Mastitis

Overview

Mastitis is an inflammatory condition that affects the mammary glands, primarily in breastfeeding women. It’s often characterized by breast pain, swelling, redness, and warmth. Mastitis can lead to complications if left untreated, such as abscess formation. [7]

Risk factors include poor latch, cracked nipples, use of a breast pump, and weaning. [1]

Mastitis: Causes, Symptoms, Treatment, and Prevention – Your Comprehensive Guide

This in-depth article covers every aspect of Mastitis, a condition that can cause significant discomfort and worry for breastfeeding mothers. Article delve into the various causes of Mastitis, including blocked milk ducts and bacterial infections. We outline the key symptoms to watch for, such as breast pain, swelling, and redness.

We explore a range of treatment options, from homoeopathic remedies and over-the-counter medications to prescription antibiotics. Article also provide practical tips for preventing Mastitis, empowering mothers to take proactive steps to protect their breast health.

Epidemiology

Causes

• Mastitis typically develops when the milk is not properly removed from the breast.
• Milk stasis can lead to the milk ducts in the breasts becoming blocked, as the breast milk is not being properly and regularly expressed.
• Mastitis may occur when the baby is not appropriately attached to the breast while feeding, when the baby has infrequent feeds or has problems suckling the milk out of the breast.
• The presence of cracks or sores on the nipples increases the likelihood of infection.
• Tight clothing or ill-fitting bras may also cause problems as they compress the breasts.
• There is a possibility that infants carrying infectious pathogens in their noses can infect their mothers  the clinical significance of this finding is still unknown.
• Mastitis and breast abscesses can also be caused by direct trauma to the breast. Such injury can occur for example during sports activities or due to seat belt injury.

Risk factors

Pathogenesis

Pathophysiology

• In lactational mastitis, it is likely that bacteria (often originating from the mouth of the infant) gain entry via cracks or fissures in the nipple surface.
• Once the primary defences are breached, organisms have an ideal culture environment in nutrient rich maternal milk leading to rapid replication.[1]

Classification

Puerperal mastitis

• When it occurs in breastfeeding mothers, it is known as puerperal mastitis lactation mastitis, or lactational mastitis.

Non-puerperal mastitis

• When it occurs in non-breastfeeding women it is known as non-puerperal or nonlocational.

Pregnancy related

• Generally, Puerperal mastitis is the inflammation of the breast in connection with pregnancy, breastfeeding or weaning.
• It appears that proper breastfeeding technique, frequent breastfeeding and avoidance of stress are the most important factors that can be influenced.
• All in all, Light cases of mastitis are often called breast engorgement; the distinction is overlapping and possibly arbitrary or subject to regional variations.

Non pregnancy related

• The term nonpuerperal mastitis describes inflammatory lesions of the breast occurring unrelated to pregnancy and breastfeeding.
• Names for non-puerperal mastitis are not used very consistently and include mastitis, subareolar abscess, duct ectasia, periductal inflammation, Zuska’s disease also others.
• it is predicted that smoking may be related. Additionally, this condition is mainly seen in young women but can also be seen in men. [1]

Clinical Features

Sign & Symptoms of Mastitis

Lactation mastitis usually affects only one breast and the symptoms can develop quickly.

The signs and symptoms usually appear suddenly and they include i.e.:

• Breast either tenderness or warmth to the touch
• Either General malaise or feeling ill
• Swelling of the breast
• Pain or a burning sensation continuously or while breast-feeding
• Skin redness, often in a wedge-shaped pattern
• Fever of 101 F (38.3 C) or greater
• The affected breast can then start to appear lumpy and red.

Some women may also experience flu-like symptoms such as:

• Aches
• Shivering and chills
• Feeling anxious or stressed
• Fatigue
• Contact should be made with a health care provider with special breastfeeding competence as soon as the patient recognizes the combination of signs and symptoms.
• Most of the women first experience the flu-like symptoms and just after they may notice a sore red area on the breast.
• Also, women should seek medical care if they notice any abnormal discharge from the nipples, if breast pain is making it difficult to function each day, or they have prolonged, unexplained breast pain.

Clinical Examination

Diagnosis

• The diagnosis of mastitis and breast abscess can usually made based on a physical examination. The doctor will also take into account the signs and symptoms of the condition.
• However, if the doctor is not sure whether the mass is an abscess or a tumor, a breast ultrasound may perform.
• In cases of infectious mastitis, cultures may need in order to determine what type of organism is causing the infection. Cultures are helpful in deciding the specific type of antibiotics that will use in curing the disease.
• These cultures may take either from the breast milk or of the material aspirated from an abscess.
• Mammograms or breast biopsies are normally performing on women.

Differential Diagnosis

• Galactocele
• Breast engorgement
• Mastodynia
• Fibrocystic breast disease
• Breast cancer
• Fibroadenoma
• Mondor’s disease
• Breast abscess

Complications

Investigations

Treatment

• In lactation mastitis, frequent emptying of both breasts by breastfeeding is essential. Also essential is adequate fluid supply for the mother and baby.
• For breastfeeding women with light mastitis, massage and application of heat prior to feeding can help as this may aid unblocking the ducts.
• No puerperal mastitis is treated by medication and possibly aspiration or drainage (see in particular treatment of subareolar abscess and treatment of granulomatous mastitis).
• In idiopathic granulomatous mastitis, successful treatment includes invasive surgical procedures or less invasive treatment with steroid medications. [1]

Prevention

Homeopathic Treatment Of Mastitis

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy.

Medicines:

1. Apis Mellifica

• Erysipelatous mastitis
• High fever, but no sweat
• Swelling, hardness of and burning, stinging in mammae
• Threatening in less degree to pass into suppuration and ulceration, great sensitiveness to touch or to slightest pressure. [2]
• Aggravation especially By cold applications.[2]

2. Belladona:

• Breasts feel heavy, red streaks running like radii from a central point.
• Accompanied by pulsating pains, heavy headache, constipation also scanty urine.
• Erysipelatous inflammation, stitches appear also disappear quickly.
• Aggravation specifically from jar or jolt.[2]

3. Bryonia:

• Stony heaviness of breast, hot, hard, painful, but not very red
• Severe stitching pains in breast
• Aggravation when lifting arm or motion, feels sick on first sitting up in bed or in a chair, and worse on standing up
• First stage of mammary abscess.[2]

4. Phytolaca:

• Hardness apparent from the start, caked breast, gathered breast, with large fistulous gaping also angry ulcers
• Discharging a watery foetid pus, nipples and mammae sensitive, even after suppuration has taken place
• Right mammae; when child nurse pain goes from the nipple all over the body.
• Aggravation evening. on the other hand; Amelioration after midnight.[2]

5. Phosphorus:

• Phlegmonous inflammation
• Breasts swollen, red in spots or streaks
• Hard knots in different places, with fistulous openings, burning stinging pains
• Watery, offensive discharge, hectic fever and night-sweats.[2]

6. Pulsatilla:

• Mastitis from mechanical pressure on gland, particularly in young girls.
• Nodosities in mammae, tensive pressure and swelling as from accumulation of milk during nursing.[2]

7. Silicea:

• Fistulous ulcers with callous edges,
• Discharge thin and watery or thick and offensive, substance of the breast seems to discharge into one common ulcer, often with pain, or there may be several orifices, one for each lobe.[2]

8. Sulphur:

• Inflammation running in radii from nipple, threatening suppuration.
• When the lumps first appear, easing the pain and modifying the destruction of tissue.
• Profuse suppuration with chilliness in the forenoon and heat in the afternoon, old ulcerations.
• Breasts feel hot, night-sweats, flushes of heat, weak and faint spells, irresistible hunger towards noon.[2]

Diet & Regimen

• Diet:

  • Hydration is key: Drink plenty of fluids, especially water, to help flush out toxins and support milk production if breastfeeding.
     
  • Nutrient-rich foods: Focus on whole, unprocessed foods like fruits, vegetables, whole grains, and lean protein to support your immune system and overall health.
     
  • Healthy fats: Include foods rich in omega-3 fatty acids, like salmon, avocados, and nuts, to help reduce inflammation.
     
  • Probiotic-rich foods: Consider adding yogurt, kefir, sauerkraut, and other fermented foods to support gut health, which can indirectly boost immunity. 
     
  • Limit sugar and processed foods: These can contribute to inflammation and may hinder healing. 
     

  Regimen:

  • Rest: Get plenty of rest to allow your body to recover.
     
  • Frequent breastfeeding or pumping: If breastfeeding, continue to nurse frequently or pump to ensure adequate milk drainage.
     
  • Warm compresses: Apply warm compresses to the affected breast before and after feeding or pumping to help relieve pain and encourage milk flow.
     
  • Proper breastfeeding technique: Ensure a good latch and proper positioning to help prevent milk stasis, which can contribute to mastitis.
     
  • Pain relief: Use over-the-counter pain medications like ibuprofen or acetaminophen as needed.
     
  • Antibiotics: If your doctor diagnoses an infection, it’s crucial to complete the full course of prescribed antibiotics. 
     
  • Supportive bra: Wear a comfortable, supportive bra that doesn’t restrict milk flow.

Do’s & Don’ts

Mastitis Do’s

Terminology

References

1. https://en.wikipedia.org/wiki/Mastitis
2. Homoeopathic Therapeutics By Lilienthal
3. The New Indian Journal of OBGYN, 5(1), 30-34. (2018). 
4. Breastfeeding and Human Lactation (6th Edition),Authors: Karen Wambach, Jan Riordan,(2021),Publisher: Jones & Bartlett Learning.
5. Core Curriculum for Lactation Consultant Practice (4th Edition)
   Editor: Nancy Mohrbacher
   (2017)’Publisher: Jones & Bartlett Learning.
6. Breastfeeding A Guide for the Medical Profession (9th Edition)
   Authors: Ruth A. Lawrence, Robert M. Lawrence,(2020),Publisher: Elsevier
7. Title: Veterinary Reproduction

Edition: 11th Edition

Author(s): Senger, P.L.

Year of Publication: 2012

Publisher: Wiley-Blackwell

Also Search As

There are several ways people can search for homeopathic articles on mastitis:

Online Databases:

PubMed: While primarily for conventional medicine, it sometimes includes homeopathic studies. Use keywords like "homeopathy mastitis" or "homeopathic treatment mastitis."

The National Center for Homeopathy (NCH): This organization’s website may have articles or links to research on homeopathic approaches to mastitis.

Homeopathic Journals:

• The Indian Journal of Research in Homeopathy 
• The American Journal of Homeopathic Medicine

Homeopathic Libraries:

Many homeopathic colleges and organizations have libraries with collections of books and journals on homeopathy. You can search their catalogs for articles on mastitis.

Homeopathic Practitioners:

Experienced homeopathic practitioners may have access to resources or can recommend relevant articles based on their knowledge and experience.

Online Search Engines:

Use search terms like "homeopathy mastitis research" or "homeopathic remedies for mastitis" to find articles, case studies, or discussions on homeopathic forums and websites.

Tips for Effective Searching:

• Use specific keywords: Include terms like "homeopathy," "mastitis," "treatment," "remedies," and "research."
• Use filters: If searching a database, use filters to narrow down results by date, publication type, or language.
• Be critical: Evaluate the quality of the information you find. Look for articles published in reputable journals and consider the evidence presented.
• Consult a homeopathic practitioner: If you are considering homeopathic treatment for mastitis, it’s important to consult with a qualified practitioner for personalized advice.