Mastitis = inflammation of the breast, can be infectious or non-infectious. In lactating women it is usually caused by an accumulation of milk

Periductal mastitis occurs in 5-9% of non-lactating women worldwide. It is most common in women of reproductive age and is almost exclusively seen in smokers.

Aetiology

May or may not be associated with infection

Non-infectious mastitis - due to an accumulation of milk causing an inflammatory response in the breast.

Infectious mastitis - When accumulated milk allows bacteria to grow. Usual organism is Staphylococcus Aerus although it may also be Staphylococcus albus and streptococci. Meticillin-resistant S. aureus(MRSA) infection is increasing, and may be more common in women who have had a caesarean section.

• Infectious mastitis can lead to a breast abscess (localised collection of pus)

Risk factors

• Problems with attachment of infant to breast during feeding, due to problems with technique or anatomical anomalies such as tongue-tie or cleft lip.
• Reduced number of feeds, or duration of feeds, leading to milk accumulation. This may be due to:
  • Partial bottle feeding.
  • Changes in regime (due to infant starting to sleep through the whole night for example).
  • Rapid weaning.
  • Painful breasts.
  • Preferred breast, leading to milk accumulation in the other.
• Pressure on the breast - due to tight clothing, seat belt, sleeping in the prone position.
• Nipple fissures, cracks and sores.
• Trauma to breasts.
• Blocked milk ducts
• smoking

PC

Diagnosed based on clinical Sx and signs indicating inflammation - breast pain + systemic features