Inflammation of the breast is called "mastitis" and "puerperal" is added when it occurs in a breastfeeding woman.
It affects approximately 5-10% of postpartum women and usually occurs during the first three months of breastfeeding, especially between the second and third week postpartum. It is usually unilateral and is more common in primiparas.
It is caused by a bacterial infection. Situations that favour the appearance of mastitis are partial obstruction of the milk duct, excess milk production, infrequent feedings, poor latch-on, inadequate feeding frequency, a short frenulum, nipple abrasions or cracks, rapid weaning, maternal or infant illness and maternal malnutrition.
Symptoms are fever, pain, breast enlargement, reddening of the skin 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 collection of pus or breast abscess.
Diagnosis is based on clinical history and physical examination of the breasts.
Treatment is based on pain relief and antibiotics to control the infection. It is also important to continue expressing milk, continue breastfeeding or using breast pumps. Sometimes surgical drainage is necessary to drain pus.
- J Michael Dixon. Lactational mastitis. UpToDate. Marzo 2016
- Foxman B. Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol 2002; 155:103.
- Fernández L. Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy. Clin Infect Dis 2016; 62:568.
- 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.
