MASTITIS

By:
Hj. Fatimah Usman, OBGYN (C)
Background
 Definition
 An inflammation of the breast tissue which may or may not be
associated with a bacterial infection

 Epidemiology
 The incidence varies from a few to 33% of lactating women,
but is usually under 10%
 most common in the second and third weeks postpartum, stage
of lactations
Etiology
 Milk stasis
 Non – infectious inflammation
 Infections
 Staphylococcus aureus  the most common pathogen
 Beta-haemolytic Streptococcus (such as Group A or Group B
streptococcus) or Escherichia coli  the less common pathogen
 Community-acquired methicillin-resistant S. aureus (MRSA) is
increasingly being identified as the causative pathogen
Risk Factor
 Incomplete breast drainage due to
Poor positioning and attachment
Missed feeds or long intervals between feeds
Tongue-tie
 Restrictive clothing/external pressure on the breast
 Trauma to breasts or nipples
 Engorgement and/or chronic oversupply
 Unresolved blocked ducts or white spot on the nipple (blocked
nipple pore)
 Rapid or abrupt weaning
 Stress, fatigue, overall poor health and nutrition
 Previous history of mastitis
 Sign and symptoms
History Physical findings
 The majority of cases occur in the  A reddened area on your breast
first 6 weeks pospartum, but can which may be hot and painful
occur at any time during lactation  Temp > 38.50C, rapid heart rate
 Chills, influenza-like symptoms  Breast pain
(muscle aches and pain)
 Area of induration (hardened)
 Nausea and/or vomiting in severe
 Fluctuance may be detected 
cases
which may indicate an abscess
 Fever for < 24hours
 Axillary nodes enlarged and tender
 The milk doesn’t flow easily and
 Malaise or myalgia
infants have difficulty latching on to
the breast due to engorgement and
a stretched, flat nipple
 Fatique
 Erythema associated
with mastitis

Lactation breast abcess

with visible swelling and
erythema
 • Improved understanding of breastfeeding management

How to • Routine measures as part of maternity care

• Effective management of breast fullness and
engorgement
prevent? • Prompt attention to any sign of milk stasis and other
difficulties with breastfeeding
• Controlled infection

• Anamnesis, medical history

Diagnose • Physical examination

• Additional examination (laboratory finding, US,
mammography)
Differential Diagnosis

Primary
invasive breast
Galactocele cancer

Nipple
sensitivity

Breast
engorgement
 Supportive
counseling

Effective Bacterial colonial

breastfeeding infection
How to
treat??
Severe sign &
Antibiotic symptomatic

Worsening after 12-

Symptomatic 24hours effective
breastfeeding
Antibiotic Therapy