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Mastitis
Mastitis means inflammation (injury from infection or irritation) of the breast tissue. Mastitis may occur in up to a third of women who are lactating (forming breast milk) after giving birth and is then called lactation mastitis. When lactation mastitis is due to an infection, it is usually caused by bacteria, although fungal (yeast) infections can also be the cause. Most cases of lactation mastitis occur during the first 3 months postpartum (after giving birth), but it may occur any time as long as a woman is breastfeeding. When mastitis is severe, an abscess (collection of pus from an infection) may develop in the breast. The April 2, 2003, issue of JAMA includes an article about lactation mastitis.
SYMPTOMS OF LACTATION MASTITIS
- Malaise (feeling tired and unwell)
- Fever
- Reddened area of the breast, usually wedge-shaped
- Warmth or tenderness of the breast
- Pain with nursing (can also be caused by sore or cracked nipples without mastitis)
POSSIBLE RISK FACTORS FOR DEVELOPING MASTITIS
- Mastitis after a previous pregnancy
- Nipple cracks or sores
- Using only one position to breastfeed so the entire breast does not empty
- Tight-fitting bra that obstructs milk flow
TREATMENT OF MASTITIS
- Continue nursing and use different feeding positions
- Complete, frequent emptying of the affected breast
- Warm compresses or warm shower
- Increase fluid intake
- Bed rest
- Pain medication
- Antibiotics if prescribed by your doctor
- Drainage of any abscess that may form
If you think you have mastitis, see your doctor. In most cases, mastitis is easily treated. Continuing to breastfeed while you have mastitis will not hurt your baby.
Mastitis can occur in older women who are not lactating. This form of mastitis is called periductal mastitis. The milk ducts near the nipple become inflamed, causing breast pain. There may also be a breast mass near the nipple, retraction of the nipple, or discharge. Because breast cancer can also cause these symptoms, it is important to see your doctor if you have any of them. Treatment of periductal mastitis may include antibiotics or surgery if the periductal mastitis is severe.
There is a form of breast cancer called inflammatory breast cancer that can be confused with mastitis. Because inflammatory breast cancer is fast-growing, aggressive, and deadly, it is important to detect it early. Fever usually occurs with mastitis but rarely occurs with inflammatory breast cancer.
FOR MORE INFORMATION
INFORM YOURSELF
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. They are available in English and Spanish. A Patient Page on breastfeeding was published in the January 24/31, 2001, issue.
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.
Sources: La Leche League, National Women's Health Information Center
Topic: WOMEN'S HEALTH
Janet M. Torpy, MD, Writer;
Cassio Lynm, MA, Illustrator;
Richard M. Glass, MD, Editor
JAMA. 2003;289:1728.
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RELATED ARTICLE
Lactation Mastitis
Cibele Barbosa-Cesnik, Kendra Schwartz, and Betsy Foxman
JAMA. 2003;289(13):1609-1612.
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