Overview of Mastitis
Mastitis is an inflammatory condition of the breast tissue that most commonly affects breastfeeding women, though it can also occur in non-lactating women and, in rare cases, men. It typically presents as breast pain, swelling, redness, and warmth, often accompanied by flu-like symptoms such as fever and fatigue. While it may begin as a simple blockage in a milk duct, if left untreated, it can develop into a bacterial infection requiring medical intervention. Understanding mastitis is key for early recognition, effective treatment, and the prevention of complications like abscess formation or recurring infections.
Understanding Mastitis: What It Is and Who It Affects
Mastitis occurs when the breast tissue becomes inflamed, usually due to a build-up of milk or an infection. It is categorized into two main types: non-infectious mastitis and infectious mastitis. Non-infectious mastitis is often caused by milk stasis, where milk isn’t properly drained from the breast. If bacteria from the skin or the baby’s mouth enter the milk ducts through a cracked nipple, the condition may progress to infectious mastitis.
Most cases of mastitis occur in lactating women, particularly within the first six to twelve weeks postpartum. However, it can develop at any stage of breastfeeding. This type is called lactational mastitis, and if not treated promptly, it can discourage women from continuing breastfeeding. Non-lactational mastitis is less common and may be linked to underlying breast conditions, smoking, or nipple piercings.
Common Symptoms
The hallmark symptoms of mastitis include:
- Breast pain and tenderness: Often localized to one area, which may feel hot to the touch.
- Redness and swelling: A wedge-shaped area of redness may develop on the breast.
- Fever and malaise: Flu-like symptoms such as chills, fatigue, and body aches are common.
- Nipple discharge: This can sometimes be purulent (pus-filled) or blood-stained.
- Lump or thickening: A hardened area in the breast, often mistaken for a tumor, but typically caused by inflammation or a blocked duct.
Lactational vs. Non-Lactational Mastitis
Lactational Mastitis
This form occurs during breastfeeding and is the most common type. It is often caused by milk stasis, which may result from:
- Infrequent feedings or missed feeds
- Improper latch or ineffective suckling
- Tight clothing compressing milk ducts
- Oversupply of milk
Bacteria like Staphylococcus aureus or Streptococcus species can enter the breast through small cracks or breaks in the nipple, leading to infection.
Non-Lactational Mastitis
This type typically affects premenopausal women who are not breastfeeding. Contributing factors may include:
- Smoking, which damages the breast ducts
- Nipple piercings or trauma
- Chronic skin conditions like eczema
- Diabetes or a weakened immune system
This form of mastitis is more likely to recur and may be linked to a rare condition called periductal mastitis, where inflammation affects the ducts behind the nipple.
Risk Factors and Prevalence
Certain factors increase the likelihood of developing mastitis, including:
- First-time motherhood
- Weaning too quickly or having irregular breastfeeding routines
- Cracked or sore nipples
- Wearing restrictive bras
- High milk supply or engorgement
- A history of previous mastitis
Mastitis affects approximately 10–20% of breastfeeding women, with the highest incidence occurring in the first few postpartum months. It is relatively rare in non-lactating individuals but should not be overlooked, especially in cases of recurrent inflammation or unusual nipple discharge.
Impact on Breastfeeding and Emotional Wellbeing
Mastitis can significantly disrupt breastfeeding. The pain and discomfort often discourage mothers from continuing, even though frequent breastfeeding or milk expression is typically key to resolving the condition.
This physical distress may also contribute to anxiety, guilt, or a sense of failure, particularly in the face of societal or familial pressures. Healthcare providers play a crucial role in supporting mothers during this time by offering education, empathy, and reassurance. With proper management, most women can continue breastfeeding safely and comfortably.
When to Seek Medical Attention
While mild cases of mastitis may be managed at home through rest, hydration, and frequent milk drainage, certain signs require medical evaluation:
- Persistent fever over 38.5°C (101.3°F)
- No improvement after 24–48 hours of self-care
- Worsening redness, pain, or swelling
- Presence of a pus-filled lump, indicating an abscess
In these cases, antibiotic therapy or surgical drainage may be necessary. Early intervention is crucial to prevent complications and ensure a quicker recovery.
Summary
In summary, mastitis is a painful and sometimes distressing condition that primarily affects breastfeeding women. While it is common and generally treatable, it requires prompt recognition and appropriate management to avoid complications. Understanding the difference between lactational and non-lactational mastitis, recognizing risk factors, and knowing when to seek medical care are essential. With support and proper care, mastitis does not have to interfere with successful breastfeeding or long-term breast health.
