Lactation Mastitis

February 2, 2017

Mastitis is a breast inflammation usually caused by infection. It can happen to any woman, although mastitis is most common during the first 6 months of breast-feeding . It can leave a new mother feeling very tired and run-down. Add the illness to the demands of taking care of a newborn, and many women quit breast-feeding altogether. But you can continue to nurse your baby. In fact, breast-feeding usually helps to clear up infection, and nursing will not harm your baby. Although mastitis can be discouraging and painful, it is usually easily cleared up with medicine.

Two types of mastitis

There are two types of mastitis: non-infectious mastitis and infectious mastitis.

  • Non-infectious mastitis – Non-infectious mastitis is usually caused by breast milk staying within the breast tissue – milk stasis – because of a blocked milk duct or a breastfeeding problem. If left untreated, the milk left in the breast tissue can become infected, leading to infectious mastitis.
  • Infectious mastitis – Infectious mastitis is caused by bacterial infection. It is important to receive treatment immediately to prevent complications, such as an abscess in the breast.

Around one in 10 women who are breastfeeding are affected by mastitis. Most women who get mastitis will develop it during the first three months after giving birth.


Mastitis most often happens when bacteria enter the breast through the nipple. This can happen when a nursing mother has a cracked or sore nipple.

Going for long stretches between nursing or failing to empty the breast completely may also contribute to mastitis. Using different breast-feeding techniques and making sure the baby is latched on properly when nursing will help with emptying the breast and avoiding cracked nipples.

Non-Infectious Mastitis – Doctors say non-infectious mastitis is usually caused by milk stasis (milk is produced, but then remains in the breast, rather than coming out during feeding). Milk stasis may have the following causes –

  • The baby is not attaching to the breast properly during feeding.
  • The baby has difficulties suckling the milk out of the breast.
  • The baby is being breastfed infrequently.
  • Milk ducts may be blocked because of pressure on the breast caused by, for example, tight clothing.

Anything which stops the milk from being properly expressed will usually result in milk stasis, which often leads to milk duct blockage.

Experts believe breast tissue becomes inflamed because of cytokines – special proteins present in milk that the immune system uses and are passed on to the baby. They say that the mother’s immune system mistakenly attacks these cytokines as if they were bacteria or viruses, inflaming the breast tissue in order to stop the spread of a supposed infection. However, nobody is really sure.

Causes of infectious mastitis – Bacteria do not generally thrive in fresh human milk. However, if the milk ducts are blocked and the milk stagnates the likelihood of infection grows. Experts believe that bacteria which exist on the surface of breast skin enter the breast through small cracks or breaks in the skin. They also suggest that bacteria in the baby’s mouth may get into the mother’s breast during a breastfeed. However, nobody is completely sure how bacteria get into the breast.

Infectious mastitis in women who are not lactating – Women who are not lactating (not producing milk, not breastfeeding) may develop infectious mastitis – this is not common. Those who do develop non-lactating infectious mastitis tend to be regular smokers in their late 20s to early 30s. Experts believe that smoking may damage the milk ducts, making them more susceptible to infection.

Mastitis after nipple piercing – Nipple piercing that is carried out by non-professional, unregistered piercing studios may raise the risk of mastitis occurring.

Stress, fatigue, anemia, weakened immunity

Risk Factors

Risk factors for mastitis include –

  • Breast-feeding during the first few weeks after childbirth
  • Sore or cracked nipples, although mastitis can develop without broken skin
  • Using only one position to breast-feed, which may not fully drain the breast
  • Wearing a tightfitting bra or putting pressure on the breast from using a seatbelt or carrying a heavy bag, which may restrict milk flow
  • Becoming overly tired or stressed
  • Previous bout of mastitis while breast-feeding
  • Poor nutrition


Mastitis usually only affects one breast and the symptoms often develop quickly.

Symptoms of mastitis include –

  • a red area on the breast that may feel hot and painful to touch
  • the breast can then start to appear lumpy and red
  • a burning pain in the breast that may be continuous or may only occur when women are breastfeeding
  • breast may also feel hard

Over half of women with mastitis may also experience flu-like symptoms such as –

  • aches
  • a high temperature (fever) of 38C (100.4F) or over
  • shivering and chills
  • feeling tired
  • feeling generally unwell


  • Recurrence – Women who have had mastitis are more likely to get it again, compared to other women. In most cases recurrence is due to late or inadequate treatment.
  • Abscess – If the mastitis is not treated properly there is a risk that a collection of pus (abscess) can develop in the breast. Abscesses usually require surgical draining.


  • Antibiotics – Treating mastitis usually requires a 10- to 14-day course of antibiotics. Women may feel well again 24 to 48 hours after starting antibiotics, but it’s important to take all the pills to minimize the chance of recurrence.
  • Pain relievers – The doctor may recommend a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
  • Adjustments to the breast-feeding technique – Making sure that women fully empty their breasts during breast-feeding and that the infant latches on correctly.
  • Self-care – Rest, continue breast-feeding and drink extra fluids to help the body fight the breast infection.

Alternative Treatment

Propolis is collected and used by bees as glue. It has a history of use against infection in Russia and a strong following among midwives in North America. It is said to accelerate healing time by increasing the body’s metabolism and general resistance to disease.

Echinacea root tincture is an excellent ally for any woman with mastitis.

Poke root (Phytolacca americana) tincture stimulates lymph gland activity and clears mastitis quickly. Poke root is potent and potentially toxic; the effect is cumulative.

Acupuncture – Oriental medicine typically views mastitis as an accumulation of toxic heat. Acupuncture can help clear the heat and toxicity while treating any underlying imbalance that may be causing or contributing to the condition.

Frozen, raw cabbage leaves as a poultice – The coolness can reduce pain and inflammation, while the cabbage leaves are said to draw out the infection. Try resting with this remedy after massaging in a hot shower. The leaves should be replaced when they reach room temperature.

Hydrate – It’s very important to drink plenty of fluids to recover from mastitis. Ten to twelve glasses of water should be consumed a day to maintain milk supply and support proper body functioning and healing.

Probiotics, specifically L. fermentum or L. salivarius strains – Research shows that both are good alternatives to antibiotics to treat mastitis and may help prevent it as well.

Cold and Hot – Alternate between ice packs (to reduce swelling) for 15 minutes and hot (but not burning) wet compresses, like hand towels wrapped around your entire breast, for another 15 minutes. Use breast massage with the heat. Hot showers also work nicely.

Massage the breast – As the baby is nursing, massage the affected breast with the fingers. This will help to loosen the plugged milk duct. Massage from the outer breast towards the nipple, in the area that is infected.

Vitamin C helps in healing the infection.


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