What is mastitis?

Mastitis is an inflammation of the breast tissue that often results in pain, swelling, warmth, and redness. It most commonly affects women who are breastfeeding, a condition known as lactational mastitis, but can also occur in women who are not breastfeeding. In some cases, mastitis can lead to an infection, requiring medical treatment. Early diagnosis and prompt management are important to prevent complications, such as an abscess, from developing.

Types of mastitis

There are two main types of mastitis:

• Lactational mastitis: This is the most common form and occurs in women who are breastfeeding. It is often caused by milk being trapped in the breast (milk stasis), which can lead to infection. Bacteria from the skin or baby’s mouth can enter the milk ducts, causing an infection.
• Non-lactational mastitis: This type of mastitis can occur in women who are not breastfeeding. It is more commonly seen in smokers and women with conditions such as diabetes or weakened immune systems. Non-lactational mastitis can also be related to certain medical conditions, such as duct ectasia, which causes the milk ducts to become inflamed and blocked.

Symptoms of mastitis

Mastitis usually develops suddenly, and the symptoms can vary in severity. Common signs and symptoms include:

• Breast pain or tenderness, usually in one breast
• Swelling and redness of the breast, often in a wedge-shaped pattern
• A feeling of warmth in the breast
• Hard or lumpy areas in the breast
• Nipple discharge (may be clear or pus-like)
• Flu-like symptoms, such as fever, chills, fatigue, and body aches

If you notice any of these symptoms, it is important to seek medical advice, especially if you are breastfeeding. Untreated mastitis can lead to the formation of an abscess, a collection of pus within the breast, which may require drainage.

Causes of mastitis

The primary causes of mastitis vary depending on whether it is lactational or non-lactational.

• Lactational mastitis is typically caused by milk stasis, which can occur when a milk duct becomes blocked or when the breast isn’t fully emptied during feeding. Poor breastfeeding techniques, infrequent feeding, or a sudden change in feeding patterns can contribute to milk stasis. Bacteria entering through cracked or sore nipples can lead to infection.
• Non-lactational mastitis is often related to blocked milk ducts or conditions such as duct ectasia, where the milk ducts become widened and inflamed. Smoking can also damage the milk ducts, increasing the risk of infection.

Diagnosis

Mastitis is usually diagnosed based on your symptoms and a physical examination. Your doctor may ask about your breastfeeding routine (if applicable) and check for signs of infection or blockages in the breast. In some cases, additional tests may be needed, including:

• Breast ultrasound: This scan may be used to identify blocked ducts, abscesses, or areas of inflammation in the breast tissue.
• Breast milk culture: If you are breastfeeding, a sample of breast milk may be tested to identify the bacteria causing the infection.
• Biopsy: In rare cases where symptoms persist despite treatment, a biopsy may be required to rule out other conditions, such as breast cancer.

Treatment options

The treatment for mastitis depends on whether the condition is infectious or non-infectious. Common treatment options include:

• Antibiotics: If mastitis is caused by a bacterial infection, antibiotics are typically prescribed. It is important to complete the full course of antibiotics, even if symptoms improve before the medication is finished.
• Pain relief: Over-the-counter pain relievers such as paracetamol or ibuprofen can help reduce breast pain and inflammation.
• Breastfeeding management: If you are breastfeeding, it is important to continue nursing or expressing milk to prevent milk stasis. Your doctor or a lactation consultant may recommend adjusting your breastfeeding technique to ensure the breast is fully emptied.
• Warm compresses: Applying warm compresses to the affected breast can help reduce pain and encourage milk flow.
• Abscess drainage: If an abscess has formed, it may need to be drained, either by needle aspiration or through a small surgical incision.

Possible risks and complications

While most cases of mastitis can be effectively treated with antibiotics and breastfeeding management, complications can occur if the condition is left untreated. The most common complication is the formation of a breast abscess, which may require drainage. Recurrent mastitis is also a risk, particularly in breastfeeding women who experience repeated episodes of milk stasis.

Other potential risks include scarring of the breast tissue, which can affect future breastfeeding, and, rarely, the spread of the infection to other parts of the body.

Recovery and follow-up care

Recovery from mastitis generally takes about 1-2 weeks, especially with prompt treatment. If you are breastfeeding, it is important to continue nursing or expressing milk to prevent further blockages. Your healthcare team may recommend follow-up visits to ensure the infection has cleared and that there are no lingering issues, such as an abscess.

For women who experience recurrent mastitis, a lactation consultant or breastfeeding specialist can provide support and guidance to help prevent future episodes.

Why choose Birmingham Breast Clinic?

At Birmingham Breast Clinic, we provide expert care for women with mastitis, offering quick diagnosis and personalised treatment plans. Our dedicated team of breast care specialists is committed to ensuring a smooth recovery and preventing complications. Whether you are a breastfeeding mother or experiencing non-lactational mastitis, we offer compassionate, patient-centred care tailored to your needs.

Contact us

If you are experiencing breast pain or symptoms of mastitis, contact Birmingham Breast Clinic to schedule an appointment.