Milk Stasis and Duct Blockage
A blocked duct traps milk and starts the mastitis cascade.
- Hours: Onset speed (rapid local swelling)
- Outer quadrant: Common site (pressure-prone area)
- Lump: Initial symptom (tender, localized)
- Skipped feeds: Risk factor (engorgement builds)
What triggers duct blockage
Thick milk or pressure narrows a duct, slowing outflow.
Frequent feeding lowers blockage risk substantially.
Local tissue response
Trapped milk stretches alveoli and irritates surrounding tissue.
Why it matters early
Untreated stasis often progresses toward infection.
Bacterial Entry Through Nipple Fissure
Cracked skin gives bacteria a direct route into breast tissue.
- S. aureus: Common pathogen (skin-origin bacteria)
- Nipple fissure: Entry point (cracked skin)
- 1–2 days: Time to symptoms (after entry)
- Poor latch: Predisposing factor (causes fissures)
How bacteria gain access
Skin breaks allow surface bacteria to reach glandular tissue.
Proper latch technique reduces fissure risk.
Bacterial colonization
Bacteria multiply within the stagnant, nutrient-rich milk.
Transition to infection
Colonization converts simple stasis into true infection.
Tissue Inflammation and Redness
The immune system reacts with redness, heat, and pain.
- 4: Classic signs (redness, heat, pain, swelling)
- Fever: Systemic symptom (often above 38.5°C)
- Fast: Onset (within hours)
- Wedge-shaped: Affected area (follows duct anatomy)
Inflammatory cascade
Immune cells flood the area, causing visible redness.
Flu-like symptoms often accompany local inflammation.
Pain and swelling mechanism
Fluid accumulation stretches tissue, increasing tenderness.
When to seek care
Worsening redness or fever warrants medical evaluation.
Continued Breastfeeding and Emptying
Regular milk removal is key to resolving stasis and inflammation.
- Keep feeding: Recommended action (do not stop abruptly)
- 8–12/day: Feeding frequency (or more if needed)
- Massage: Support technique (aids duct drainage)
- Warm compress: Recovery aid (before feeding)
Why emptying helps
Removing milk clears the blockage and eases pressure.
Continued feeding is safe and speeds recovery.
Supportive measures
Massage and warmth improve milk flow during healing.
Monitoring progress
Symptoms should steadily improve within a couple days.
Antibiotic Therapy for Bacterial Mastitis
Targeted antibiotics clear infection when self-care alone is insufficient.
- 10–14 days: Typical duration (full course needed)
- Dicloxacillin: First-line drug (covers S. aureus)
- 24–48h: Improvement time (after starting therapy)
- Breastfeeding-safe: Compatibility (most antibiotics)
When antibiotics are needed
Persistent or worsening symptoms indicate bacterial infection.
Complete the full antibiotic course even if feeling better.
How antibiotics work here
Drugs target bacterial cell walls to clear the infection.
Preventing recurrence
Good latch and regular emptying reduce repeat episodes.