Mastitis is an infection of the breast, most often experienced by nursing mothers. It can also occur unrelated to pregnancy or lactation. It is caused by bacteria that enter the nipple, usually from the baby’s nose or throat, causing the mammary glands to swell. This inflammation can spread throughout the breast and the bacterial infection can enter the bloodstream. The most common bacteria are Staph aureus, S. epidermidis, and Streptococci. Nipple abrasion, blocked milk ducts, poor let-down, a tight bra, long intervals between feedings, such as during weaning, or a history of mastitis during breastfeeding are risk factors. Symptoms include breasts that become red, swollen, warm, painful, cracked nipples, and enlarged lymph nodes in the armpits. They may also report fever, flu-like symptoms, and hard breasts.
Abscess formation, recurrence, and milk stasis are complications of mastitis. If there is an abscess, an incision may be made to drain it. Recurrence may occur with future children. Milk stasis is when milk does not drain completely and leaks into the surrounding breast tissue causing pain and swelling. A breast ultrasound may be done to determine if an abscess or tumor is present. Treatment includes lukewarm baths, loose fitting bras and shirts, continued breastfeeding to prevent engorgement, antibiotics, and pain relievers. Be sure to wash your hands and breasts well before and after nursing. An over-the-counter antibiotic ointment can be applied to cracked nipples, but should be washed off before nursing. Medical-grade modified lanolin can be applied to the nipple and does not need to be washed off before feeding. Hydrogel dressings are designed to heal nipples, but may require a prescription. If you have an abscess, you may need to use a breast pump until it heals. Breastfeeding the baby when he has mastitis will not harm the baby since he is the source of the infection. Follow-up with a lactation consultant is a good idea.
Prevention of recurrence of mastitis includes emptying the breasts completely to prevent milk stasis. Alternate feeding positions and rotate pressure areas around the nipple. The baby must be correctly positioned with the entire areola in the mouth. Expose sore nipples to air as much as possible. Drink plenty of fluids and eat a healthy diet. Take a warm shower, allowing the warm water to hit the breasts and massage the breasts in a downward sweeping motion to help drain the breasts. The importance of washing hands and breasts cannot be expressed enough. It will help prevent bacteria on the surface of the skin from getting into a cracked nipple.