Main
- Mastitis — inflammation of the breast: infection enters through cracks in the nipple, and milk stasis creates an environment for bacteria.
- Symptoms: pain, redness, lump, fever and chills; if there is purulent discharge from the nipple, call an ambulance.
- Diagnosis: examination and palpation, full blood count, culture of discharge, ultrasound; mammography — to rule out other pathology.
- Doctors: managed by a mammologist, in their absence — a gynaecologist or surgeon; if there is an abscess, surgery is required.
- Prevention: correct latching, nipple care, loose underwear, hygiene and regular check-ups with a doctor.
What is mastitis
Mastitis is an inflammation of the breast that most often occurs due to infection entering through damage to the nipple. Below is an analysis of how this condition develops, what circumstances provoke it and who experiences it more often.
What happens in the body
Mastitis begins when bacteria penetrate the breast tissue through a crack or abrasion on the nipple. The skin of the nipple serves as a natural barrier, and when its integrity is compromised, microbes gain a path inside. If milk is not fully expressed during feeding, it stagnates in the ducts and becomes a nutrient medium for the multiplication of microbes. In response, the breast tissue reacts with inflammation: blood flow increases, redness and swelling appear. The woman feels pain and fullness, and the lump itself can be felt as a dense area. Body temperature rises, which reflects the body's general reaction to the inflammatory process. The sooner the breast is emptied and milk flow is restored, the fewer conditions remain for further multiplication of bacteria.
What causes it to develop
- Cracks and damage to the nipples: bacteria enter the breast tissue through them, so any abrasions require attention.
- Milk stasis: when the breast is not fully emptied, milk is retained and creates conditions for the multiplication of microbes.
- Incorrect latching technique: with such feeding, the breast is emptied unevenly, which maintains stasis.
- Reduced immunity: after childbirth or an illness, the body resists infection less effectively.
- Failure to observe hygiene during feeding: infrequent washing of hands and breasts increases the risk of bacteria entering.
- Tight underwear: it compresses the breast and disrupts milk flow, so it is important to choose loose styles.
Who experiences it more often
Most often, this condition is encountered by women during breastfeeding, especially in the first weeks after childbirth. At this time, the breast is still only adapting to milk production, and milk flow may be incomplete. Women who have already had cracked nipples encounter inflammation more often because the skin remains damaged. Incorrect latching of the baby to the breast also increases the risk, as the breast is emptied unevenly. Reduced immunity after childbirth or an illness weakens defences and makes the body more vulnerable to infection. Tight underwear and infrequent hygiene during feeding add further conditions for the development of inflammation. If a breastfeeding mother notices pain, redness or a lump, she should consult a doctor as early as possible, without waiting for the symptoms to worsen.
What symptoms can there be?
Mastitis manifests as local changes in the breast and general symptoms that develop gradually. It is important to recognise the first signs in time and distinguish them from ordinary fatigue, and to understand when help is needed without delay.
How it is noticed at the very beginning
Mastitis usually begins with local pain and a lump in the breast, which a woman notices during feeding or expressing. The skin over this area gradually becomes red and hot to the touch. Many attribute such sensations to fatigue, lack of sleep or an uncomfortable position when feeding the baby. Because of this, a visit to the doctor is postponed, although the inflammation continues to develop at this time. Feeding or expressing begins to cause sharp pain that is already difficult to endure. Gradually, chills and a rise in body temperature join the local signs. If the pain and lump do not go away after feeding, this is a reason not to wait, but to see a mammologist or gynaecologist.
Signs that occur most often
- Pain in the breast: intensifies during feeding and expressing, interferes with the usual care of the baby.
- Redness and swelling of the skin: appear over the lump, the skin becomes hot to the touch.
- Rise in body temperature: often accompanied by chills and general malaise, weakness.
- Lump or swelling: can be felt in the breast and is painful when pressed.
- Purulent discharge from the nipple: appears as the inflammation develops and requires a doctor's attention.
- Enlargement of the axillary lymph nodes: they become painful, this is a sign of involvement of the lymphatic system.
When to seek help urgently
Examinations and tests
The diagnosis of mastitis is based on a doctor's examination and the collection of complaints, while additional methods clarify the nature of the inflammation. Understanding which tests are prescribed and why helps you calmly go through the path from the first appointment to a clear picture.
How the examination begins
An examination for suspected mastitis begins with an examination and palpation of the mammary glands, which the doctor performs at the first appointment. During the examination, the specialist pays attention to redness of the skin, swelling, lumps and tenderness of areas of the gland. Palpation helps determine the boundaries of the inflammation and assess the condition of nearby tissues. The doctor asks in detail about the complaints, how long they have been present and changes in how you feel over recent days. Separately, it is clarified whether there have been previous problems with the mammary gland, surgery or trauma to this area. Such a conversation is needed to distinguish inflammation from other conditions requiring a different approach. If the complaints and the picture on examination fit a typical picture, additional investigations may not be needed. With unclear or concerning signs, the doctor decides which methods will clarify the situation.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries from previous visits: take the conclusions of other doctors regarding the mammary gland so that the specialist can see the dynamics of the observations.
- Results of previous examinations: bring the images and reports of ultrasound or mammography, if they were performed earlier.
- List of complaints: write down in advance when the pain, redness or lump appeared and how they changed.
- Information about nipple discharge: note the colour, amount and what its appearance is associated with, this is important for choosing the examination.
- Questions for the doctor: formulate in advance what you want to clarify about your condition and further steps.
Which doctor should I see?
This section explains which specialist to consult for mastitis, what happens at the first appointment and what areas of care the treatment consists of.
Which specialist manages this condition
Mastitis is managed by a breast physician (mammologist), and in their absence care is provided by a gynaecologist and a surgeon. The breast physician deals with the mammary gland and its inflammatory changes, so it is to them that patients are referred when this condition is suspected. The gynaecologist becomes involved when the inflammation is related to the postpartum period or to changes in the gland against the background of hormonal adjustment. A surgeon is needed if an abscess has formed in the gland and surgical intervention is required. At the first appointment the doctor examines and palpates the gland, clarifies the complaints and the history of their onset. They also establish how long ago the pain, lump, redness of the skin and fever appeared. If a specialised doctor is not available nearby, start with a gynaecologist or a surgeon: they will assess the condition and refer you further.
What the treatment consists of
- Selection of antibacterial therapy: the doctor determines whether antimicrobial agents are needed and selects them taking into account the form of the process.
- Emptying of the gland: regular and correct emptying of the gland is important, since stagnation maintains the inflammation.
- Pain relief and anti-inflammatory support: these measures reduce pain and swelling, easing the general condition and allowing emptying to continue.
- Physiotherapy: the procedures are prescribed by a specialist, they complement the main treatment and are selected according to the stage of the process.
- Surgery for an abscess: if an abscess has formed, conservative measures are not enough and surgical intervention is required.
What depends on the patient herself
The result largely depends on how regularly the patient follows the prescriptions and attends check-ups. The gland should be emptied as often as the doctor has determined, without skipping or postponing it for long. If the pain intensifies, a new lump appears or the temperature rises, the doctor should be informed without waiting for the next visit. Attending the follow-up examination allows the doctor to notice in time that the inflammation is not resolving and to change the approach. Reducing feedings or abruptly stopping emptying often increases stagnation and worsens the course of the process. Maintaining a drinking regime and rest supports strength, but does not replace the prescribed care. Keep simple notes about the time of emptying and how you feel — this helps the doctor assess the dynamics more accurately.
What helps prevent an exacerbation?
Prevention of mastitis is especially important during breastfeeding, when the breast is vulnerable to inflammation. What depends on the woman herself and how daily habits reduce the risk of exacerbation — this is discussed below.
What to change in habits
Proper latching of the baby to the breast is the foundation of prevention: with a correct latch, milk flows out evenly and does not stagnate in the ducts. If latching is painful or the nipple is flattened after feeding, it is worth showing the feeding technique to a specialist so as not to let it come to cracks. Timely emptying of the mammary glands is also important when there is an excess of milk: stagnation in a lobule quickly causes swelling and tenderness. Care of the nipples and treatment of cracks should not be postponed, because infection penetrates more easily through damaged skin. Wearing comfortable underwear without compression helps lymph and blood flow freely, while tight cups with underwires compress the ducts. Maintaining personal hygiene — a daily shower and changing underwear — reduces the number of microbes on the skin around the nipple. If after feeding there is still a feeling of fullness, expressing until relief helps, but not until complete emptying.
What should be kept under control
- Latching: check the latch at every feeding, because complete emptying of the breast and the absence of stagnation depend on it.
- Condition of the nipples: examine the skin after feeding in order to notice cracks in time and begin care before inflammation.
- Emptying of the glands: monitor the evenness of milk outflow, because stagnation in one lobule quickly causes swelling and pain.
- Underwear: choose models without compression and underwires, since a tight cup disrupts the outflow of lymph and milk.
- Hygiene: a daily shower and changing underwear reduce the number of microbes on the skin around the nipple and areola.
- Well-being: note lumps, redness or pain so as not to miss the onset of exacerbation and to consult a doctor in time.
How often to see a doctor
A regular examination by a doctor is needed even when feeling well, because the onset of inflammation is not always noticeable immediately. During breastfeeding the breast changes daily, and what in the morning seems like mere engorgement may by evening become a dense area with redness. The doctor assesses the condition of the glands, the feeding technique and nipple care, and if necessary refers for additional examination. If cracks, pain or a lump appear, the visit should not be postponed, because early intervention is simpler and safer. In the absence of complaints, routine examinations are sufficient, which are agreed with the doctor taking into account the course of breastfeeding. A woman should write down when changes appeared and how they changed, so as to give an accurate picture at the appointment. Such monitoring does not replace the prescribed treatment, but helps not to miss an exacerbation and to preserve breastfeeding.
What is worth remembering
Mastitis is a condition in which it is important not to delay seeing a doctor and not to try to figure it out on your own. Below are several conclusions that help you make the right decision.
Key conclusions
Mastitis requires careful attention to your condition, because delay can complicate the course of the inflammatory process in the mammary gland. When a person notices pain, a lump, redness of the skin or a rise in temperature, it is not worth postponing a visit to a specialist. Mastitis does not always manifest itself in the same way: in some people the signs increase quickly, in others they develop gradually, and it is impossible to distinguish one condition from another by appearance. Attempts to deal with mastitis on your own, to warm the breast or to wait for everything to pass by itself often lead to the inflammation dragging on. Mastitis in women during breastfeeding and outside it may have a different origin, so the decision on what to do is made only by a doctor after an examination. If mastitis is not treated or is treated incorrectly, it can progress to a more severe form requiring a different approach. Therefore, at the first suspicious signs it is sensible to see a specialist as early as possible and follow their recommendations.
