Mastitis is painful inflammation of the breast, usually accompanied by infection.
Mastitis can occur after delivery, usually during the first 6 weeks and almost always in women who are breastfeeding. Less commonly, breast infections happen after an injury or surgery. Having diabetes or taking corticosteroids increases the risk of breast infections.
If the baby is not positioned correctly during breastfeeding, cracking and soreness can develop. Mastitis is different from the pain and cracking of nipples that frequently accompanies the first days of breastfeeding. If the skin of or around the nipples becomes cracked, bacteria from the skin can enter the milk ducts and cause an infection.
Fever several weeks after the start of breastfeeding is frequently due to mastitis.
An infected breast usually appears red and swollen and feels warm and tender. Only part of the breast may be red and sore.
Rarely, breast infections result in a pocket of pus (breast abscess). The area around the abscess swells, and pus may drain from the nipple.
Doctors base the diagnosis on results of a physical examination.
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Treatment of Mastitis
Complete emptying of milk from the breast
Medication for pain, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
Sometimes antibiotics
Pain and swelling are managed with cold compresses and pain relievers, such as acetaminophen or NSAIDs, including ibuprofen. The breast should be completely emptied when milk ducts are full by breastfeeding or pumping. To completely empty the breast milk, warm compresses can be applied to the breast prior to or during breastfeeding or pumping. Women are encouraged to stay hydrated (increase fluid intake). These measures are sufficient to treat many cases of mild or moderate mastitis.
If mastitis seems to be due to a bacterial infection, it is treated with antibiotics, such as dicloxacillin, cephalexin, clindamycin, or sometimes erythromycin.
Women are encouraged to drink plenty of fluids.
If symptoms of the infection do not lessen or symptoms are serious, women should seek medical attention—for example, if the breast looks red, the redness is spreading, or the woman has fever and chills.
Women who have a breast infection and are breastfeeding should continue to breastfeed because emptying the breast helps with treatment and decreases the risk of a breast abscess.
Breast abscesses are diagnosed by ultrasound. Abscesses are treated with antibiotics and are usually drained surgically. This procedure can be done using a local anesthetic but may require sedatives given by vein (intravenously) or a general anesthetic.
If taking antibiotics does not relieve the infection or there is no infection, doctors do an evaluation to check for other causes of breast lumps or inflammation.
