Most frequently occurs during the first 6-8 weeks postpartum, although it may occur at any time during breastfeeding
A study showed that lactational mastitis is associated with decreased levels of carbohydrate, fat and energy in breast milk which may be due to the cytokine-induced inflammatory response and increased permeability of the blood-milk barrier
Incidence is 2-10% in lactating mothers, while <1% in nonpuerperal mothers
Nonpuerperal mastitis is most commonly associated with breast cyst
Breast abscess is a complication of mastitis, refers to the collection of pus in the breast
Definition
Inflammation of the breast
May or may not be associated with bacterial infection
Etiology
Staphylococcus aureus is the most common organism associated with mastitis, particularly methicillin-resistant S aureus (MRSA) in lactational mastitis
Other pathogens are streptococci (alpha, beta and non-hemolytic), Escherichia coli, Bacteroides species, Corynebacterium species
Consider Candida infection if with symptoms of burning nipple pain or radiating breast pain
Signs and Symptoms
Firm, erythematous, tender, swollen area in the affected breast
Skin that may appear shiny and tight with red streaks
Fever or temperature >38°C
May present with headache, myalgia, lethargy, nausea, anxiety, flu-like aching, or systemic illness
Axillary pain and swelling from reactive lymphadenopathy
Risk Factors
Incomplete breast drainage which may be caused by difficulties in infant attachment, missed feedings or infrequent feedings, infant mouth abnormalities (eg tongue-tie, cleft lip or palate)
Engorgement and/or chronic oversupply of milk
Abrupt or rapid weaning
Blocked nipple or milk ducts
Trauma to breasts or nipples
Excoriated or cracked nipples
Poor maternal health like fatigue, stress, malnutrition
Prior history of mastitis
Tight-fitting clothes or external pressure on the breast
