Mastitis

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, especially during the baby's first 2 months. After 2 months, the baby's feeding patterns become more regular, which helps prevent mastitis.

Mastitis can leave a new mother feeling very tired and run-down. Add the illness to the demands of taking care of a newborn, and many women quit breastfeeding altogether. But you can keep nursing your baby. In fact, breastfeeding usually helps to clear up infection. Nursing won't harm your baby.

Mastitis can be discouraging and painful. But it is usually easily cleared up with medicine.

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. Mastitis can lead to a breast abscess, which feels like a hard, painful lump.

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

Your doctor can usually diagnose mastitis based on your symptoms and by checking your affected breast. Tests usually aren't needed. But tests may be done to confirm a diagnosis. They may also be done to help guide treatment for other problems that can develop.

If you have an infection that isn't improving with treatment, your doctor may do a breast milk culture. To provide a sample for a culture, you will squeeze a small sample of milk from the affected breast onto a sterile swab. The culture results help your doctor confirm a diagnosis and find out the specific bacteria causing the infection.

Culture results may also be used to find out which antibiotic will work best for you.

Mastitis won't go away without treatment. Treating it right away helps keep the infection from quickly getting worse and usually eases symptoms after about 2 days. Delaying treatment can lead to an abscess, which can be harder to treat.

Treatment usually includes:

• Taking antibiotics. They destroy the bacteria causing the infection.
• Regularly emptying your breast by breastfeeding or pumping breast milk. This helps prevent more bacteria from collecting in the breast. It may shorten the time that the infection lasts.
• Self-care. This includes varying your breastfeeding positions and taking acetaminophen to relieve pain, fever, or discomfort. You can rest as needed and use an ice pack or warm compress on your breast.

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

• 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) or ibuprofen (Advil, Motrin) to relieve pain and fever. 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 extra fluids.
• 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.