Mastitis means infection of the breast. It can occur in women who are nursing a baby (or have recently finished nursing) or, occasionally, in women who are not breast-feeding. It is caused by bacteria, often Staphylococcus aureus.

Mastitis causes pain, swelling, and redness in the infected breast. Sometimes the swelling is in the form of a small, painful lump. Like many bacterial infections, mastitis can cause general symptoms, like chills, fever (sometimes quite high), and aches. If not treated, it can develop into an abscess, a pocket of pus beneath the skin.

What causes mastitis?

In nursing mothers, the source of the bacteria is probably the baby’s mouth. In women who are not breast-feeding, it is possible that bacteria can be introduced from the mouth of a sexual partner.

Insect bites can lead to mastitis. Once the skin is broken, bacteria can enter; and once into the breast tissue, an infection can smolder and then become full-blown mastitis. Any area of redness or change should be examined by a physician.

How is mastitis treated?

Mastitis can be treated quite successfully with antibiotics. If it develops in a woman who is not breast-feeding, usually the course of antibiotics is quite long, to wipe out any bacteria that may be hiding within the breast tissues. Women who have one episode are likely to have recurrences, maybe several months or a year later. It is possible that these recurrences develop from bacteria “hiding” deep within the breast tissues.

As for self-help measures, warm soaks bring comfort. The heat from the compresses increases the dilation of the blood vessels, so that the blood cells that fight infection can more readily come into the infected area and do their work.

Are women who have had mastitis at increased risk for breast cancer?

No, they are not. However, it is possible that the symptoms of mastitis can be mistaken for those of inflammatory carcinoma. That is why follow-up is important to make sure that any lump or lesion goes away or resolves itself completely.

If you’ve had several episodes of mastitis during breast-feeding, should you consider giving up nursing?

It depends on the severity of the infection and on how important breast-feeding is to you, in terms of both your child’s nutritional status and your own emotional and psychological priorities. Certainly you can nurse from one breast if the other is infected. Try to keep the infected breast as empty as possible. If it is too painful to nurse from the infected breast, you can hand pump that breast to empty it.

Many women are concerned about antibiotic use while breast-feeding. Most antibiotics are safe: the two principal categories you cannot use are tetracyclines and quinolones (cipro-type drugs).

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