Breast Infection (Mastitis)

Mastitis is an infection in the lactating breast. This may be due to a plugged milk duct or skin breakdown from sucking.

There are several causes:

• Anything that leaves your breasts fuels or engorged like missed or shorter feedings or irregular feeding patterns.
• Limiting the time your baby is nursing. Feel your breasts to see if they are soft after your baby nurses.
• If your baby is sleepy, you should try to help them wake up more by undressing them.
• When your baby starts to sleep through the night.
• Giving a bottle and skipping a feeding, can lead to engorgement.
• Pacifiers can reduce the time the baby is nursing.
• During busy times of the year like Christmas you may skip a feeding or become over tired.
• Anything that puts a constant pressure on your breast like: a tight bra or bathing suit, the strap from your purse, diaper bag or baby carrier, sleeping on your stomach, the baby resting on your breast, holding onto your breast too tight while nursing or the baby pressing too hard with their hands on your breast.
• The baby is not latched on right, or has a weak suck.

What is the difference between a plugged duct and a Breast Infection?

A tender, sore spot or lump on one of your breasts without having a fever is usually plugged duct.

A plugged duct may be the cause if:

• It comes on gradually
• The spot changes from one area to another.
• Your breast does not feel warm or hot where the spot is.
• The pain is mild and stays just in the area of the lump.
• You feel O.K. other than the sore spot on your breast.
• Your fever is less than 38.4C (101F)

For a breast infection it may:

• Happen all of a sudden.
• Stay in the same spot.
• Cause the breast to be red, hot, and swollen.
• Really hurt in one spot.
• Cause flu-like symptoms.
• Cause a fever that is higher than 38.4C (101F)

You may also have the following, which may mean a breast infection:

• A crack in your nipple with redness and swelling around it.
• You may notice blood or pus in the milk.
• There are red streaks coming from the sore spot on your breast.

Treatment:

• Nurse frequently on the breast with the discomfort (at least every 2 hours) to help keep the milk flowing well and keep the breast from getting too full.
• Put wet heat (hot cloth) on the problem area. While the breast is still warm, massage the area gently in a circular motion. You could also soak your breast in warm water in the tub or shower for 10 min. 3 times a day. It is also helpful to apply heat between nursings. It helps to unplug the duct, if you nurse or express milk while the breast is still warm.
• Do not wear any tight clothes over your breast. If possible, do not wear your bra for a few days or you could wear a bra that is too big. This will help to relieve any pressure on your breast.
• It is important to check the position of the baby and how they are latched on. The baby's whole body should be facing you.
• By changing the position of the baby, (lying down, football hold, cradle hold) it may help relieve the blocked duct. Make sure the baby is latched on right (sucking properly).
• You need to rest. Sometimes mastitis is the first sign that you are doing too much. You should get help and only do the things that you really must do. Put you and your baby first.
• You will need an antibiotic to fight the bacteria. The doctor will give you one that will be O.K. to take while nursing.
• You may want to take acetaminophen or ibuprofen to help with your fever and/or pain (unless you have a history of allergies to one of them). Take them as directed on the package or ask the doctor or pharmacist.

Return to the Emergency Department or see your Doctor IF:

• You do not start to feel better after taking antibiotics for 48 hours.
• You feel worse.