Mastitis: Learn All About Mastitis During Breastfeeding

You have recently had your baby, are breastfeeding, and notice some unpleasant changes in one or both breasts? Do you have severe breast pain, high fever, feel very sick? Your breast is swollen and red? Then mastitis, also called inflammation of the breast, could be the cause.

Find out everything you need to know about mastitis and what you can do about it.

What Is Mastitis?

Mastitis is an inflammation of the mammary gland. The term is derived from the Greek word “mastos” (mammary gland) and the Greek suffix “itis” (inflammation). Mastitis is a mastopathy, which is a benign disease in women of childbearing age.

Most often, breastfeeding mothers are affected during the postpartum period, namely within the first six weeks after birth. During this period, the inflammation of the breast is called mastitis puerperal.

Mastitis non-puerperal, i.e. mastitis outside the puerperium, and periductal mastitis must be distinguished from this type of mastitis. Very rarely, men can also become ill. This article deals specifically with puerperal mastitis.

How Does Mastitis Occur?

This mastopathy (disease of the mammary glands) usually occurs during breastfeeding due to milk engorgement. When your baby drinks less than you produce milk, the amount in the breast becomes more and more.

Therefore, it is very important that you, on the one hand, latch on correctly and, on the other hand, regularly express excess milk. This works very well if you first warm the breast, massage it gently, and then stroke it towards the nipple.

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Alternatively, you can suck out the milk with a manual or electric pump. It is also possible for a germ to enter the milk ducts through sore nipples or small injuries on the breast. If the germ multiplies, it causes inflammation. Once the mastitis is underway, it often happens very quickly.

Therefore, you should already go to the doctor at the first signs so that the pain in the breast does not become too severe. The drugs of choice today are breastfeeding-friendly antibiotics that target inflammation. Sometimes an abscess (artificial cavity filled with pus) has formed, which must be opened surgically and flushed with antibiotics.

The good news is that you usually do not have to wean despite mastitis. The antibiotics are chosen in such a way that your baby does not get them through breast milk, and the baby usually cannot catch the germs.

You can and you should even continue breastfeeding so that your baby continues to get the valuable nutrients in breast milk and the breast is emptied regularly to prevent further milk engorgement. There are also painkillers for severe breast pain that can be taken despite breastfeeding.

Please always consult your doctor about this. Mastitis is usually a very painful and unpleasant disease, but it is easily treatable if diagnosed early and in most cases, it is not necessary to stop breastfeeding at all.

If you react quickly to the typical symptoms, you will definitely save yourself from bad breast pain. It is best to prevent milk retention in general so that it does not get that far.

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Mastitis As A Complication During Breastfeeding

Mastitis within the first six weeks after birth is not that rare. You have certainly heard about it among your acquaintances. This extremely painful inflammation should be treated by a doctor as soon as possible, as it is very unpleasant on the one hand and can considerably impair breastfeeding on the other.

Inflammatory Or Infectious Mastitis?

Mastitis can be divided into two categories depending on its cause:

Inflammatory Mastitis

This form is also called congestive mastitis or parenchymatous mastitis and usually results from milk stasis. Milk engorgement often occurs in the first few weeks after birth, when the breast produces more milk than the infant drinks.

If the breast is not emptied regularly by frequent lactation or pumping, the milk backs up in the milk ducts and provides a clear path for invading germs.

Infectious Mastitis

This type is also known as bacterial or interstitial mastitis and is caused by germs such as staphylococci (over 90%), streptococci, or pseudomonas. The pathogens are introduced into the body either during breastfeeding by the infant or through inadequate hand hygiene via sore nipples and small injuries.

How Is Mastitis Diagnosed?

It is not particularly difficult to recognize mastitis, as it causes considerable breast pain. The inflammation develops relatively quickly and is further accompanied by redness, swelling in the breast and armpit area (lymph nodes!), and a strong feeling of illness.

If you have severe pain in the chest, sore nipples, or even high fever, you should see a doctor immediately. He or she will check your blood for white blood cells, which multiply greatly during infections, and will examine the breast visually and palpate (palpation).

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In addition, an ultrasound examination may be performed to narrow down areas of inflammation. Breast inflammation cannot go unnoticed, as it causes great pain and an extreme feeling of illness.

It is also important in the diagnosis to rule out other possible causes such as breast carcinoma (breast cancer). To do this, it may be necessary to have a mammogram, which is an x-ray of the breast.

This does not affect milk production, and the milk is not contaminated in the process, as many women fear. Your baby cannot be harmed if he or she feeds at your breast again after the mammogram.

How Is Mastitis Treated?

A few years ago, the first measure was to wean immediately to prevent further irritation of the breast and infection of the baby with the germ. Today, this procedure is discouraged in most cases, as it is unnecessary and can even lead to a continuation of the invaded germs, as the milk does not drain further.

Moreover, there is no risk of infection for the infant. The method of choice nowadays is conservative antibiotic administration. In this case, an antibiotic is chosen that is not compatible with milk – so your baby does not ingest the medication while drinking.

Your baby should absolutely continue to be breastfed since on the one hand it needs breast milk for healthy development and on the other hand the milk should continue to drain continuously. If an abscess (artificial cavity filled with pus) has already formed, it is usually helped manually in the form of drains or punctures.

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This means that the abscess is opened surgically to allow the pus to drain and the cavity to be flushed with a liquid antibiotic. In principle, bed rest is advised because the body needs to recover, especially if the chest pain is severe and there is a fever.

If the chest pain is difficult to bear, it is also possible to take certain painkillers – always in consultation with your doctor, as the wrong medication could harm your baby. Cool compresses also help to make the breast pain bearable.

You can prevent mastitis to reduce the likelihood of mastitis, there are a few things you should keep in mind. It is essential to prevent milk stasis. This can be achieved by regular and correct latching on so that your baby can drink often and a lot. If this is not possible for any reason, you should pump milk regularly.

Also, you should not wear too tight clothing so that the milk ducts are not squeezed. In addition, a weak immune system increases the risk of a germ spreading quickly.

Therefore, make sure you take plenty of vitamins and get enough exercise in the fresh air while you are breastfeeding. Taking probiotics after consultation with a midwife and doctor can also be useful.

This preparation ensures the right balance of the physiological bacterial colonization in the breasts. Regular warming and massaging of the breasts also help to prevent milk engorgement.


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