What is mastitis?
Mastitis is an infection in the mammary gland of the breast and is thought to affect around 10 percent of lactating women, although some studies have shown mastitis rates that are as high as 33 percent. Mastitis most often occurs during the first 6 to 12 weeks following delivery and is usually due to a blocked milk duct or to bacteria entering the breast through a break in the skin. Mastitis can result in you feeling run-down and unable to take care of your baby and in some cases, mastitis can lead a mother to wean her baby early. However, in general, continuing to breastfeed is better for you and your baby, even if you are taking an antibiotic for the infection.
Risk factors for mastitis
There are certain things you can do to prevent to mastitis, such as:
- Avoiding wearing tight or uncomfortable bras, or putting pressure on your breast from carrying a heavy bag, which may restrict milk flow
- Ensuring you eat a good diet
- Using more than one breastfeeding position to feed your baby, which helps ensure that your breast is drained
- Trying to not become overly tired or stressed
Other risk factors that are a bit more out of your control are:
- A previous episode of mastitis during breastfeeding
- Sore or cracked nipples, although mastitis can still develop in the absence of broken skin
Breastfeeding is also obviously a risk factor for developing mastitis; however, as there are large benefits for your baby from breast milk, it is worth taking this risk perhaps.
Symptoms of mastitis
At first you may feel like you are coming down with the flu and the following symptoms may then suddenly occur:
- Breast pain and tenderness
- Burning pain when breastfeeding
- Redness, warmth, and swelling pointing toward the nipple
- Chills and fever
- Nipple discharge
- An area of hardness or a breast lump around the affected area
You should let your healthcare provider know straight away if you experience these symptoms because if the infection is left untreated pus may build up, resulting in an abscess in your breast. This is less likely to happen if you continue to breastfeed and keep the milk flowing as this will prevent bacteria from building up in the blocked milk duct. Treatment for mastitis is a course of antibiotics
Could these symptoms be something else?
Unfortunately, many of the symptoms of mastitis, aside from fever, are very similar to another more serious disease – inflammatory breast cancer. As well as the above symptoms for mastitis, other symptoms of inflammatory breast cancer include:
- Redness of the breast that comes and goes.
- Swelling of the breast: Part of or all of the breast may be swollen, enlarged, and hard.
- Orange-peel appearance: Your breast may swell and start to look like the peel of a navel orange (this is called “peau d’orange”).
- Swelling of lymph nodes: The lymph nodes under your arm or above the collarbone may be swollen.
- Flattening or inversion of the nipple: The nipple may go flat or turn inward.
- Other skin changes: The skin of the breast might look pink or bruised, or you may have what looks like ridges, welts, or hives on your breast.
Luckily inflammatory breast cancer is very rare, making up only around 1 percent of all breast cancer cases each year. However, if you are taking antibiotics for your mastitis and your symptoms haven’t resolved within 5 weeks, a full medical investigation should be carried out to make sure you don’t have inflammatory breast cancer.
A breast abscess versus breast cancer
Rarely, breast cancer can have similar symptoms to a breast abscess and so in certain women, a biopsy will be taken to rule this diagnosis out. A breast abscess is an accumulation of pus in the breast and affect between 5 and 11 percent of women with infectious mastitis during breastfeeding. Risk factors for developing a breast abscess include:
- Birth after 41 weeks gestation
- Age of more than 30 years
- Recent mastitis
- Having given birth to your first baby (primiparity)
Symptoms of a breast abscess are similar to the symptoms of mastitis and a lump is not always present, especially if the breast is quite large. Treatment for a breast abscess usually involves aspiration with a needle and a course of antibiotics.