Symptoms of mastitis during breastfeeding: how to recognize it, causes, types and prevention

During breastfeeding, one of the major breast problems that we can find is with the appearance of a mastitisIn fact, it is estimated that 1 each 10 Breastfeeding mothers experience it at some point. Knowing their symptoms Symptoms of mastitis during breastfeeding es fundamental to detect it early and act before complications such as abscess or early cessation of breastfeeding appear.

What is mastitis during breastfeeding?

Mastitis is the inflammation of breast tissuewhich may or may not be accompanied by a bacterial infectionThe breast is made up of mammary lobes, which are the structures in charge of form the milkMastitis usually affects one breastbecoming inflamed one or more lobes or quadrants of the gland, although in some cases it may appear in both breasts.

In the context of breastfeeding, we talk about puerperal or lactation mastitiswhich is the most frequent form. It appears with higher incidence at the beginning of breastfeeding (first weeks or months), when the breast is adjusting milk production and problems are more common milk retention, the bad grip or cracks in the nippleHowever, it can happen anytime while breastfeeding is maintained, and even in women who do not breastfeed and in men, although the latter is much less frequent.

From a clinical point of view, mastitis can manifest as a acute episode (with very obvious symptoms, fever and intense discomfort) or as a subacute or subclinical mastitis, more difficult to identify because its symptoms are milder or internal.

Types of mastitis during breastfeeding

Acute mastitis

Acute mastitis is the form more striking and obviousIt usually appears when beginning of lactation and is characterized by local symptoms in the breast and general symptoms that resemble the flu.

Amongst the local symptoms The most characteristic features of acute mastitis include:

• Redness of the skin, often wedge-shaped or with a well-defined spot in one of the quadrants of the chest.
• Warm to the touch in the affected area, which may feel warmer than the rest of the breast.
• Visible inflammation of the chest, which appears larger, tighter, or swollen.
• Intense painwhich may worsen when breastfeeding or touching the area.
• Hardening or breast lump (thickening of breast tissue).
• Sometimes cracks in the nipple or small wounds that can serve as an entry point for bacteria.

In addition, they often appear general symptoms due to the body's inflammatory response:

• Fever during breastfeeding, often higher than 38 ºC.
• Chills and a feeling of intense cold.
• General discomfort and pronounced fatigue.
• Muscle or joint pain, like with the flu.
• Feeling of being very weak or exhaustedwhich can make caring for the baby more difficult.

La most frequent cause Acute mastitis is caused by an infection with a bacterium called Staphylococcus aureus, favored by a poor drainage of an area of ​​the breastWhen the milk doesn't flow properly, it produces a milk accumulation which triggers a inflammatory reaction and creates the ideal environment for bacteria to proliferate.

Main risk factor's The following are conditions that cause acute mastitis:

• Cracks or wounds on the nipplewhich facilitate the entry of germs from the baby's skin or mouth.
• Previous mastitiswhich can leave more sensitive areas or damaged ducts.
• Very marked breast engorgement at the beginning of breastfeeding, when milk production exceeds what the baby drinks.
• Blocked mammary ducts due to incomplete emptying of the breast.
• External pressure on the breast, due to very tight bras, sleeping face down, or tight backpacks and belts.
• Extreme tiredness, stress, or poor diet, which decrease the mother's defenses.

El treatment of acute mastitis usually includes:

• Appropriate antibiotics, preferably after performing a milk culture to identify the responsible bacteria, especially if the symptoms are severe or do not improve within a few hours.
• Anti-inflammatories compatible with breastfeeding to relieve pain and inflammation.
• Good emptying of the affected breast through the baby's sucking or, if that is not possible, with manual expression or a breast pump.
• Mild local cold after intake to reduce pain and inflammation, without applying ice directly to the skin.
• Rest, hydration, and good nutrition to promote recovery.
• In cases, a treatment with specific probiotics It can help balance the breast microbiota.

It is important to note that Breastfeeding should not be stopped because of acute mastitis. On the contrary, keep the chest functioning It helps resolve the inflammatory process more quickly. Abrupt weaning can worsen symptoms by increasing milk retention.

Breast abscess

If mastitis It is not handled correctly or if it is allowed to develop for too long, a very serious infection can occur localized that leads to a breast abscess. This is the most serious complication of lactation mastitis.

In the abscess, the general symptoms They are similar to those of mastitis (fever, pain, discomfort), but very specific characteristics appear in the breast:

• Increased pain in a very specific area of ​​the breast.
• To the touch, you can feel a soft zone that fluctuatesIn other words, it's perceived as a bag full of purulent fluid (pus).
• The skin can be very reddened and tense.

The abscess requires a surgical drain (by puncture or small incision) and treatment with antibioticssometimes even because intravenously if the condition is very severe or the mother is in poor general health.

Although It is not essential to stop breastfeedingThe pain can be so intense Many women are forced to stop breastfeeding from the affected breast, and even to wean. With a good professional support You can consider expressing milk from that breast while it recovers, and continue offering the healthy breast to maintain the bond and production.

Subacute or subclinical mastitis

Subacute mastitis usually appears later during breastfeeding and is a type of mastitis very difficult to diagnoseBecause It does not present such clear visible signs in the breast such as intense redness or high fever.

In this case, it is fundamental listen to what the mother noticesThe most common symptoms are:

• Deep stabbing pains in the chest during or after the intake, often described as needles piercing from the inside.
• Burning sensation or internal burning.
• Cramps or pulls which can radiate to the back or arm.
• Impression of low milk production in that breast, because the milk It comes out with more difficulty.
• Baby that nod when eating, pull at the nippleHe appears restless or even reject that breast.

The main cause is a mild inflammation y narrowing of the caliber of the lactiferous ductswhich makes it difficult for the milk to flow out and causes it to remain stagnant. accumulated. This causes a progressive decrease in production milk from that breast and changes in the composition of the milk.

When milk is retained for a longer time, its content increases. sodium and other components, therefore changes the flavorThe baby may notice a more pronounced taste. salty in the milk of that breast and, therefore, show rejection or restlessness when breastfeeding.

In subacute mastitis, a overgrowth of certain bacteria normally present in the mammary gland, such as Staphylococcus epidermidis, some viridans/mitis group streptococci (Streptococcus mild, Streptococcus salivariusand certain species of CorynebacteriumThese bacteria can form biofilms (dense layers that adhere to the ducts), hardening them and making them less flexible, which contributes to blockage.

To diagnose it, it is important to look for specific risk factors, such as:

• Restrictive intakesThat is, scheduled intakes in which limits time on chest instead of letting the baby empty the breast on demand.
• Mothers who They let many hours pass without breastfeedingFor example, during the night or during the workday, without making intermediate extractions.
• Improper use of the breast pump, with extractions that are either too short or, conversely, excessive, which disrupt the natural regulation of production.
• constant pressure on specific areas of the chest by bras or backpacks.

El treatment of subacute mastitis It is based mainly on:

• Improve the breast emptying, Which is the most effective therapeutic measureOffer the affected breast first, check the latch, and use breastfeeding positions that promote drainage of the fullest areas.
• Use of anti-inflammatory compatible with breastfeeding to relieve pain.
• Specific probiotics to balance the breast microbiota, when indicated by the healthcare professional.
• If the discomfort does not improve, it may be very helpful to perform a milk culture to rule out specific infections and adjust the treatment.

Key symptoms of mastitis during breastfeeding

recognize the Symptoms of mastitis during breastfeeding Early detection helps prevent complications and maintain safe breastfeeding. These issues may arise in... one breast or bothand sometimes they are installed in a abrupt.

The most common symptoms include:

• Localized tenderness or pain in a part of the chest.
• Swelling or increase in size of the affected breast.
• Breast tissue thickening or feeling of package on the chest.
• Heat to the touch in the affected area.
• Redness of the skin, sometimes in the shape of a wedge; in very dark skin it may be less evident.
• Burning pain, internal twinges or cramps.
• Difficulty in the milk flowing normally, need for more time for the ejection reflex to work or a feeling that the milk is being retained.
• Feverchills, general malaise, and extreme tiredness.

It is recommended consult with a health professional (midwife, family doctor, gynecologist, pediatrician, or lactation consultant) for any breast symptoms that concern you. early diagnostic It allows for the application of simple measures and prevents mastitis from progressing to an abscess or unwanted weaning.

Causes of mastitis during breastfeeding

The main cause of lactational mastitis is retained milk in the breastWhen milk is not effectively extracted, it accumulates, increasing pressure within the ducts and triggering a inflammation of breast tissueThis inflammation can further narrow the ducts, hindering milk flow and facilitating bacteria growth.

The most common causes include:

• Blocked mammary ductIf a breast is not completely emptied during feeding or expression, one of the ducts may become blocked, causing a painful lump and predisposing to infection.
• Germs that enter the breastBacteria from the baby's skin or mouth can access the milk ducts through a crack in the nipple or from the openings of the ducts themselves. In stagnant milk, these bacteria find a favorable environment for multiplying.
• Improper grip techniqueIf the baby doesn't latch on properly, It does not empty the breast effectively., which promotes retention and inflammation.
• Infrequent or widely spaced dosesLong intervals without breastfeeding or expressing milk increase the risk of Engorgement and blocked ducts.
• Excessive pressure on the chest, due to tight bras, underwired garments, or certain sleeping positions that they compress a specific area.
• Fatigue, stress, and poor dietA weaker immune system makes it easier for inflammation and infection to take hold.
• Smoking and other unhealthy habits, which alter vascularization and the responsiveness of tissues.

In recurrent or prolonged mastitis, there is often a problem with bacterial biofilms that obstruct the ducts or a overgrowth of certain bacteria in the mammary gland. In these cases, it may be essential to perform a milk culture and assess specific treatments along with probiotics.

Risk factors for mastitis during breastfeeding

Some circumstances increase the probability of developing mastitis during breastfeeding:

• Personal history of mastitis in previous breastfeeding experiences or during the same breastfeeding period.
• Sore or cracked nippleswhich facilitate the entry of bacteria.
• Frequent breast engorgement or milk retention because production exceeds what the baby takes.
• Inadequate breastfeeding technique or incorrect latch of the baby, which cause incomplete drainage of the breast and the appearance of cracks.
• Decreased frequency of intakeFor example, to space out nighttime intakes or when returning to work without an extraction plan.
• Use of underwire bras or too tight, which can put pressure on specific areas of the chest.
• Incorrect sleeping position, pressing on the breasts for many hours at a time.
• Antibiotic treatments during pregnancy or postpartum that alter the breast microbiota.
• Intense stress, lack of rest, and accumulated fatigue.
• Poor hygiene skin irritation on the breast or use of harsh products that irritate the nipple.
• Unbalanced diet, with a deficiency of antioxidants such as vitamin A, vitamin E or selenium.
• Smoke or be regularly exposed to tobacco.
• Nipple piercingswhich can interfere with milk flow and promote infections.

How to prevent mastitis while breastfeeding

A large proportion of mastitis episodes can avoid mastitis if you take care of it breastfeeding technique From the very beginning, the needs of both baby and mother are respected. Some practical recommendations include:

• Do not set a rigid schedule for feedings. The baby Mark when you want to eatIt's best to forget old rules like "every three hours and only ten minutes." A newborn may need up to 12 or more doses per dayAnd this is normal and healthy.
• Make sure the baby Empty at least one breast completely in every shot. Who The better the breast drains, the baby. You vary your posture so that no areas are left full of milk when I finish.
• Use a little bit of gentle heat before taking, gently empty the breast or give a very gentle massage can help you soften the chest and make it easier for the baby to latch on.
• Apply gentle chill after intakeEspecially during the first few days of engorgement. Never use ice directly on the skin; something else is sufficient. fresh, like a cold cabbage leaf, placed on the breast.
• respect the night shots. Its fundamental to maintain good milk production and avoid prolonged retention.
• If you are going to incorporate into the worktalk to your midwife or lactation consultant to make a partial weaning plan or extraction that avoids congestion.
• Check with a professional that the baby's grip is correctthat there is no pain at the beginning of the feeding and that the nipple comes out rounded, without marks or flattening.
• Avoid bras that compress the chest; opt for cotton garments without underwire that adapt to changes in volume.
• Take care of rest, hydration and nutritionAsking for help at home whenever possible to reduce stress levels.

Before him minimal suspicious symptom (painful lump, hot area, noticeable pricking sensations, fever or malaise) consult your midwife or healthcare professionalOften, with very simple and early measures The problem is solved and it is prevented from escalating.

Remember who It's better to empty your breast, it's your baby.. Don't stop breastfeeding because of mastitis without seeking help beforehand. Asking for specialized support and acting early makes a big difference in how you feel and how breastfeeding progresses.

Understanding what mastitis is, why it occurs, and what its symptoms are. most frequent symptoms And knowing how to prevent it allows you to experience breastfeeding with more security and confidence, knowing that most episodes resolve well when treated in time and that continuing to breastfeed is usually part of the solution and not the problem.