Mastitis

‘’Mastitis is a common condition in lactating women; estimates range from 3% to 20% depending on the definition and length of postpartum follow-up. The majority of cases occur in the first 6 weeks, but mastitis can occur at any time during lactation. There have been few research trials in this area. The usual clinical definition of mastitis is a tender, hot, swollen, wedge-shaped area of breast associated with a temperature of 38.5°C or greater, chills, flu-like aching, and systemic illness. However, mastitis literally means, and is defined herein, as an inflammation of the breast; this may or may not involve a bacterial infection. […] There appears to be a continuum from engorgement, non-infective mastitis, infective mastitis, to breast abscess.’’ (Amir, 2008) Kvist et al (2008) found 5 different types of pathogenic bacteria in the milk of both healthy women and those diagnosed with mastitis and being treated with antibiotics or not.  First and main cause for mastitis is milk stasis, (unmoving milk in the breast’’, which possibly will thicken and more accumulation of milk, increased pressure on the surrounding tissue and inflammation. Factors contributing to milk stasis and thus mastitis are insufficient or infrequent milk removal, pressure on or pinching off of breast tissue, fatigue, stress or low nutritional status of the mother, sub-optimal feeding techniques of the child and sore or bruised nipples. First and most important course of treatment is to remove the cause by thoroughly draining the breast. Accompanying measures include rest and sufficient nutrition and hydration. Pain management, inflammation treatment and treatment of the systemic illness are secondary. In case bacteriological factors are diagnosed or suspected antibiotics can be prescribed. The advice to interrupt or stop breastfeeding can be considered to be a first class medical failure.
Amir LH: ABM Clinical Protocol #4 : Mastitis. Breastfeeding Medicine,(2008) 3(3): 177-180
Amir LH, IngramJ: Health professionals' advice for breastfeeding problems: Not good enough! International Breastfeeding Journal 2008, 3:22
Kvist LJ, Larsson BW, Hall-Lord ML, Steen A, Schalén C: The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment. International Breastfeeding Journal 2008, 3:6