mastitis

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Mastitis

 

Definition

Mastitis is an infection of the breast. It usually only occurs in women who are breastfeeding their babies.

Description

Breastfeeding is the act of allowing a baby to suckle at the breast to drink the mother's milk. In the process, unaccustomed to the vigorous pull and tug of the infant's suck, the nipples may become sore, cracked, or irritated. This creates a tiny opening in the breast, through which bacteria can enter. The presence of milk, with high sugar content, gives the bacteria an excellent source of nutrition. Under these conditions, the bacteria are able to multiply, until they are plentiful enough to cause an infection within the breast.
Mastitis usually begins more than two to four weeks after delivery of the baby. It is a relatively uncommon complication of breastfeeding mothers, occurring in only approximately 3% to 5% of nursing women.

Causes and symptoms

The most common bacteria causing mastitis is called Staphylococcus aureus. In 25-30% of people, this bacteria is present on the skin lining normal, uninfected nostrils. It is probably this bacteria, clinging to the baby's nostrils, that is available to create infection when an opportunity (crack in the nipple) presents itself.
Usually, only one breast is involved. An area of the affected breast becomes swollen, red, hard, and painful. Other symptoms of mastitis include fever, chills, and increased heart rate.

Diagnosis

Diagnosis involves obtaining a sample of breast milk from the infected breast. The milk is cultured, allowing colonies of bacteria to grow. The causative bacteria then can be specially prepared for identification under a microscope. At the same time, tests can be performed to determine what type of antibiotic would be most effective against that particular bacteria. Sometimes, women and their physicians confuse mastitis with breast engorgement, or the tenderness and redness that appears when milk builds up in the breasts. Mastitis often can be distinguished if symptoms are accompanied by fever.

Treatment

A number of antibiotics are used to treat mastitis, including cephalexin, amoxicillin, azithromycin, dicloxacillin, and clindamycin. Breastfeeding usually should be continued, because the rate of abscess formation (an abscess is a persistent pocket of pus) in the infected breast goes up steeply among women who stop breastfeeding during a bout with mastitis. Most practitioners allow women to take acetaminophen while nursing, to relieve both fever and pain. As always, breastfeeding women need to make sure that any medication they take is also safe for the baby, since almost all drugs they take appear in the breastmilk. Warm compresses applied to the affected breast can be soothing.

Prognosis

Prognosis for uncomplicated mastitis is excellent. About 10% of women with mastitis will end up with an abscess within the affected breast. An abscess is a collection of pus within the breast. This complication will require a surgical procedure to drain the pus.

Prevention

The most important aspect of prevention involves good handwashing to try to prevent the infant from acquiring the Staphylococcus aureus bacteria in the first place. Keeping the breast clean before breastfeeding also helps prevent infection. Keeping the breasts from becoming engorged may help prevent mastitis by preventing plugging of milk ducts.

Resources

Periodicals

Hager, W. David. "Managing Mastitis: Antibiotics Can Prove Invaluable in the Treatment of Mastitis, but Before You Prescribe Them, It's Important to Distinguish Breast Engorgement from Infectious Mastitis." Contemporary OB/GYN January 2004: 32-41.

Organizations

La Leche League International. 1400 N. Meacham Rd., Schaumburg, IL 60173-4048. (800) 525-3243. http://www.lalecheleague.org.

mastitis

 [mas″ti´tis]
inflammation of the breast, occurring in a variety of forms and degrees of severity. fibrocystic disease of the breast (called also chronic cystic mastitis) is the most common disorder of the breast resulting from hormonal imbalance. It generally occurs in women between the ages of 35 and 50, is probably related to the activity of the ovaries, and is rare after menopause. Occasionally mastitis becomes so severe as to require a mastectomy.

Young girls whose breasts are maturing sometimes experience a painful swelling and hardness of the breast, known as puberty mastitis; this is rarely serious and usually resolves within a few weeks. Occasionally a cloudy liquid may be squeezed from the nipples. It is best to wear a brassiere that gives mild support but does not irritate.

A mild inflammation known as stagnation mastitis, or caked breast, may occur during the early lactation period. Glands of the breast can become congested with milk, with formation of painful lumps.

Acute mastitis may occur after childbirth, when it is known as puerperal mastitis. This is an infection that usually results from the presence of staphylococci, or occasionally streptococci, which enter through cracks in the skin of the breast, particularly of the nipples. The breasts are tender, red, and warm and become swollen and painful. The inflammation responds quickly to sulfonamide medicines or other antibiotics, but in some cases an abscess may develop which must be incised and drained.

A galactocele, or milk cyst, sometimes develops during lactation. It is probably caused by obstruction of a duct and can be removed after the baby has been weaned.

There are other types of infectious mastitis not related to lactation. Inflammation of the breast sometimes accompanies mumps, particularly in adults. Tuberculous mastitis usually occurs in young women and accompanies tuberculosis of the lungs or of the cervical lymph nodes. Treatment is with antibiotics, although surgery is sometimes necessary.

A condition that may occur at the time of menopause or later in women who have had children is mammary duct ectasia, or comedomastitis, which is distention of the milk-producing ducts caused by the caking of secretions; some of the material may be discharged from the nipple. Eventually this may develop into plasma cell mastitis. The breast may be tender and painful, with lump formation, nipple retraction, change in contour, and possibly a cloudy discharge from the nipple.
chronic cystic mastitis fibrocystic disease of the breast.

mas·ti·tis

(mas-tī'tis),
Inflammation of the breast.
Synonym(s): mastadenitis
[masto- + G. -itis, inflammation]

mastitis

(mă-stī′tĭs)
n.
Inflammation of a mammary gland or udder, usually caused by infection.

mas·tit′ic (-tĭt′ĭk) adj.

mastitis

Inflammation of breast tissue, which is most often due to bacterial infection—most commonly Staphylococcus aureus, less commonly S epidermidis and streptococci—typically in a background of breast-feeding.
 
Management
Warm wet compresses, oral antibiotics.

mastitis

Breast inflammation, often bacterial, often staphylococcal, often during breast-feeding Management Warm wet compresses, oral antibiotics. See Breast abscess, Plasma cell mastitis.

mas·ti·tis

(mas-tī'tis)
Inflammation of the breast.
Synonym(s): mastadenitis.
[masto- + G. -itis, inflammation]

mastitis

Inflammation of the breast. This is commonest during LACTATION and is usually caused by infection with organisms such as Staphylococcus aureus entering through cracks or abrasions in the nipples. There is high fever, redness, hardening and tenderness. Treatment is with antibiotics but an abscess may form which may have to be drained surgically.