Mastitis, a condition that can become a medical emergency if it is not treated in time

• Mastitis, common during breastfeeding, can lead to an abscess or a generalised infection if it is not treated in time, warns Dr Francis Aquino, of Médico Express.

Santo Domingo. Mastitis is an inflammation of the breast tissue that mainly affects women who are breastfeeding, although it can also appear outside that stage. Without timely attention, it can develop into complications such as a breast abscess and, in rare cases, lead to a generalised infection.

Dr Francis Aquino, obstetrician-gynaecologist and subspecialist in gynaecological oncology at Médico Express, explains that the condition usually begins with milk building up in the milk ducts when the breast is not fully emptied. That can happen because of infrequent feeds, a poor latch by the baby or excessive milk production.

“Milk that stagnates encourages inflammation of the breast tissue. If there are also cracks or small lesions on the nipple, bacteria — mainly staphylococci — can get in and cause an infection that needs medical treatment,” says the specialist.

Although most cases appear during the first weeks after birth, Aquino points out that mastitis can also develop in women who are not breastfeeding. In those patients it may be linked to infections that get in through wounds or piercings in the nipple, skin lesions, or blocked milk ducts caused by hormonal changes, thick secretions or duct ectasia.

There are also factors that raise the risk of developing the condition, among them smoking, diabetes, a weakened immune system, trauma to the breasts and wearing bras or clothing that is too tight.

Symptoms tend to appear suddenly and usually affect only one breast. The most common are intense pain, redness, swelling, a rise in local temperature and a hardened area or painful lump. These can be accompanied by a fever above 38 degrees Celsius, chills, extreme tiredness, headache, nausea and a general malaise similar to flu.

The specialist warns that mastitis should not be played down. “If it is not treated in good time, the infection can develop into a breast abscess that requires surgical drainage. In rare situations, the bacteria can spread into the bloodstream and cause sepsis, a potentially serious complication,” he explains.

One of the most frequent mistakes, Aquino adds, is stopping breastfeeding because of the pain. Although the first sucks usually cause intense, stabbing pain, continuing to breastfeed helps empty the breast and contributes to a faster recovery.

Treatment generally includes keeping feeds frequent, applying warm compresses before breastfeeding, gentle massage to help the milk flow, resting, staying well hydrated and using pain relief compatible with breastfeeding on medical advice. Where there is a bacterial infection, a course of antibiotics is also needed; their effects are usually seen within the first 24 to 48 hours, although the course must be completed as prescribed.

Beyond the physical discomfort, mastitis can have a significant impact on the mother’s emotional health. Pain, fever and exhaustion can make it harder to rest and to care for the newborn, while worry about not being able to keep breastfeeding brings anxiety, frustration and stress.

“It is a condition that affects the mother’s physical, emotional and family health. When it forces breastfeeding to stop earlier than planned, it can also have a significant psychological impact,” says Aquino.

To reduce the risk of developing mastitis, the specialist recommends ensuring a good latch and correct positioning of the baby from the start of breastfeeding, feeding on demand while making sure both breasts are properly emptied, alternating positions during feeds, treating any cracks or lesions on the nipples immediately, avoiding clothing that presses on the breasts, and maintaining good hydration, a balanced diet and enough rest.