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 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 occur every time a woman is breastfeeding.

In rare cases, it can occur even when a woman is not breastfeeding.

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 area of ​​the breast.

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 completely.

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 long 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, which can lead to mastitis.

Bacteria presence

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

Proper hand washing 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 of time, or sleeping on her stomach can lead to plugged ducts.

Stress and fatigue

There is some evidence that women who are stressed or excessively tired 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, an increase in its 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, painful, in the depths severely damaged lobes are defined.

At this point the mastitis is still reversible.

The main 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, for the application of antibacterial treatments.

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

The presence of mastitis can be suspected if the breast is swollen, tender or hot to the touch, a painful or burning area during lactation, skin redness, 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 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 properly 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 in the future.

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.

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

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

If inflammatory breast cancer is suspected, a biopsy is done to determine if the patient has cancer.

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.

In general, common 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.

In fact, 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 start to 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.
  • 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 completely.

If you stop breastfeeding abruptly, your mastitis may get worse 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 from 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 / or surgery.

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

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

During the surgery, the surgeon will also examine the lymph nodes to see if the 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 the cancer so that the surgery is more effective.

After the surgery is done, chemotherapy and / or 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 10 years of diagnosis.

Patients often receive radiation therapy after surgery. This helps reduce the chance that the 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 main 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 both men and women.

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

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 completely empty one breast before switching to the other.

With each feeding, mothers should change the breast using the last breast to breastfeed first. 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 seems to increase 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.