What is breast inflammation?
Breast infection most commonly affects women between the ages of 18 and 50 and is much less common than it used to be. Breast infection can be split into two groups: those which occur in women who are breastfeeding and that which occurs spontaneously.

Breastfeeding infection
This is most likely to occur during the first six weeks of breastfeeding although some women develop it during weaning. With better hygiene, breastfeeding infection is much less common than it used to be. It is important at all times to be careful and try to prevent breast infection by careful attention to hygiene. If you have problems getting your baby to breastfeed, seek the advice of a midwife, a breastfeeding counsellor or a health visitor.

What are the symptoms of breastfeeding infection?
The first symptoms of breast infection are pain, swelling, redness and tenderness. You may start to feel unwell, almost as if you have the flu with a raised temperature, general aches and pains and a headache.

You may be aware, before infection is apparent, of a cracked nipple or a break in the surrounding skin. You may also be aware that part of the breast is engorged because the breast is not draining properly.

If you suspect you are developing an infection, you should see your doctor as soon as you can. You will almost certainly be given an antibiotic that can be safely taken while you are breastfeeding.

It is important that you carry on breastfeeding because draining the infected milk can reduce the chances of an abscess forming. Your baby will not come to any harm from germs in the milk as they will easily be killed off once they reach the baby's stomach.

If you cannot carry on breastfeeding for any reason, then you should express your milk.

If, having started antibiotics, your infection does not settle quickly, then it is likely that an abscess has developed and your GP will send you to hospital to have it drained. It used to be necessary to have a general anaesthetic to drain a breast abscess but now it is usually possible to treat it either by removing the pus through a needle or making a small hole in the breast and draining the abscess under local anaesthetic.

Non-breastfeeding infection
Women who are not breastfeeding can still develop infection. The most common site affected is the area close to the nipple. Most women who get this type of infection are in their late 20s and early 30s and about 90 per cent of them smoke cigarettes. It seems that something in cigarette smoke damages the duct underneath the nipple and causes it to become infected. This condition is called periductal mastitis and causes pain and redness around the nipple and there is sometimes an associated lump.

Antibiotics will get rid of the infection, but if the duct underneath the nipple is damaged, then it is likely that the infection will recur. If you do get recurrent episodes of infection, then you may have to have an operation to remove the diseased duct or ducts.

Infection of the skin over the breast
Some women with large breasts find that the skin underneath the breasts becomes infected on a number of occasions. This happens because this area becomes hot and sweaty and this provides an ideal breeding ground for germs. Once antibiotic cream has settled the infection, you need to need to ensure that you try and keep the area underneath your breasts as dry and clean as possible. This usually means washing the area twice a day and dabbing it dry with a cotton towel or even using a hair dryer to dry the skin. You should avoid using any talc or creams and wear cotton next to the skin either using a cotton bra or a cotton T-shirt worn inside the bra. If you are overweight, you can reduce the chances of getting further episodes of infection by losing weight. If you have large breasts, it may be worth asking your doctor if you would benefit from breast reduction surgery.

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