Causes of Mastitis

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Mastitis happens most often during breastfeeding. It is often caused by an infection that enters the breast through a crack or a break in the skin of the nipple. The most common bacteria involved is Staphylococcus aureus, but other bacteria such as Staphylococcus epidermis and Streptococci are sometimes the cause.

Bacteria such as these are found commonly on the skin but they only cause harmful infections if they get inside the body. They may come from the motherâ€™s own skin or from the babyâ€™s skin (especially if the baby has a skin infection). Good hygiene measures such as regular washing will help prevent bacteria from multiplying on the skin, and will lower your chances of getting an infection.

Mastitis can also happen during breastfeeding if your breast is not emptying fully at each feed. This may happen if the baby is not latching on properly to your nipple. The breasts then become swollen, lumpy and sore, but symptoms are not as severe as when infection is involved. If a milk duct in your breast becomes blocked and infected, the same symptoms can happen, but will be localised around the part of the breast containing the blocked duct.

Mastitis that is not linked to breastfeeding can happen for a number of reasons:

Infection elsewhere in the body, with bacteria or with viruses such as the mumps virus, can then spread to the breast;
Serious diseases such as tuberculosis, syphilis or actinomycosis can cause chronic (long-term) mastitis, when the germs travel to the breasts;
Smoking greatly increases your chances of a type of mastitis called periductal mastitis, which causes pain and redness around the nipple;
Nipples can become sore and infected if they rub against clothing, for example through vigorous exercise such as jogging, particularly if you do not wear a supportive bra;
Piercings break the skin of the nipple and if they are not kept clean then infections may enter the body during the healing process.

The skin of the breast can also be affected by a skin condition called cellulitis, which causes similar symptoms of swelling, soreness, and fever.

You are more likely to have infections if your skin has been damaged by previous surgery or radiotherapy, if your immune system is not very strong because you have had chemotherapy or have an immunodeficiency condition such as lupus, or if you have poor personal hygiene.