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Mastitis

DEFINITION

Mastitis is the medical name for infection of the breast. Mastitis is characterized by pain, swelling, redness of the breast and may involve fever or chills. Generally, mastitis is a result of breast-feeding, but can occur to women who are not breast feeding as well. Most often, mastitis happens within the first three months of breast feeding, but can occur at any time throughout that period. Mastitis is common during breast feeding because bacteria from the skin or the baby’s mouth can enter the breast tissue through tiny cracks in the nipple caused by breastfeeding. Bacteria can also get into the breast tissue through the opening to the milk ducts. Inside the breast tissue, the bacteria grow and multiply, making a more severe infection. Risk factors for mastitis include having cracked skin on the breast or nipples, history of having mastitis previously, not using more than one position to breast feed (multiple positions help the milk drain fully), and wearing a tight bra that restricts milk flow to the baby. Feeding a baby while having mastitis seems like a bad idea, but is actually one of the steps that are necessary to prevent mastitis from getting worse. If left alone, mastitis can lead to milk stasis (a condition where milk builds up in the breast and seeps into the surrounding tissue) or the formation of an abscess or pocket of local infection in the breast. Both of those conditions can be extremely painful. Having support to help you take care of your baby will be very helpful as this illness can make you feel very fatigued.

SYMPTOMS
Breast pain, breast warmth to touch, redness of the breast, swelling of the breast, feeling ill, pain with breast-feeding, fever

DIAGNOSIS
Your doctor will begin by taking to you about the history of your problem and doing a physical examination. If your doctor is certain that you have mastitis, likely no further testing will be done. If your doctor suspects abscess, he or she may want to do an ultrasound to get a better look at the area.

TREATMENT
Treatment of mastitis always involves antibiotics. Usually a course of antibiotics 10-14 days in length is required. Even though your breast may start feeling better after a few days, it is important to complete the whole treatment to fully get rid of the infection. Though the tendency is to stop breast feeding, you should continue. The breast needs to drain milk to prevent milk stasis and worsening of infection. The infection will not harm the baby. If your baby will not feed from the breast, you should use a breast pump to allow the milk to pass freely from the breast and prevent complications. After mastitis, you will want to make sure that you use different positions to fully empty the breast of milk when breast feeding. Your doctor may want to talk about your breast feeding technique to ensure that the baby is latching properly and the milk is being drained appropriately. You will need to take good care of yourself during this infection including drinking fluids, resting, continuing to breast feed, wearing a supportive bra, and not waiting too long between breast feeding sessions. A lactation consultant may be a helpful person both to work on breastfeeding technique and prevent further episodes of mastitis. It is important to follow-up with your doctor if the swelling and redness does not go away with treatment as a rare form of breast cancer called inflammatory breast cancer can look exactly like mastitis.

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