Mastitis: Definition, Causes, Stages, Symptoms, Complications, Diagnosis, Treatment and Prevention

It is a common condition in breastfeeding mothers.

Mastitis is inflammation of the breasts that is often caused by infection.

The painful condition occurs when a milk duct becomes blocked and does not drain properly.

Some of the milk that collects behind the blocked duct can be forced into the nearby breast tissue, causing the tissue to swell.

Although it often occurs during the first six weeks of breastfeeding when feeding patterns are not yet established, it can happen every time a woman is breastfeeding.

It can occur even when a woman is not breastfeeding in rare cases.

A nursing mother can usually identify mastitis or a blocked or plugged duct, such as a red, swollen, tender, or warm lump or wedge-shaped breast area.


This painful condition can also cause flu-like symptoms, such as fatigue, body aches, and fever.

Causes of mastitis

Mastitis is most common before feeding patterns are established during the first six weeks a woman is breastfeeding because mastitis often occurs when the breast does not empty.

Some risk factors for developing mastitis are:


Because engorgement can lead to mastitis, mothers who produce too much milk, or have an oversupply, are more likely to get mastitis.

If you suspect that you are overproducing milk, you should try breastfeeding more frequently or use the device to express your milk.

Fast weaning

Spending extended periods between feedings, skipping feedings, or not replacing missed feedings with pumping sessions can cause the breasts to fill with blood or become overly full, leading to mastitis.

Bacteria presence

You can also get an infection that causes mastitis when bacteria enter the nipple, often through a cracked nipple.

Proper handwashing should be practiced before feeding or expressing milk, keeping pump parts sanitized, and treating cracked nipples with natural oils or creams.

Pressure in the breasts

Excessive pressure on a nursing mother’s breasts, whether from a tight bra, long periods, or sleeping on her stomach, can lead to plugged ducts.

Stress and fatigue

There is evidence that stressed or exhausted women are more susceptible to mastitis.

Stages of mastitis

In the development of lactational mastitis, it is necessary to distinguish several stages, such as:

The initial phase (stagnant)

It is the starting point for the development of mastitis; it begins with an insufficient evacuation of breast milk.

There is a feeling of heaviness in the mammary gland, palpable swollen lobules, and symptoms of discomfort.

If the evacuation of milk is not carried out, as a general rule, in 2 to 3 days, mastitis develops.

Stage of serous inflammation

In this stage, mastitis is accompanied by acute pains in the mammary gland, increased volume due to edema, generalized hyperemia, chills, and high body temperature, since milk has pyrogenic action.

When palpated, the breast is hot to the touch and painful; severely damaged lobes are defined in the depths.

At this point, the mastitis is still reversible.

The primary condition for the treatment is the qualitative removal of residual milk in various ways: with the help of a breast pump or by manual decantation.

When the treatment of serous inflammation is ineffective, the infiltration forms, and the process moves to another stage.

Mastitis in the infiltration stage

Practically, mastitis is already irreversible since the introduction of pathogenic microflora occurs.

Given the presence of pathogenic microflora, the child is transferred to artificial feeding to apply antibacterial treatments.

In this case, a patient with mastitis can be prescribed a full range of antibacterial therapy, physiotherapy, and compression bandages with antiseptics.

Mastitis in the abscess stage

The pain in the chest intensifies. The hyperemia is localized over the abscess.

Mastitis symptoms

Mastitis symptoms can occur suddenly.

Mastitis can be suspected if the breast is swollen, tender, or hot to the touch, a painful or burning area during lactation, skin redness, and high fever.

Other signs of mastitis include cold or flu symptoms, such as fever, chills, and body aches.

Generally, the symptoms of mastitis when inflammatory breast cancer occurs are:

Inflammatory breast cancer patients experience swelling in their breasts.

Additional symptoms may include an itchy chest, pink or red skin on the chest, ridges and thickened areas of skin on the chest, a bruised appearance on the breast, nipple retraction, nipple discharge (which may or may not be bloody), breast pain, change in color and texture of the areola, or the breast may be warm to the touch.


If mastitis is not treated correctly or is related to a plugged milk duct (called milk stasis), a collection of pus (called an abscess) can develop in the breast tissue.

An abscess usually feels like a small, hard lump in the breast.

Patients with breast abscesses generally need to have the fluid surgically drained.

Some research suggests that up to 10% of women with mastitis develop abscesses.

However, many experts consider this estimate to be very high.

Women who have had mastitis in the past are more likely to experience the condition again.

Diagnosis of mastitis

Tests are generally not needed to diagnose mastitis.

A doctor unmistakably diagnoses mastitis based on a physical exam.

The doctor looks for characteristic signs of the condition, including fever, chills, and a sore area on the chest.

The doctor will also check to see if the patient has developed a collection of pus, called an abscess, in the breast tissue during the exam.

This is a common complication that develops when mastitis is not treated.

A biopsy is done to determine if the patient has cancer or if inflammatory breast cancer is suspected.

A small sample of the patient’s breast tissue is tested in a cancer cell laboratory.


Infections are usually caused by a penicillin-resistant bacteria called S. aureus.

Other bacteria called Streptococcus, and Escherichia coli can also cause mastitis.

If an infection is causing mastitis, patients generally take antibiotics by mouth for 10 to 14 days.

Cephalexin and dicloxacillin are frequently prescribed, but they are not safe for infants.

Erythromycin may be prescribed if a patient is allergic to other antibiotics and is generally considered safe while breastfeeding.

Side effects depend on the specific medication used.

Typical side effects include mild nausea, vomiting, heartburn, muscle aches, diarrhea, dizziness, fatigue, joint pain, vaginal itching, or vaginal discharge.

Some antibiotics can be harmful to infants, so ask your doctor if you can continue to breastfeed while taking medications.

Keeping the milk flowing into the infected breast helps clear the infection.

If the nipples are too painful to continue breastfeeding, a breast pump can be used to empty the breast.

Until antibiotics work, people can take mild pain relievers, such as ibuprofen or acetaminophen.

Self-care techniques can be used to increase milk flow and reduce pain, such as:

  • Before breastfeeding, mothers can apply a warm compress to the affected breast for about 15 minutes to reduce pain and increase milk flow.
  • Alternatively, patients can take a hot shower.
  • The baby should be breastfed with his chin or nose positioned towards the affected area. In this way, the baby’s facial features will give the blocked milk duct a gentle massage during feeding.
  • I am using essential oils and massaging the affected breast with edible oils (such as coconut oil) or natural lubricants during or after feedings to help clear clogged ducts.

Mothers with mastitis can continue to breastfeed safely because the infection cannot pass through breast milk.

Although it may be painful at first, you should not stop breastfeeding altogether.

If you stop breastfeeding abruptly, your mastitis may worsen, and your risk of developing a breast abscess increases.

Breastfeeding will help empty the breast and disconnect the blocked milk duct.

To breastfeed the baby, you must start feeding on the affected breast. If it is too painful, try the other breast.

Once the milk is flowing, move your baby to the affected breast, feeding until the breast is completely drained.

You can gently massage the affected area while feeding or positioning the baby so that your nose or chin gently presses on the affected area.

If you cannot fully breastfeed, try expressing with a manual or automatic pump.

Mastitis caused by inflammatory breast cancer is treated with chemotherapy, radiation therapy, and surgery.

Inflammatory breast cancer patients generally undergo several chemotherapy sessions before surgery to increase the chances of effective surgery.

Due to the nature of cancer, the entire breast usually must be removed. This type of surgery is called a mastectomy.

The surgeon will also examine the lymph nodes during the surgery to see if cancer has spread to other parts of the body.

If the lymph nodes under the arm are removed in addition to the breast, the procedure is called a modified radical mastectomy.

Chemotherapy drugs help kill cancer cells in the body.

This helps shrink cancer so that the surgery is more effective.

After the surgery is done, chemotherapy and radiation treatments are given again to kill any cancer cells that may still be in the body.

It is not safe for women to breastfeed while undergoing chemotherapy.

Even with treatment, recurrence is generally high with this type of cancer, particularly within ten years of diagnosis.

Patients often receive radiation therapy after surgery. This helps reduce the chance that cancer will come back.

In such cases, radiation is usually started three to four weeks after surgery.

Patients generally receive treatment five days a week for five to six consecutive weeks.

The treatments are painless and are similar to an X-ray. Each session lasts approximately 30 minutes.

Radiation therapy may be the primary treatment for patients who cannot have surgery.

Mastitis Prevention

Patients can take steps to reduce their risks of developing mastitis.

However, some cases, especially those caused by inflammatory breast cancer, may not be completely preventable.

Avoid nipple piercings, as these increase the risk of developing infections that cause mastitis in men and women.

People with nipple piercings are advised to clean their nipples with soap and warm water regularly.

Breasts should be emptied while breastfeeding; breastfeeding mothers can reduce the risk of developing mastitis by completely draining milk from their breasts.

Mothers are encouraged to allow their babies to empty one breast before switching to another.

With each feeding, mothers should first change the breast using the last breast for breastfeeding. A breast pump can be used to empty the breast.

Changing feeding positions can also help ensure that breast milk is emptied during feeding.

Don’t wait until your breasts are full to start breastfeeding.

People are encouraged to practice good hygiene. Washing your hands and nipples regularly with soap and warm water can help reduce the risk of developing infections.

Limit alcohol consumption; drinking two or more alcoholic drinks a day increases the risk of many types of cancer, including inflammatory breast cancer.

Therefore, people are encouraged to consume alcohol in moderation.

Breastfeeding should be your first line of defense against mastitis.

Breastfeeding helps your body overcome mastitis, and the antibacterial properties of your milk will help protect your baby from infection.