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Introduction
- May occur spontaneously or during lactation
- Most frequently occurs during the first 6-8 weeks postpartum, although it may occur at any time during breastfeeding
- A study showed that lactational mastitis is associated with decreased levels of carbohydrate, fat and energy in breast milk which may be due to the cytokine-induced inflammatory response and increased permeability of the blood-milk barrier
- Incidence is 2-10% in lactating mothers, while <1% in nonpuerperal mothers
- Nonpuerperal mastitis is most commonly associated with breast cyst
- Breast abscess is a complication of mastitis, refers to the collection of pus in the breast
Definition
- Inflammation of the breast
- May or may not be associated with bacterial infection
Etiology
- Staphylococcus aureus is the most common organism associated with mastitis, particularly methicillin-resistant S aureus (MRSA) in lactational mastitis
- Other pathogens are streptococci (alpha, beta and non-hemolytic), Escherichia coli, Bacteroides species, Corynebacterium species
- Consider Candida infection if with symptoms of burning nipple pain or radiating breast pain
Signs and Symptoms
- Firm, erythematous, tender, swollen area in the affected breast
- Skin that may appear shiny and tight with red streaks
- Fever or temperature >38°C
- May present with headache, myalgia, lethargy, nausea, anxiety, flu-like aching, or systemic illness
- Axillary pain and swelling from reactive lymphadenopathy
Risk Factors
- Incomplete breast drainage which may be caused by difficulties in infant attachment, missed feedings or infrequent feedings, infant mouth abnormalities (eg tongue-tie, cleft lip or palate)
- Engorgement and/or chronic oversupply of milk
- Abrupt or rapid weaning
- Blocked nipple or milk ducts
- Trauma to breasts or nipples
- Excoriated or cracked nipples
- Poor maternal health like fatigue, stress, malnutrition
- Prior history of mastitis
- Tight-fitting clothes or external pressure on the breast
- Yeast infection
- Illness in mother or baby
