Mastitis
Mastitis is inflammation of the breast or udder, usually associated with breastfeeding.[1][5][6] Symptoms typically include local pain and redness.[1] There is often an associated fever and general soreness.[1] Onset is typically fairly rapid and usually occurs within the first few months of delivery.[1] Complications can include abscess formation.[2]
For Mastitis in dairy cattle, see Mastitis in dairy cattle.Mastitis
mammitis; garget
Localized breast pain and redness, fever[1]
Rapid[1]
Based on symptoms[2]
Plugged milk duct,[3] breast engorgement,[4] breast cancer (rare)[1]
Frequent breastfeeding with good technique[2]
10% of breastfeeding women[2]
Risk factors include poor latch, cracked nipples, use of a breast pump, and weaning.[1] The bacteria most commonly involved are Staphylococcus and Streptococci.[1] Diagnosis is typically based on symptoms.[2] Ultrasound may be useful for detecting a potential abscess.[1]
Prevention of this breastfeeding difficulty is by proper breastfeeding techniques.[2] When infection is present, antibiotics such as cephalexin may be recommended.[2] Breastfeeding should typically be continued, as emptying the breast is important for healing.[2][1] Tentative evidence supports benefits from probiotics.[1] About 10% of breastfeeding women are affected.[2]
Treatment[edit]
Lactational mastitis[edit]
When mastitis is associated with breastfeeding, the treatment has to balance short-term reduction of symptoms with solving the underlying problems that caused mastitis. For example, the Academy of Breastfeeding Medicine recommends against trying to "empty" the breasts, whether through pushing the baby to feed more or through using a breast pump.[27] It may reduce the feeling of being full or swollen in the short term, at the cost of triggering milk oversupply, which can cause a mastitis recurrence in the coming days and weeks.[27]
Prevention[edit]
Most efforts to prevent mastitis in breastfeeding women are believed to be ineffective or have a relatively small effect.[36] Acupoint massage probably reduces the risk somewhat.[36] Possibly effective prevention measures include taking probiotics, breast massage, and low-frequency pulse treatment.[36] Ineffective methods included prophylactic antibiotics, topical treatments (mastitis is inflammation deep in the breast, so treating the skin is irrelevant[27]), specialist breastfeeding education, and anti‐secretory factor‐inducing cereal.[36]
Epidemiology[edit]
Mastitis is quite common among breastfeeding women. The WHO estimates that although incidences vary between 2.6% and 33%, the prevalence globally is approximately 10% of breastfeeding women. Most mothers who develop mastitis usually do so within the first few weeks after delivery. Most breast infections occur within the first or second month after delivery or at the time of weaning.[21] However, in rare cases it affects women who are not breastfeeding.[54]
![Serous exudate from bovine udder in E. coli mastitis[55] at left. Normal milk at right.](http://upload.wikimedia.org/wikipedia/commons/thumb/b/b2/Mamite_%C3%A5_colibacile_laecea.jpg/200px-Mamite_%C3%A5_colibacile_laecea.jpg)
Cat with mastitis
Mastitis occurs in other animals as in humans, and is especially a concern in livestock, since milk from the affected udders of livestock may enter the food supply and pose a health risk.
It is a major condition in some species, like dairy cows. It is the cause of much unwanted suffering for the dairy cows. It is of tremendous economic importance for the dairy industry, and it is also of concern for public health. The same considerations apply to mastitis in sheep and goats and other milk-producing females. It is also of economic importance in the sow, but, in this species, it is not related to public health. In other domestic females (queen, mare, etc.), it is more an individual illness dealt with by veterinary practitioners.