Mastitis is an inflammation of breast tissue that most often affects women who are breastfeeding (lactation mastitis), but it can sometimes occur in women who aren’t breastfeeding, and even in men. It can result in pain, swelling, warmth and redness in the breast. Mothers experiencing mastitis may also experience fever and chills. Understanding the nursing diagnosis and appropriate care for mastitis is crucial for effective management and to support continued breastfeeding.
Understanding Mastitis
Mastitis is typically caused by a bacterial infection entering the breast tissue through a crack in the nipple or milk duct. Milk stasis in the breast can also lead to mastitis. This occurs when the breast is not fully emptied during breastfeeding, leading to a blockage in the milk ducts.
Symptoms of Mastitis
Recognizing the symptoms of mastitis early is vital for prompt intervention. Common signs and symptoms include:
- Breast tenderness or warmth to the touch
- Swelling of the breast
- Pain or burning sensation continuously or while breastfeeding
- Skin redness, often in a wedge-shaped pattern
- Fever
- Malaise or feeling run down
Causes and Risk Factors
Several factors can increase the risk of developing mastitis:
- Blocked milk ducts: Incomplete breast emptying during feedings can lead to milk stasis.
- Nipple damage: Cracked or sore nipples provide an entry point for bacteria.
- Infrequent feeding or missed feedings: Irregular breastfeeding patterns can contribute to milk stasis.
- Poor latch: An improper latch can lead to nipple trauma and ineffective milk removal.
- Tight bras or pressure on the breast: These can restrict milk flow.
- Maternal fatigue and stress: These factors can weaken the immune system.
Diagnosing Mastitis
Diagnosis of mastitis typically involves a clinical evaluation by a healthcare professional.
Physical Exam and Medical History
A healthcare provider will conduct a physical examination, assessing the breasts for signs of inflammation, redness, and tenderness. They will also inquire about symptoms, breastfeeding practices, and medical history.
Breast Ultrasound and Fluid Aspiration
In some cases, a breast ultrasound may be recommended to visualize the breast tissue and rule out other conditions, such as an abscess. If there is a collection of fluid, aspiration (removing fluid with a needle) may be performed. This fluid can be sent for culture to identify the specific bacteria causing the infection and determine the most effective antibiotic.
Differentiating from Inflammatory Breast Cancer
It’s important to differentiate mastitis from inflammatory breast cancer, a rare but aggressive form of breast cancer that can present with similar symptoms like redness and swelling. If symptoms are severe or do not resolve with antibiotics, or if there are atypical findings, further investigation with a mammogram or ultrasound, or both, may be necessary.
Biopsy if Symptoms Persist
If mastitis symptoms do not improve after a course of antibiotics, a breast biopsy may be recommended to rule out inflammatory breast cancer. Follow-up appointments after completing antibiotic treatment are crucial to ensure complete resolution and exclude other underlying conditions.
Mastitis Care and Treatment
Effective care for mastitis focuses on managing the infection, relieving symptoms, and supporting continued breastfeeding.
Antibiotics
If a bacterial infection is confirmed or strongly suspected, a course of antibiotics is the primary treatment. Typically, a 10 to 14-day course is prescribed to ensure complete eradication of the infection and prevent recurrence. It is essential to complete the entire course of antibiotics as prescribed, even if symptoms improve, to prevent antibiotic resistance and relapse. If symptoms do not improve within a few days of starting antibiotics, it’s important to contact the healthcare provider.
Pain Relief
Pain management is an important aspect of mastitis care. Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can effectively reduce pain and fever associated with mastitis.
Continued Breastfeeding
It is safe and highly recommended to continue breastfeeding even with mastitis. Breastfeeding helps to drain the breast, which is crucial for clearing the infection and reducing milk stasis. Abruptly stopping breastfeeding can worsen symptoms and lead to complications like breast abscess.
Lactation Consultant Support
Consulting with a lactation consultant can provide valuable support and guidance for mothers with mastitis. They can assess breastfeeding technique, latch, and positioning to optimize milk removal and prevent recurrence. Lactation consultants can also offer advice on managing pain and maintaining milk supply.
Breastfeeding Techniques for Mastitis
Proper breastfeeding techniques are essential for managing mastitis and promoting healing.
Proper Latch
Ensuring the infant has a deep and effective latch is crucial. A good latch helps to efficiently empty the breast and prevents nipple trauma. A lactation consultant can provide personalized guidance on achieving a proper latch.
Frequent Emptying
Frequent and effective breast emptying is key to resolving mastitis. Breastfeed frequently, aiming to nurse every 2-3 hours. Start feeding on the affected side first, as the infant will likely suck more vigorously at the beginning of the feeding, helping to drain the affected breast more effectively. If the baby is not feeding effectively or frequently enough, pumping after breastfeeding can help ensure the breast is fully emptied.
Massage and Warm Compresses
Gentle breast massage during breastfeeding or pumping can help to improve milk flow and relieve blockages. Start massaging from the affected area towards the nipple. Applying warm compresses to the breast before breastfeeding or pumping can also help to soften the breast and improve milk flow. Avoid vigorous massage or squeezing, which can worsen inflammation.
Breastfeeding Positions
Experimenting with different breastfeeding positions can help ensure all breast ducts are effectively drained.
Cross-cradle hold
The cross-cradle hold is beneficial, especially in the early days of breastfeeding. Sit upright comfortably, supporting the baby across your body, tummy to tummy. Use the arm opposite the feeding breast to hold the baby, supporting their head with your hand. Use your other hand to support the breast in a U-shape. Guide the baby to the breast, ensuring you bring the baby to you, not leaning forward.
Cradle hold
Similar to the cross-cradle hold, the cradle hold involves using the arm on the same side as the nursing breast to support the baby. Cradle your baby in your arm, ensuring their head rests in the crook of your elbow, facing your breast. Use a pillow for extra support if needed.
Football hold
The football hold can be particularly comfortable after a C-section or for mothers with larger breasts. Hold your baby beside you, supporting their head with your hand and their back along your forearm. Use a C-shaped hold with your other hand to support your breast. Pillows can provide added comfort.
Side-lying hold
The side-lying hold is ideal for nighttime feedings or when you need to rest. Lie on your side facing your baby, supporting them with one hand. Use your other hand to guide your breast to the baby’s mouth. Ensure you are awake and alert while using this position and return the baby to their own safe sleep space after feeding.
Football hold for twins
For mothers of twins, the football hold can be adapted for tandem breastfeeding. Position each baby at your side, supported by pillows, in a football hold position on each breast simultaneously.
Lifestyle and Home Remedies
In addition to medical treatment and breastfeeding techniques, several lifestyle and home remedies can help manage mastitis symptoms and promote comfort:
- Prevent breast engorgement: Breastfeed frequently and ensure effective milk removal to avoid engorgement.
- Cool compresses: Apply cool compresses or ice packs to the breast after breastfeeding to reduce pain and inflammation.
- Supportive bra: Wear a well-fitting, supportive bra, but avoid underwire bras or tight clothing that can restrict milk flow.
- Rest and hydration: Get plenty of rest and drink ample fluids to support your body’s recovery.
When to Seek Medical Advice
It is important to seek medical advice if you suspect you have mastitis. Prompt diagnosis and treatment can prevent complications and ensure effective management. Consult a healthcare provider if you experience:
- Symptoms of mastitis, such as breast pain, redness, swelling, and fever.
- Symptoms that do not improve within 24-48 hours of home care measures.
- Symptoms that worsen despite antibiotic treatment.
- Recurrent episodes of mastitis.
Conclusion
Mastitis is a treatable condition, and with prompt nursing diagnosis and appropriate care, mothers can effectively manage symptoms, continue breastfeeding, and recover fully. Understanding the causes, symptoms, and management strategies for mastitis empowers women to take proactive steps in maintaining their breast health and continuing to provide the best nutrition for their babies through breastfeeding. Seeking support from healthcare professionals and lactation consultants is invaluable in navigating mastitis and ensuring a positive breastfeeding journey.
