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What is mastitis?

Mastitis is an infection of the breast tissue. It often happens to women when they breastfeed their babies. Most of the time only one breast is affected.

What causes mastitis?

It is commonly caused by bacteria that enter through a break or crack in the skin on the nipple. It can also happen if a milk duct becomes plugged or does not empty completely. Using certain creams on your breast may also cause mastitis. If you have had mastitis before, you are more likely to have it again.

What are the signs and symptoms of mastitis?

  • Swelling or breast engorgement
  • A small cut in the nipple
  • Redness, swelling, warmth, and tenderness of the breast
  • Itching
  • Tenderness under your arm
  • Chills and fever

How is mastitis diagnosed?

Your caregiver will examine you. He may ask if you have had mastitis before. Samples of your breast milk may be taken to a lab and tested for bacteria.

How is mastitis treated?

You can usually continue to breastfeed your baby while you are being treated for mastitis. This is because the infection is in the breast tissue and not in your milk. Breastfeeding when you have mastitis may help speed your recovery.

  • Antibiotics: This medicine may be used to kill the bacteria causing the mastitis.
  • Acetaminophen: This medicine decreases pain and fever. Acetaminophen is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Ibuprofen: This medicine decreases pain, swelling, and fever. Ibuprofen is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Ibuprofen can cause stomach bleeding and kidney damage if not taken correctly.
  • Incision and drainage: If the swelling does not go away and an abscess forms, your caregiver will make a small incision in your breast to drain the pus.

How can I manage my symptoms?

  • Rest as needed: Get more rest until your fever is gone and your breast is not sore. Do not sleep on your stomach until your infection is gone.
  • Continue to breastfeed: This will help your breast to drain and decrease the risk that the infection will spread to other areas of your breast. If it is painful when your baby nurses on that breast, breastfeed your baby from the other breast. Open both sides of your bra when breastfeeding and let milk flow from the infected breast onto a towel. This will help relieve pressure as you feed your baby on the opposite side. Pump the infected side to completely drain your breast. You may save the pumped milk to feed your baby.
  • Use different positions to breastfeed: Change the position of your baby during feedings. This may help to relieve your discomfort.
  • Use heat: Heat helps decrease pain from mastitis. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed. It may help to take a warm shower before you feed your baby or pump your breasts.
  • Use cold: A cold towel or ice may help decrease swelling and pain. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your breast for 15 to 20 minutes every hour as directed.
  • Massage your breast: Gently massage your breast before and during breastfeeding to help drain your milk.

How can I prevent mastitis?

  • Prevent breast engorgement: Although it is normal for your breasts to fill with milk, they may become too full. This may feel uncomfortable or even painful. Engorgement can be prevented by breastfeeding, expressing milk by hand, or using a breast pump. You can also feed your baby whenever he is hungry (feed on demand) to help prevent engorgement.
  • Empty your breasts completely while nursing: Begin nursing on the sore breast to keep it emptied. Nurse your baby on both breasts every 1 to 3 hours, both day and night.
  • Treat sore and cracked nipples: Ask a lactation specialist or your caregiver how to treat sore and cracked nipples. You may need to change your baby's position when he breastfeeds or teach him how to latch on properly. Do not let your baby chew on your nipples when he is breastfeeding.
  • Care for your breasts: Keep your nipples clean and dry between feedings. Check them for cracks, blisters, or other irritated areas. Wash your hands before and after you breastfeed your baby or pump your breasts. Wear a nursing bra that supports your breasts but is not too tight.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.
  • Your breast redness, pain, or swelling lasts more than 2 days.
  • You have painful swelling or a lump in your breast.
  • You have swollen and tender lymph nodes in your armpit on the same side as the infected breast.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.