Mastitis and breast engorgement

Mastitis and breast engorgement

Mastitis (parenchymatous inflammation of the mammary glands) and breast engorgement (congestion) are disorders that may affect lactating females.
Mastitis occurs postpartum in about 1% of patients, mainly in primiparas who are breast-feeding. It occurs occasionally in nonlactating females and rarely in males. All breast-feeding mothers develop some degree of engorgement, but it’s especially likely to be severe in primiparas. The prognosis for both disorders is good.


Mastitis develops when a pathogen that typically originates in the nursing infant’s nose or pharynx invades breast tissue through a fissured or cracked nipple and disrupts normal lactation. The most common pathogen of this type is Staphylococcus aureus; less commonly, it’s Staphylococcus epidermidis or beta-hemolytic streptococci. Rarely, mastitis may result from disseminated tuberculosis or the mumps virus. Predisposing factors include a fissure or abrasion on the nipple; blocked milk ducts; and an incomplete let-down reflex, usually due to emotional trauma. Blocked milk ducts can result from a tight bra or prolonged intervals between breast-feedings.

Causes of breast engorgement include venous and lymphatic stasis and alveolar milk accumulation.

Signs and symptoms

Mastitis may develop anytime during lactation but usually begins 3 to 4 weeks postpartum with fever (101° F [38.3° C] or higher in those with acute mastitis), malaise, and flulike symptoms. The breasts (or, occasionally, one breast) become tender, hard, swollen, and warm. Unless mastitis is treated adequately, it may progress to breast abscess.

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Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Mastitis and breast engorgement

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