- J Michael Dixon, MD
J Michael Dixon, MD
- Professor of Surgery and Consultant Surgeon
- Edinburgh University
- Section Editors
- Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C)
- Section Editor — Breast Surgery
- Associate Professor, Department of Surgery
- Yale University School of Medicine
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
- Deputy Editors
- Elinor L Baron, MD, DTMH
Elinor L Baron, MD, DTMH
- Deputy Editor — Infectious Diseases
- Assistant Clinical Professor of Medicine
- Tufts University School of Medicine
- Kristen Eckler, MD, FACOG
Kristen Eckler, MD, FACOG
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Assistant Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Lactational mastitis is an infection of the breast associated with pain, redness, fever, myalgias, and malaise that occurs in the setting of breastfeeding. It is most common during the first six weeks postpartum.
Issues related to lactational mastitis will be reviewed here. Issues related to other breast infections are discussed separately. (See "Breast abscess" and "Breast cellulitis: Clinical manifestations, diagnosis, and management".)
Lactational mastitis has been estimated to occur in 2 to 10 percent of breastfeeding women; the incidence of mastitis requiring hospitalization is much lower . In one cohort including 136,459 new mothers, 127 women were hospitalized for mastitis, an incidence of 9 per 10,000 deliveries .
Lactational mastitis often occurs in the setting of the following breastfeeding problems, which typically result in prolonged engorgement or poor drainage :
●Blocked milk duct
- Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 361: Breastfeeding: maternal and infant aspects. Obstet Gynecol 2007; 109:479.
- Stafford I, Hernandez J, Laibl V, et al. Community-acquired methicillin-resistant Staphylococcus aureus among patients with puerperal mastitis requiring hospitalization. Obstet Gynecol 2008; 112:533.
- Foxman B, D'Arcy H, Gillespie B, et al. Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol 2002; 155:103.
- Department of child and adolescent health and development. Mastitis: Causes and management. World Health Organization 2000. http://whqlibdoc.who.int/hq/2000/WHO_FCH_CAH_00.13.pdf (Accessed on August 17, 2009).
- Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician 2008; 78:727.
- Dixon JM. Breast abscess. Br J Hosp Med (Lond) 2007; 68:315.
- Prachniak GK. Common breastfeeding problems. Obstet Gynecol Clin North Am 2002; 29:77.
- Berens PD. Prenatal, intrapartum, and postpartum support of the lactating mother. Pediatr Clin North Am 2001; 48:365.
- Kvist LJ, Rydhstroem H. Factors related to breast abscess after delivery: a population-based study. BJOG 2005; 112:1070.
- Dener C, Inan A. Breast abscesses in lactating women. World J Surg 2003; 27:130.
- Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #4: mastitis. Revision, May 2008. Breastfeed Med 2008; 3:177.
- Schoenfeld EM, McKay MP. Mastitis and methicillin-resistant Staphylococcus aureus (MRSA): the calm before the storm? J Emerg Med 2010; 38:e31.
- Dixon JM, Khan LR. Treatment of breast infection. BMJ 2011; 342:d396.
- Thomsen AC, Espersen T, Maigaard S. Course and treatment of milk stasis, noninfectious inflammation of the breast, and infectious mastitis in nursing women. Am J Obstet Gynecol 1984; 149:492.
- Amir LH. Breast pain in lactating women--mastitis or something else? Aust Fam Physician 2003; 32:141.
- Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev 2009; :CD005458.
- Dixon JM. Breast infection. In: ABC of Breast Diseases, Dixon JM (Ed), Blackwell Publishing, Oxford 2006. p.19.
- Dixon JM, Bundred NJ. Management of disorders of the ductal system and infections. In: Diseases of the Breast, Harris JR, Lippman ME, Morrow M, Osborne CK (Eds), Lippincott Williams & Wilkins, Philadelphia 2004. p.47.
- Hughes LE, Mansel RE, Webster DJT. Miscellaneous conditions. In: Benign Disorders and Diseases of the Breast: Current Concepts and Clinical Management, Hughes LE, Mansel RE, Webster DJT (Eds), Edward Arnold, London 2000. p.231.
- Arroyo R, Martín V, Maldonado A, et al. Treatment of infectious mastitis during lactation: antibiotics versus oral administration of Lactobacilli isolated from breast milk. Clin Infect Dis 2010; 50:1551.
- Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev 2013; 2:CD005458.