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What Is Lactational Mastitis?

Mastitis is an infection of one or more ducts of the breast. It’s usually related to breastfeeding and can cause serious illness if not found and treated aggressively. Some 2% to 3% of nursing women get mastitis.

What Causes Lactational Mastitis?

Mastitis is often caused by common bacteria found in the nose and mouth of the baby. Bacteria enter the breast through a crack in the skin (of the nipple) or through the milk duct openings of the nipple. Diabetes and cracked or bruised nipples can increase chances of getting this infection.

What Are the Symptoms of Lactational Mastitis?

Symptoms include a firm, sore, red, tender breast. The upper outer part of the breast is usually affected. Pain or burning in the breast all the time or only when breastfeeding can occur. The breast may show swelling. Some women may develop a high temperature, chills, headaches, and loss of appetite. Persistent high fever and pain in the breast may indicate that an abscess (collection of pus) has occurred in the breast.

How Is Lactational Mastitis Diagnosed?

The health care provider makes a diagnosis from symptoms and an examination. Blood tests, breast milk analysis, or cultures of samples taken from the baby’s mouth may also be done but aren’t really needed to make the diagnosis or start treatment.

How Is Lactational Mastitis Treated?

Treatment involves pain relievers such as ibuprofen and acetaminophen, ice packs, rest, and support (a well-fitting bra). Women with mild mastitis don’t need to stop nursing. The health care provider will prescribe antibiotics for the infection and suggest nursing from the unaffected breast, pumping, or expressing the involved breast. Emptying the breast adequately may stop bacteria from collecting in the breast and may help shorten the infection.

If tenderness and fever don’t get better quickly, an abscess (pocket of pus) may be present. The abscess may need prompt surgical drainage.

DOs and DON’Ts in Managing Lactational Mastitis:

  • DO pay attention to good hygiene practices during nursing. Avoid using drying agents, always wash your hands, and keep your nipples and baby clean.
  • DO breastfeed from the uninfected breast and empty both breasts completely using a pump on the infected breast.
  • DO avoid getting dehydrated. Drink extra fluids.
  • DO get enough rest and eat a balanced diet when you nurse. You have a greater chance of infection if you’re rundown.
  • DO prevent cracking or fissuring of nipples. Use a breast or nipple shield if you have cracked nipples.
  • DO call your health care provider if you have a high temperature, vomiting, or increasing redness, swelling, or pain in your breast.
  • DO check with your health care provider in 1 to 2 weeks to make sure that the infection is gone.
  • DON’T stop nursing unless your health care provider says to.
  • DON’T ignore worsening symptoms. Untreated mastitis can lead to breast abscesses, a serious condition.

Contact the following sources:

  • American College of Obstetricians and Gynecologists
    Tel: (202) 638-5577
  • WebMD
  • U.S. Department of Health and Human Services

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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