Breast infection while breastfeeding
Mastitis usually settles with antibiotics and breastfeeding continues. What happens if an abscess forms.
Why it happens
Breast inflammation during breastfeeding is called mastitis. The most common cause is milk not draining properly: milk collecting in a duct first blocks it and then becomes inflamed. Cracks in the nipple also make it easier for bacteria to enter.
It appears most often in the first three months after birth and at times when the feeding routine changes. Being common does not make it trivial; untreated, it can progress to an abscess.
Signs
- Redness, warmth and pain in one area of the breast
- A firm, tender area, usually on one side, that can be felt by hand
- Fever above 38 °C, with chills and shivering
- Flu-like aching and general weakness
When fever is part of the picture, see a doctor within 12–24 hours. Treatment started early largely prevents an abscess from forming.
Treatment
Stopping breastfeeding makes things worse. Continue feeding from the affected breast, and express with a pump if the baby does not take it. The milk is not harmful to the baby.
An antibiotic compatible with breastfeeding is started and the course is completed. Symptoms ease within two or three days; stopping early leads to a relapse.
Painkillers that are safe while breastfeeding can be used. Warmth before a feed helps the milk flow; a cold pack afterwards reduces swelling.
If there is no improvement in 48–72 hours despite antibiotics, an ultrasound is done to look for an abscess. If one is found it is drained with a needle; larger abscesses may need drainage through a small incision.
Inflammation that does not settle must not be ignored
Breast infections that appear outside breastfeeding, or that keep coming back despite treatment, must always be investigated. Duct inflammation seen in smokers is a common cause of this picture.
Rarely, there is a type of breast cancer that mimics inflammation. That is why redness and swelling that do not settle despite proper treatment are imaged and, if needed, biopsied from the skin. The aim is not to alarm you but to make sure nothing is missed.
The content on this site is for general information and does not replace an examination by a physician. If you have symptoms, please book an appointment.
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