Mastitis is an infection of the breast, most often experienced by nursing mothers. It can also occur unrelated to pregnancy or breastfeeding. It is caused by bacteria entering the nipple, usually from the baby’s nose or throat, that causes inflammation of the mammary glands. This inflammation can spread through the entire breast and the bacterial infection can enter the blood stream. The most common bacteria are Staph aureus, S. epidermidis, and Streptococci. Abrasion of the nipple, blocked milk ducts, poor let down, tight bra, long intervals between breastfeedings, such as while weaning, or a prior history of mastitis while breastfeeding, are risk factors. Symptoms include the breast(s) becoming red, swollen, hot, painful, nipple cracks, and enlarged lymph nodes of the under arms. They may also report fever, flu like symptoms, and hard breasts.
Abscess formation, recurrence, and milk stasis are complications of Mastitis. If an abscess is present, an incision may be made to drain it. Recurrence can occur with future children. Milk stasis is when milk is not completely drained, and it seeps into the surrounding breast tissue causing pain and inflammation. A breast ultrasound may be performed to determine if there is an Abscess or Tumor present. Treatment includes warms soaks, loose bras and shirts, continuation of breastfeeding to prevent engorgement, antibiotics, and pain medication. Make sure to wash hands and breasts thoroughly before and after nursing. Over the counter antibiotic ointment can be applied to cracked nipples, but must 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 for nipple healing, but may require a prescription. If you have an abscess, you may need to use a breast pump until you heal. Breastfeeding the baby when you have Mastitis will not hurt the baby as he is the source of the infection. Following up with a lactation specialist is a good idea.
Preventing Mastitis from recurring includes emptying the breasts completely to prevent milk stasis. Alternate feeding positions, and rotate pressure areas around the nipple. The baby should be properly position with the entire areola in the mouth. Expose sore nipples to the air as much as possible. Drink plenty of fluids and eat a healthy diet. Take a warm shower, allowing warm water to hit the breasts, and massage the breasts in a downward sweeping motion to help with draining the breasts. The importance of hand and breast washing cannot be stated enough. It will help prevent bacteria at the surface of the skin from entering a cracked nipple.