Complications of Mastitis
Complications of mastitis can develop when the condition is not treated, poorly managed, or keeps coming back. While most cases improve with early treatment, some people—especially breastfeeding mothers—may face problems that affect both their physical health and emotional well-being. Complications can be local (affecting the breast tissue), systemic (affecting the whole body), or psychological. Understanding these risks is important for early prevention, quick detection, and the right treatment.
1. Breast Abscess
A serious complication of mastitis is the formation of a breast abscess. This happens when pus builds up in the breast, usually due to an untreated infection.
It shows up as a painful, red, swollen, and hard lump that feels warm. You may also experience fever, chills, and a soft spot that indicates pus under the skin.
An abscess often needs to be drained, either by a needle or with surgery. Antibiotics alone are usually not enough to fully treat the abscess.
This complication can delay recovery and make breastfeeding much harder.
2. Recurrent Mastitis
Mastitis can return repeatedly, especially in breastfeeding mothers who may have ongoing mechanical problems or bacterial infections.
Problems like poor latch, tight bras, skipped feeds, or oversupply can cause inflammation to return. Bacteria, such as Staphylococcus aureus, may stay in the nipple or breast ducts, leading to flare-ups.
Chronic mastitis might also suggest other conditions like duct ectasia, granulomatous mastitis, or autoimmune issues.
Treatment includes fixing breastfeeding techniques, finishing antibiotic treatments, and sometimes testing breast milk to choose the right therapy.
3. Scarring and Ductal Damage
If mastitis or an abscess is severe or keeps happening, it can cause scarring in the breast tissue. This can lead to:
- Blocked milk ducts, increasing the risk of future infections.
- Changes in the breast’s shape or texture.
- Long-term tenderness or sensitivity.
Although these changes might not always be visible on the outside, they can affect breastfeeding comfort and function, especially for women planning to breastfeed future children.
4. Breastfeeding Cessation
Pain, emotional stress, and lack of support may cause some mothers to stop breastfeeding earlier than planned. This isn’t usually medically necessary.
Stopping breastfeeding early can be physically hard on the mother because of engorgement and hormonal changes. It may also deprive the baby of the best nutrition.
The emotional toll of stopping breastfeeding due to mastitis—rather than a choice—can cause guilt, sadness, or even symptoms of postnatal depression.
This highlights the importance of clear advice and support from lactation specialists during treatment to help mothers continue breastfeeding when safe.
5. Systemic Infection (Sepsis)
In rare cases, untreated or severe mastitis can lead to a systemic infection, known as sepsis, which is a life-threatening condition.
Sepsis symptoms include high fever, a fast heartbeat, low blood pressure, confusion, and trouble breathing.
It occurs when bacteria from the breast spread into the bloodstream, causing widespread inflammation.
Sepsis requires urgent hospital treatment, including antibiotics through an IV and fluids.
Recognizing worsening symptoms and seeking medical help quickly is crucial.
6. Fistula Formation
In some cases of non-lactational mastitis, especially those with periductal or granulomatous inflammation, a fistula may form between the breast ducts and skin.
This creates a chronic discharge from a skin opening near the areola.
Surgical treatment may be needed, particularly if abscesses or tissue damage happen repeatedly.
Smoking is a known risk factor for this kind of mastitis and should be addressed during treatment.
Fistulae can be distressing and affect quality of life, both physically and emotionally.
7. Chronic Pain and Nipple Damage
Even after treatment, some women continue to experience ongoing breast pain or nipple damage. This can be caused by scarring, nerve sensitivity, or unresolved feeding problems.
Cracked nipples may return or lead to infections like thrush.
Chronic pain can make breastfeeding or even wearing clothes uncomfortable. Conditions like costochondritis or intercostal neuralgia may be mistaken for recurring mastitis.
These issues show the importance of follow-up care and educating patients to help them recover and feel confident breastfeeding in the future.
8. Delayed Milk Production or Reduced Supply
In severe or both-sided mastitis, milk supply can drop temporarily. This may happen because of:
- Pain making feeding difficult.
- Swelling blocking milk ducts.
- Inflammation affecting milk production.
This can lead to a fussy baby or force mothers to use formula, which can reduce demand and milk production even more. Lactation consultants are key to helping restore milk supply during and after recovery.
9. Emotional and Mental Health Impacts
Mastitis often happens during the vulnerable postpartum period, and its complications can affect mental health.
Feelings of failure, frustration, or isolation are common.
Frequent infections or breastfeeding struggles may lead to postnatal anxiety or depression.
Hospital treatment, drainage procedures, or having to suddenly stop breastfeeding can be traumatic for some mothers.
Mental health support, peer counseling, and reassurance from healthcare professionals are vital to the overall care of mastitis.
10. Misdiagnosis or Delayed Diagnosis of Breast Cancer
Although rare, inflammatory breast cancer can look like mastitis, especially in women who aren’t breastfeeding.
Symptoms like ongoing redness, swelling, and skin changes (peau d’orange) should be investigated further if they don’t go away.
If “mastitis” keeps coming back or doesn’t respond to treatment, it’s important to get imaging (ultrasound or mammogram) and possibly a biopsy to rule out cancer.
A misdiagnosis can delay cancer treatment and hurt the chances of recovery. Vigilance is especially important for high-risk individuals.
Summary
In summary, the complications of mastitis can range from local issues like abscesses and duct damage to serious problems like sepsis and emotional distress. Many of these complications can be prevented with early diagnosis, the right antibiotics, and proper breastfeeding support. Lactation consultants, healthcare providers, and family members all play an important role in ensuring recovery and emotional well-being. Recognizing warning signs and empowering patients with knowledge can reduce the risks linked to this common condition.
