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Breast infection & inflammation (mastitis)

Breast infection is an infection of breast tissue usually caused by bacteria, most often staph (Staphylococcus aureus), which are found on the skin and enter the breast through a break in the skin or nipple, as during breast-feeding. The infected breast may be swollen, hot, reddened, and painful. There may be low grade fever. Treatment includes warm wet compresses and antibiotics. Breast infections are usually caused by a common bacteria found on normal skin (Staphylococcus aureus). The bacteria enter through a break or crack in the skin, usually the nipple. The infection then takes place in the parenchymal (fatty) tissue and causes swelling of the parenchymal tissue outside the milk ducts.

This swelling compresses on the milk ducts, and the result is pain and swelling of the infected breast. Breast infections usually occur in women who are breast-feeding. Breast infections that are not related to breast-feeding must be differentiated from a rare form of breast cancer. A breast infection may occur after nursing mothers experience a cracked nipple or a plugged milk duct. Other possible causes are a tight bra, skipped feedings, infrequent changes of wet breast pads, anemia, stress or fatigue. Although doctors usually prescribe antibiotics for mastitis, many women recover quickly without them.

The term mastitis is often used as a synonym for breast infection but, strictly speaking, mastitis means inflammation of the breast irrespective of the cause. Breast mastitis is an infection that commonly affects women who are breast-feeding (especially during the first two months after childbirth) but can occur in all women at any time. Mastitis is a benign (non-cancerous) condition that can usually be treated successfully with antibiotics. Signs of mastitis include red, hot, painful, or inflamed breasts and other flu-like symptoms such as headache, nausea, high temperature (101 degrees Fahrenheit, 38.4 degrees Celsius or greater), or chills. Women with symptoms of mastitis should see a physician. Breast-feeding with mastitis is generally not harmful to the baby and may actually help speed up recovery.

Mastitis most commonly occurs when the breasts are not fully emptied of milk. The milk overflows from the breast glands and engorges the breasts. Breast engorgement (swelling) can occur any time the breasts produce more milk than the amount being removed by breast-feeding, pumping, or manual (hand) expression. Breast engorgement increases the risk of infection. If bacteria enter the breast through an opening in the nipple or a break in the skin, the breast tissue becomes infected.

When bacteria enters the breast ducts, it grows and attracts inflammatory cells. Inflammatory cells release substances to fight the infection (mastitis) but also cause the breast tissue to well and increases blood flow. Nasopharyngeal organisms from the infant's mouth, sinuses and other air passages are usually the source of breast infections in breast-feeding women. Though women may be inclined to stop breast-feeding if they have mastitis, continued breast-feeding actually helps to clear the infection. Breast-feeding with mastitis is usually not harmful to the baby.

Mastitis while breast-feeding usually affects only one breast and starts as a painful area that is red or warm. Fever, chills, and flulike symptoms or body aches can also develop. If you have any of these symptoms, call your health professional immediately. Signs that mastitis is getting worse include swollen, painful lymph nodes in the armpit next to the infected breast, an increased heart rate, and worsening flulike symptoms. Mastitis infection can lead to a breast abscess, which feels like a hard, painful lump.

Infective mastitis is usually treated with a course of antibiotics. However, a mild case may resolve without any treatment. If you notice a tender swollen area in a breast when you are breastfeeding, it may be a blocked milk duct or a developing mastitis. It may be reasonable to 'see how it goes' over a day or so. However, if symptoms become worse it is best to see a doctor who may prescribe antibiotics. The infection will usually clear within a few days once you start antibiotics. For simple mastitis without an abscess, oral antibiotics are prescribed. Cephalexin (Keflex) and dicloxacillin (Dycill) are two of the most common antibiotics chosen, but a number of others are available. The antibiotic prescribed for you will depend on the clinical situation, your doctor’s preference, and your medication allergies, if any. This medicine is safe to use while breastfeeding and will not harm the baby. Chronic mastitis in nonbreastfeeding women can be complicated. Recurrent episodes of mastitis are common. Occasionally this type of infection responds poorly to antibiotics. Therefore, close follow-up with your doctor is mandatory.

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All information is intended for reference only. Please consult your physician for accurate medical advices and treatment. Copyright 2005,, all rights reserved. Last update: July 18, 2005