Mastitis is a condition characterized by inflammation of the breast tissue, often resulting in pain, swelling, redness, and warmth in the affected area. Although it frequently occurs in individuals who are breastfeeding, mastitis can also affect non-lactating individuals. With early diagnosis and appropriate care, most cases can be effectively managed, allowing for continued breastfeeding and full recovery.

Types of Mastitis

Mastitis is generally classified into two main categories: lactational mastitis and non-lactational mastitis.

Lactational Mastitis

This is the most common form of mastitis and typically develops in people who are breastfeeding. It usually arises due to milk stasis (milk not draining properly from the breast), which can create an environment for bacterial growth. This type of mastitis most often appears within the first few weeks postpartum.

Non-Lactational Mastitis

This type occurs in individuals who are not breastfeeding. It may be triggered by blocked ducts, infections, trauma to the breast, or inflammatory conditions. A rare form called idiopathic granulomatous mastitis (IGM) can mimic symptoms of breast cancer and often occurs months to years after breastfeeding has ended.

Other distinctions include:

  • Uncomplicated mastitis: mild to moderate symptoms, resolves with standard care

  • Complicated mastitis: may involve abscesses, more severe infections, or antibiotic resistance

  • Recurrent mastitis: repeated episodes, often due to unresolved underlying issues

Symptoms of Mastitis

Symptoms may develop suddenly and often affect only one breast. Common signs include:

  • Breast tenderness or localized pain

  • Swelling and warmth in the breast

  • Red or inflamed skin, often wedge-shaped

  • Firm or hardened areas of the breast

  • Nipple discharge, which may be white, yellow, or tinged with blood

  • Fever, chills, fatigue, and body aches (flu-like symptoms)

  • Swollen lymph nodes in the armpit

  • Cracked or sore nipples

Causes

Lactational Mastitis

This typically develops due to two main factors:

  • Infection: Bacteria from the skin or the baby’s mouth can enter the breast through cracked nipples, leading to inflammation and infection. Staphylococcus aureus is the most common pathogen.

  • Milk Stasis: When milk isn’t effectively removed during feedings, it can build up and block ducts, causing pressure and swelling. This stagnant milk provides an ideal environment for bacterial growth.

Non-Lactational Mastitis

While the exact cause is often unclear, contributing factors may include:

  • Autoimmune reactions

  • Hormonal imbalances

  • Smoking (which may damage ductal tissue)

  • Chronic infection or injury

Risk Factors

Certain conditions and behaviors may increase the risk of developing mastitis:

  • Breastfeeding, especially during the early postpartum period

  • Improper latch or feeding technique

  • Infrequent feedings or long intervals between nursing sessions

  • Nipple trauma or cracked skin

  • Wearing tight or restrictive bras

  • High levels of stress or fatigue

  • Previous history of mastitis

  • Smoking

Diagnosis

Diagnosis is usually made through a physical examination and discussion of symptoms and feeding habits. Additional tests may be required in complicated cases:

  • Ultrasound to detect abscesses

  • Nipple discharge culture to identify the bacteria involved

  • Blood tests to assess the severity of infection

  • Biopsy, if necessary, to rule out cancer or confirm conditions like IGM

Treatment

Treatment aims to relieve symptoms, resolve infection, and maintain milk flow.

At-Home Care

  • Continue breastfeeding or pumping, starting on the affected side

  • Ensure the breast is emptied completely during each session

  • Use warm compresses before feeding and cold compresses after

  • Massage the breast gently toward the nipple to help unclog ducts

  • Get plenty of rest and stay hydrated

  • Take over-the-counter pain relievers like acetaminophen or ibuprofen (consult with a healthcare provider first)

Medical Treatment

If symptoms persist or worsen:

  • Antibiotics may be prescribed to treat bacterial infections

  • Corticosteroids or immunosuppressants may be used for non-infectious forms like IGM

  • Surgical drainage may be needed if an abscess is present

  • Rarely, surgical removal of affected ducts is necessary in chronic or severe cases

Prevention

Preventing mastitis involves maintaining healthy breastfeeding habits and breast care:

  • Ensure proper latch and feeding position

  • Breastfeed or pump frequently and on a regular schedule

  • Alternate breasts and vary feeding positions

  • Avoid tight clothing or bras that compress the breasts

  • Treat nipple damage promptly

  • Clean nipples gently with water (avoid harsh soaps)

  • Avoid sudden weaning, which can increase the risk of engorgement

  • Seek help from a lactation consultant if needed

Complications

When not treated promptly, mastitis may lead to:

  • Breast abscess: A painful collection of pus that may require surgical drainage

  • Reduced milk supply: Due to inflammation or early weaning

  • Recurrent infections: Especially if underlying issues remain unaddressed

  • Emotional distress: Pain and difficulties with breastfeeding can affect mental well-being and parent-infant bonding

  • Early cessation of breastfeeding: Due to unresolved pain or fear of recurrence

Final Thoughts

Mastitis is a manageable condition that responds well to early treatment. While it can be painful and discouraging, especially during the postpartum period, proper care and support make recovery possible. Breastfeeding can usually continue during and after treatment. If you suspect mastitis or are experiencing symptoms, speak to a healthcare provider to receive timely care. Lactation consultants can also be a valuable resource for navigating feeding challenges and preventing recurrence.