Mastitis is the name given to inflammation of the breast, and "puerperal" is added when it occurs in a woman who is breastfeeding.
It affects about 5-10% of postpartum women and usually occurs during the first three months of lactation, especially between the second and third weeks of postpartum. It is usually unilateral and more common in first-time mothers.
It is caused by a bacterial infection. Situations that favor the occurrence of mastitis are partial obstruction of the milk duct, excessive milk production, infrequent feeding, poor latching, inadequate feeding frequency, a short frenulum, nipple abrasions or cracks, rapid weaning, maternal or infant illness, and maternal malnutrition.
Symptoms include fever, pain, breast enlargement, skin redness, and swollen lymph nodes in the armpit on the same side. It may be accompanied by flu-like symptoms such as fever and chills. About 10% of cases progress to a pus collection or breast abscess.
Diagnosis is based on clinical history and physical examination of the breast.
Treatment is based on pain relief and antibiotics to control the infection. It is also important to continue expressing milk, breastfeeding, or using a breast pump. Sometimes surgical drainage is needed to remove pus.
- J Michael Dixon. Lactational mastitis. UpToDate. Marzo 2016
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- Department of child and adolescent health and development. Mastitis: Causes and management. World Health Organization 2000.
- Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician 2008; 78:727.
