What will the nurse teach a nursing mother to do to reduce the risk of mastitis?

Overview

What is mastitis?

Mastitis is an infection that develops in breast tissue. The painful condition causes one breast to become swollen, red and inflamed. In rare cases, it affects both breasts. Mastitis is a type of benign (noncancerous) breast disease.

Who might get mastitis?

Mastitis most commonly occurs during the first six to 12 weeks of breastfeeding. But men, as well as women who aren’t breastfeeding, also get mastitis. You’re more likely to get mastitis if you have:

• Breast implants.
• Diabetes or other autoimmune disease.
• Eczema or similar skin condition.
• Nicks in skin from plucking or shaving chest hairs.
• Nipple piercing.
• Tobacco or nicotine addiction (smoking).

What are the types of mastitis?

The different types of mastitis include:

• Lactation: This infection type affects breastfeeding women. Also called puerperal mastitis, it's the most common.
• Periductal: Menopausal and postmenopausal women and smokers are more prone to periductal mastitis. Also called mammary duct ectasia, this condition occurs when milk ducts thicken. The nipple on the affected breast may turn inward (inverted nipple) and produce a milky discharge.

Does mastitis increase your risk of breast cancer?

Mastitis doesn’t increase your risk of breast cancer. However, mastitis symptoms are similar to inflammatory breast cancer symptoms. This rare type of breast cancer causes breast skin changes. Signs may include dimples and a breast rash that has an orange-peel texture. Like mastitis, one or both breasts may become red and swollen. Inflammatory breast cancer doesn’t usually cause breast lumps.

Inflammatory breast cancer is an aggressive cancer. It requires prompt diagnosis and treatment. Contact your healthcare provider right away any time you notice breast changes.

Is it safe to continue breastfeeding when you have mastitis?

Yes, you should continue to nurse your baby. You can’t pass a breast infection to your baby through breast milk. In fact, breast milk has antibacterial properties that help babies fight infections. Antibiotics that your provider prescribes for mastitis are also safe for your baby.

It may be uncomfortable to nurse when you have mastitis. But breastfeeding helps move milk through milk ducts, opening them up. When nursing, start your baby on the affected breast first. That way, you’ll ensure milk doesn’t stay in the milk ducts and allow bacteria to grow.

Symptoms and Causes

What causes mastitis?

Mastitis occurs when bacteria found on skin or saliva enter breast tissue through a milk duct or crack in the skin. Milk ducts are a part of breast anatomy that carry milk to the nipples. All genders have milk ducts and can get mastitis.

Infection also happens when milk backs up due to a blocked milk duct or problematic breastfeeding technique. Bacteria grow in the stagnant milk. These factors increase the risk of a nursing mom developing mastitis:

• Cracked, sore nipples.
• Improper latching technique or using only one position to breastfeed.
• Wearing tight-fitting bras that restrict milk flow.

What are the symptoms of mastitis?

Many people with mastitis develop a wedge-shaped red mark on one breast. (Rarely, mastitis affects both breasts.) The breast may be swollen and feel hot or tender to touch. You may also experience:

• Breast lumps.
• Breast pain (mastalgia) or burning sensation that worsens when your baby nurses.
• Fatigue.
• Flu-like symptoms, including fever and chills.
• Headaches.
• Nausea and vomiting.
• Nipple discharge.

Diagnosis and Tests

How is mastitis diagnosed?

Your healthcare provider will do a physical exam and check your symptoms to make a diagnosis. If you aren’t breastfeeding, you may get a mammogram or other tests to rule out breast cancer or a different breast condition.

Management and Treatment

How is mastitis managed or treated?

Your healthcare provider may prescribe an oral antibiotic to treat mastitis. The infection should clear up within 10 days but may last as long as three weeks. Mastitis sometimes goes away without medical treatment.

To reduce pain and inflammation, you can:

• Apply warm, moist compresses to the affected breast every few hours or take a warm shower.
• Breastfeed every two hours or more often to keep milk flowing through the milk ducts. If needed, use a breast pump to express milk between feedings.
• Drink plenty of fluids and rest when possible.
• Massage the area using a gentle circular motion starting at the outside of the affected area and working in toward the nipple.
• Take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS).
• Wear a supportive bra that doesn’t compress the breast.

Can I get mastitis more than once?

Yes, it’s possible to get mastitis multiple times. If you’re breastfeeding and frequently get mastitis, your healthcare provider may recommend seeing a lactation consultant (breastfeeding specialist). There may be a problem with how the baby is positioned or latches on during nursing.

What are the complications of mastitis?

If left untreated, a breast infection like mastitis can lead to a breast abscess. This type of abscess typically needs to be surgically drained. If you have an abscess that needs to be drained, your healthcare provider will perform minor surgery or use a small needle to drain the pus. Often, you may need to be admitted to the hospital for IV antibiotics. A breast abscess will not go away with warm compresses.

Prevention

How can I prevent mastitis?

Breastfeeding moms can take these steps to lower their chances of getting mastitis:

• Air out your nipples after nursing.
• Don’t wear nursing pads or tight-fitting bras that keep nipples moist.
• Nurse your baby on one side, allowing the breast to empty, before switching to the other breast.
• Switch up breastfeeding positions to fully empty all areas of the breast.
• Use your finger to break your baby’s suction on a nipple if you need to stop a feeding.

Outlook / Prognosis

What is the prognosis (outlook) for people with mastitis?

Mastitis is painful and uncomfortable, but it doesn’t cause long-term problems. If you’re nursing, you may make less milk as your body fights off the infection. Milk production should increase as you start to feel better. A breast infection like mastitis in someone who isn’t breastfeeding may be cause for concern. See your healthcare provider.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Breast pain.
• Changes in the way your breasts look or feel.
• Newly discovered lump.
• Nipple discharge.
• Worsening of mastitis symptoms after 24 hours of antibiotics or at-home treatment.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• Why did I get mastitis?
• What is the best treatment for me?
• What steps can I take to prevent getting mastitis again?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Any type of breast change is a reason to call your healthcare provider. While mastitis isn’t cancerous, your healthcare provider should evaluate your symptoms. Rarely, breast infection symptoms are a sign of inflammatory breast cancer. Breastfeeding moms who develop mastitis may benefit from a consultation with a lactation consultant. This expert can ensure proper latching and breastfeeding technique so you don’t develop mastitis again.

What teaching should a nurse provide to a client to prevent mastitis?

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