Mastitis is an infection of the breast that causes redness, pain, and swelling. It is common during breastfeeding but can also happen in non-breastfeeding women (especially women with diabetes or those who smoke). Sometimes the infection can turn into an abscess which may need to be drained using a needle. Rarely, the abscess needs to be opened and drained (incised with a scalpel). We use a needle to aspirate the fluid, which is then sent to the lab to help us tailor antibiotic therapy. It is common to need a repeat aspiration, and sometimes these infections can recur.
The most common bacteria that cause breast infections are staph aureus, strep, and gram negative bacilli like e. coli. Oftentimes infections are due to bacteria that live on the skin. Although breastfeeding is the biggest risk factor for breast infections, breast trauma, foreign bodies like piercings, and diabetes can increase the risk.
Good breastfeeding techniques can help prevent sore and cracked nipples that may lead to mastitis. Other ways to decrease risk of breastfeeding-related mastitis include breastfeeding regularly, alternating sides, and ensuring correct positioning of the baby. If you are having issues with breastfeeding, a lactation consultant may help. When you have decided to stop breastfeeding, it may be helpful to decrease gradually.
Most breast infections do not need to be managed by a breast surgeon unless they do not respond to standard therapies. Warm compresses three times per day and ibuprofen (if not otherwise contraindicated) can be helpful for pain. If you don’t see an improvement in your symptoms (redness and swelling) after more than a week of antibiotics, you may need to see a breast surgeon for a biopsy to rule out a serious type of breast cancer.
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