Mastitis is typically diagnosed by a physician based on signs such as swollen, red, and painful breasts and flu-like symptoms. If a physician is unsure whether a patient has mastitis, he or she may order a laboratory culture of the breast milk. Approximately 10% of women with mastitis develop abscesses in the infected breast area. An abscess is a benign (non-cancerous) closed pocket containing pus (a creamy, thick, pale yellow or yellow-green fluid). Abscesses are usually drained with needles. A particularly large abscess may need to be cut open to drain. Usually, the area I numbed with a local anesthesia and covered with gauze after the procedure.
Symptoms
Infection usually produces the worst symptoms. The breast becomes red, hot, swollen and shiny and the nipple may produce pus. More general symptoms include high fever, shivers, muscle aches, nausea and vomiting.
Breast infections most commonly occur one to three months after the delivery of a baby, but they can occur in women who have not recently delivered as well as in women after menopause. Other causes of infection include chronic mastitis and a rare form of cancer called inflammatory carcinoma.
With engorgement, mastitis develops because the breasts are not emptying properly at each feed. They become swollen, lumpy, sore, leaky and tense. Superficial ducts full of milk may appear like hard cords along the surface of the breast, and both breasts may be affected.
Infective mastitis may develop from milk stasis or it may be caused by invading germs, although how exactly infection enters a breast isn’t clear. Some women who have had mastitis have also had cracked nipples and the infection may have passed through the crack or fissure in the nipple into the lymphatic system of the breast. Other experts believe that mastitis and cracked nipples are both symptoms resulting from poor latch-on technique and so the two are likely to be linked in this way.
Problems with recurrent mastitis are usually the result of irregular breastfeeding patterns: missing feedings, giving bottles in place of breastfeedings, or skipping pumping sessions when separated from the baby. Recurrent mastitis may also mean that mother’s immune system is generally run down, because of fatigue and stress. Mastitis is a sign that you need to take a closer look at your lifestyle and breastfeeding relationship and make some adjustments.
Current medical advice is to continue feeding from the affected breast even if it is infected. The infection will not harm the baby. However, the last thing you may want to do is to feed from the affected side at all as it is so painful. This will only make things worse and you may end up with an abscess. If this happens you will need to have the abscess drained by a doctor.
If you are worried about your baby drinking milk from the affected breast a good alternative is to express and dispose of the milk and to feed only from the unaffected side. Your body will adapt. It will continue to supply enough milk for your baby from the unaffected breast. And as long as you express regularly from the affected breast the milk supply will be maintained. You produce breastmilk on a supply and demand basis so there will always be enough. When the infection clears up you can simply return to your usual feeding pattern.