Clinical Reference Systems: Pediatric Advisor 10.0
Breast Infection (Mastitis)
Mastitis is an infection in the breast. The condition
usually occurs in women who are breast-feeding. You may have
both general symptoms of illness and breast symptoms
- achy, flulike feeling
- breast pain
- breast redness
- breast firmness
- nipple or areolar pain
- difficulty getting milk to flow.
Breast infections are usually caused by bacteria. Bacteria
are normally present on the nipple and in a baby's mouth.
They can enter the breast through a cracked nipple or the
milk ducts and cause mastitis.
Many factors can make a breast-feeding mother susceptible to
mastitis. One of the principal factors is inadequate
drainage of milk from your breasts. Poor emptying can occur
by allowing too much time to pass between feedings. Also,
milk may not drain well if a duct is clogged, or a tight-
fitting bra may obstruct milk flow.
Injury to the breast can make a breast-feeding woman more
susceptible to mastitis. The injury may be caused by a baby
teething on the breast or incorrectly latching on to the
nipple. Use of a breast pump that generates excessive
vacuum can also injure the breast.
Exhaustion may contribute to mastitis. For example,
returning to work, not getting enough sleep, and having house
guests may tire a new mother.
- Call your obstetrician or family physician promptly if
you have any symptoms of mastitis.
The sooner you start treatment, the sooner you will feel
better. Prompt treatment may prevent complications, such
as a breast abscess (a pocket of pus requiring
- Take all of the antibiotic your doctor prescribes even
if you feel much better after a few days.
Mastitis is usually treated with an antibiotic for
- Rest and stay in bed as much as possible.
Get all the help you can for at least the next 2 days.
- Drink plenty of fluids, especially if you have a fever.
- Take medicine for the pain if necessary.
You will probably need pain medication during the first
2 days of your illness. Ask your doctor for a
prescription if necessary. Ibuprofen is a good choice
for over-the-counter pain medication. Only very small
amounts of ibuprofen are excreted in breast milk.
- Nurse more often, especially from the side that is
infected, to keep your breasts well emptied.
You do not have to wean your baby if you have mastitis.
In fact, you should nurse more often. You may need to
put moist heat on the affected area of your breast
before nursing to help start milk flow. For example,
put a warm washcloth on the breast, take a warm shower,
or submerge the breast in a basin or tub of warm water.
You can begin feedings on the side that is not infected
and then move your baby to the infected breast once your
let-down has been triggered.
If you are pumping milk for a sick or premature
hospitalized baby when you develop mastitis, discard the
milk collected from the infected side until you are well.
- Pump your breasts if necessary.
If nursing your baby is too painful or doesn't relieve
your breast fullness, you may need to rent an electric
breast pump. Often an electric pump will comfortably
and efficiently empty your breasts.
CALL YOUR DOCTOR DURING OFFICE HOURS IF:
- Your symptoms are not better within 48 hours after you
start taking antibiotics.
- A tender breast lump develops that is not relieved by
CALL YOUR BABY'S DOCTOR DURING OFFICE HOURS IF:
- You think your milk supply is decreasing.
- Your baby shows any signs of illness such as fever, poor
feeding, tiredness, irritability, trouble breathing, or
a rash. Call any time if you are worried.
- Your baby develops a diaper rash while you are taking
antibiotics. The rash may be due to a yeast infection
and may require treatment with a medication.
YOU MAY NEED TO RENT AN ELECTRIC BREAST PUMP IF:
- The infected breast is still not emptying well even though
you have followed the treatment suggestions.
- Nursing your baby from the infected breast is too painful.
- Your baby refuses to nurse from the infected breast.