be caused by poor milk flow from the breast. When milk builds up in a breast, it leaks into the nearby breast tissue. Infection can also develop when the nipples become cracked or irritated. The tissue can then become infected with bacteria.

Antibiotics can usually cure mastitis. For women who are nursing, continued breastfeeding (or pumping) can help. If mastitis is not treated, a pocket of pus may form in the breast and need to be drained.

If you have mastitis, you may first notice:

• A painful area on one breast. It may be red, warm to the touch, or both.
• Chills, aches, and flu-like symptoms.
• A fever.

These first symptoms may start after you have reopened a blocked milk duct.

Signs that mastitis is getting worse include swollen and painful lymph nodes in the armpit next to the infected breast, a fast heart rate, and flu-like symptoms that get worse.

The symptoms of mastitis most often appear within 4 to 6 weeks after childbirth.

In some cases, symptoms of mastitis get worse and the breast forms a pocket of pus (abscess) in the infected area.

Thrush infection

Thrush (yeast infection) can occur in your baby's mouth and spread to your nipples and breast ducts. You may have a yeast infection if you have:

• Symptoms of mastitis that don't go away with treatment.
• Pain in the nipple area during and after you breastfeed.
• Sharp breast pain between feedings.
• Nipples that look very pink.

If you have yeast infection symptoms, both your nipples and your baby's mouth should be checked for thrush.

Thrush can also begin with a sudden start of pain or burning when breastfeeding has been going well without problems.

Mastitis won't go away without treatment. If you have mastitis symptoms, you may need to call your doctor today. Treating mastitis right away helps keep the infection from quickly getting worse and usually eases symptoms after about 2 days.

Be sure to get treatment for mastitis. Delaying treatment can lead to a breast abscess, which can be harder to treat.

Treatment for mastitis usually includes:

• Antibiotics you take by mouth. They destroy the bacteria that are causing the infection.
• Regularly emptying your breast well by breastfeeding or pumping breast milk. Emptying the affected breast helps prevent more bacteria from collecting in the breast. And it may shorten the time that the infection lasts.
• Self-care. This includes varying your breastfeeding positions and taking acetaminophen (such as Tylenol) to relieve your pain, fever, or discomfort. You can also rest as needed and use an ice pack or warm compress on your breast.

If your doctor prescribes antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of pills. The antibiotics won't harm the baby. If treatment doesn't work at first, your doctor may send a sample of your breast milk to a lab to help find out the type of bacteria that is causing the infection.

You can safely keep breastfeeding your baby or pumping breast milk to feed your baby during the illness and treatment. Your baby is the most efficient pump you have for emptying your breasts. Your breast milk is safe for your baby to drink. Any bacteria in your milk will be destroyed by the baby's digestive juices.

Continuing breastfeeding

Breastfeeding from your affected breast is safe for your baby. If starting with the affected breast is too painful, try feeding your baby with your healthy breast first. Then, after your milk is flowing, breastfeed from the affected breast. If your nipples are too cracked and painful to breastfeed from that breast, hand express or use a breast pump to empty the breast of milk. Try this each time that you can't breastfeed.

Your doctor can usually diagnose mastitis based on your symptoms and by checking your affected breast. Tests usually aren't needed.

• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you are breastfeeding, continue breastfeeding or pumping breast milk. It is important to empty your breasts regularly, every 2 to 3 hours while you are awake. These tips may help:
  • Before breastfeeding, place a warm, wet washcloth over your breast for about 15 minutes. Try this at least 3 times a day. This increases milk flow in the breast. Massaging the affected breast may also increase milk flow.
  • Breastfeed on both sides. Try to start with your healthy breast first. Then, after your milk is flowing, breastfeed from the affected breast until it feels soft. You should empty this breast completely. Then switch back to the healthy breast, and breastfeed until your baby has finished.
  • Pump or hand-express a small amount of breast milk before breastfeeding if your breasts are too full with milk. This will make your breasts less full and may make it easier for your baby to latch on to your breast.
  • Pump or express milk from the affected breast if it hurts too much to breastfeed.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Rest as much as possible.
• Drink plenty of fluids. If you have to limit fluids because of a health problem, talk with your doctor before you increase the amount of fluids you drink.
• If pus is draining from your infected breast, wash the nipple gently and let it air-dry before you put your bra back on. A disposable breast pad placed in the bra cup may absorb the pus.
• Sometimes, a blocked nipple pore, called a milk blister (or bleb) happens. This causes milk to back up in the breast. It can cause mastitis, so it's important to treat this if it happens. A milk blister is often a white dot on your nipple that can be painful. If a milk blister is causing you pain, it may help to place a warm, wet washcloth over the blister before breastfeeding or pumping. If this doesn't clear the blockage, your doctor can open the blister using a sterile needle.

You are more likely to get mastitis from breastfeeding if:

• You've had mastitis before.
• You delay or skip breastfeeding or pumping sessions. When you don't empty the breast regularly or completely, your breasts get too full (engorged). This can lead to mastitis.
• You have cracked or irritated nipples. This can be caused by your baby not being in a good position or not latching on well.

Mastitis most often happens when bacteria enter the breast through the nipple. This can happen when a nursing mother has a cracked or sore nipple.

Going for a long time between nursing sessions or not emptying the breast completely may also may also make mastitis more likely. You can try using different breastfeeding techniques. And make sure that your baby is latched on properly when nursing. These steps will help with emptying the breast and avoiding cracked nipples.

Mastitis is a breast inflammation usually caused by infection. It can happen to any woman. But it's most common during the first 6 months of breastfeeding. You can keep nursing your baby. In fact, breastfeeding usually helps to clear up infection, and nursing won't harm your baby.