MASTITIS IN LACTATING PATIENTS - A LITERATURE REVIEW

Keywords: Mastitis, Lactating Women, Breastfeeding, Treatment

Abstract

Abstract: Mastitis is a common and significant complication affecting breastfeeding women worldwide. It can substantially impact maternal health and infant feeding, frequently resulting in premature cessation of breastfeeding. If inadequately managed, mastitis can progress to more severe outcomes such as breast abscess, recurrent infection, or in rare cases, be mistaken for inflammatory breast cancer. Due to prevalence of the condition, potential complications and the need for effective treatment, mastitis still poses a big challenge for clinical practitioners.

Aim of the study: This review aims to summarize current knowledge on the etiology, clinical presentation and management of symptoms, which includes both pharmacological and nonpharmacological treatment of the condition.

Materials and Methods: A literature review was conducted focusing on the epidemiology, risk factors, clinical presentation, prevention and management strategies of mastitis in lactating women.

Results and conclusions: Mastitis in lactating women varies widely- ranging from around 3% to over 30% due to differences in diagnostic criteria, duration of follow-up, and type of  population. It is characterized by breast pain, swelling, erythema, and can often be accompanied by systemic flu-like symptoms such as fever and malaise. Optimal management hinges on early recognition, combined with non-pharmacological strategies such as maintaining direct breastfeeding, correcting latch issues, providing adequate rest and hydration, completed by a pharmacological treatment that includes: use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and in confirmed or persistent bacterial cases- a targeted use of antibiotics.

References

Wilson, E., Woodd, S. L., & Benova, L. (2020). Incidence of and risk factors for lactational mastitis: A systematic review. Journal of Human Lactation, 36(4), 673–686. https://doi.org/10.1177/0890334420907898

Scott, J. A., Robertson, M., Fitzpatrick, J., Knight, C., & Mulholland, S. (2008). Occurrence of lactational mastitis and medical management: A prospective cohort study in Glasgow. International Breastfeeding Journal, 3(21). https://doi.org/10.1186/1746-4358-3-21

Khanal, V., Scott, J. A., Lee, A. H., & Binns, C. W. (2015). Incidence of mastitis in the neonatal period in a traditional breastfeeding society: Results of a cohort study. Breastfeeding Medicine, 10(10), 481–487. https://doi.org/10.1089/bfm.2015.0080

World Health Organization. (2000). Mastitis: Causes and management. Department of Child and Adolescent Health and Development. World Health Organization. WHO/FCH/CAH/00.13

Pevzner, M., & Dahan, A. (2020). Mastitis while breastfeeding: Prevention, the importance of proper treatment, and potential complications. Journal of Clinical Medicine, 9(8), 2328. https://doi.org/10.3390/jcm9082328

Fetherston, C. (1998). Risk factors for lactation mastitis. Journal of Human Lactation, 14(2), 101–109. https://doi.org/10.1177/089033449801400209

Michie, C., Lockie, F., & Lynn, W. (2003). The challenge of mastitis. Archives of Disease in Childhood, 88(9), 818–821. https://doi.org/10.1136/adc.88.9.818

Cullinane, M., Amir, L. H., Donath, S. M., Garland, S. M., Tabrizi, S. N., Payne, M. S., & Bennett, C. M. (2015). Determinants of mastitis in women in the CASTLE study: A cohort study. BMC Family Practice, 16, Article 181. DOI: 10.1186/s12875-015-0396-5

Mitoulas, L. R., & Davanzo, R. (2022). Breast Pumps and Mastitis in Breastfeeding Women: Clarifying the Relationship. Frontiers in Pediatrics, 10, Article 856353. https://doi.org/10.3389/fped.2022.856353

Angeliki Angelopoulou, Des Field, C. Anthony Ryan, Catherine Stanton, Colin Hill, & R. Paul Ross. (2018). The microbiology and treatment of human mastitis. Medical Microbiology and Immunology, 207(2), 83–94. https://doi.org/10.1007/s00430-017-0532-z

Reddy, P., Qi, C., Zembower, T., Noskin, G. A., & Bolon, M. (2007). Postpartum mastitis and community-acquired methicillin-resistant Staphylococcus aureus. Emerging Infectious Diseases, 13(2), 298-301. https://doi.org/10.3201/eid1302.060989

Pérez, A., Orta, L., Padilla, E., & Mesquida, X. (2013). CA-MRSA puerperal mastitis and breast abscess: A potential problem emerging in Europe with many unanswered questions. Journal of Maternal-Fetal & Neonatal Medicine, Early Online, 1–3. https://doi.org/10.3109/14767058.2013.766700

Dagla, M., Dagla, C., Mrvoljak-Theodoropoulou, I., Sotiropoulou, D., Kavakou, A.-T., Kontiza, E., & Antoniou, E. (2021). Do maternal stress and depressive symptoms in perinatal period predict the lactation mastitis occurrence? A retrospective longitudinal study in Greek women. Diagnostics, 11(9), 1524. https://doi.org/10.3390/diagnostics11091524

Fernández, L., Cárdenas, N., Arroyo, R., Manzano, S., Jiménez, E., Martín, V., & Rodríguez, J. M. (2016). Prevention of Infectious Mastitis by Oral Administration of Lactobacillus salivarius PS2 During Late Pregnancy. Clinical Infectious Diseases, 62(5), 568–573. https://doi.org/10.1093/cid/civ974

Mediano, P., Fernández, L., Rodríguez, J. M., & Marín, M. (2014). Case–control study of risk factors for infectious mastitis in Spanish breastfeeding women. BMC Pregnancy and Childbirth, 14, 195. https://doi.org/10.1186/1471-2393-14-195

Spencer, J. P. (2008). Management of mastitis in breastfeeding women. American Family Physician, 78(6), 727-731, 732. PMID: 18819238

Osterman, K. L., & Rahm, V.-A. (2000). Lactation Mastitis: Bacterial Cultivation of Breast Milk, Symptoms, Treatment, and Outcome. Journal of Human Lactation, 16(4), 297-302. https://doi.org/10.1177/089033440001600405

Morcomb, E. F., Dargel, C. M., & Anderson, S. A. (2024). Mastitis: Rapid Evidence Review. American family physician, 110(2), 174–182. PMID: 39172675

Mitchell, K. B., Johnson, H. M., Rodríguez, J. M., Eglash, A., Scherzinger, C., Widmer, K., Berens, P., Miller, B., & the Academy of Breastfeeding Medicine. (2022). Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeeding Medicine, 17(5). https://doi.org/10.1089/bfm.2022.29207.kbm

Patani, N., MacAskill, F., Eshelby, S., Omar, A., Kaura, A., Contractor, K., Thiruchelvam, P., Curtis, S., Main, J., Cunningham, D., Hogben, K., Al-Mufti, R., Hadjiminas, D. J., & Leff, D. R. (2018). Best-practice care pathway for improving management of mastitis and breast abscess. The British journal of surgery, 105(12), 1615–1622. https://doi.org/10.1002/bjs.10919

Dener, C., & İnan, A. (2003). Breast abscesses in lactating women. World Journal of Surgery, 27(2), 130–133 https://doi.org/10.1007/s00268-002-6563-6

Buescher, E. S., & Hair, P. S. (2001). Human milk anti-inflammatory component contents during acute mastitis. Cellular Immunology, 210(2), 87–95. https://doi.org/10.1006/cimm.2001.1813

Benson, E. A. (1989). Management of Breast Abscesses. World Journal of Surgery, 13(6), 753-757. https://doi.org/10.1007/BF01658428

Crepinsek, M. A., Taylor, E. A., Michener, K., & Stewart, F. (2020). Interventions for preventing mastitis after childbirth. Cochrane Database of Systematic Reviews, 2020(9), Article CD007239. https://doi.org/10.1002/14651858.CD007239.pub4

Smith-Levitin, M., & Skupski, D. W. (1995). Antepartum Mastitis: A Case Report. Infectious Diseases in Obstetrics and Gynecology, 3, 34-36. Wiley-Liss, Inc. https://doi.org/10.1155/S1064744995000275

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Published
2025-07-22
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How to Cite
Kamila Krzewska, Agnieszka Floriańczyk, Ewa Romanowicz, Aleksandra Kołdyj, Agnieszka Ozdarska, Adrian Krzysztof Biernat, Marcin Lampart, Anna Rupińska, Hanna Skarakhodava, & Katarzyna Kozon. (2025). MASTITIS IN LACTATING PATIENTS - A LITERATURE REVIEW. International Journal of Innovative Technologies in Social Science, (3(47). https://doi.org/10.31435/ijitss.3(47).2025.3491

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