Patient's question:
Wife checked for postpartum mastitis.Doctor's answer:
Postpartum mastitis is very common, and the vast majority of patients seeking treatment for mastitis in outpatient clinics are due to postpartum mastitis. If classified, mastitis is divided into lactation mastitis and non-lactation mastitis. Although both are types of mastitis, their causes are quite different. Milk is the best bacterial culture medium.Additionally, some new mothers wonder why they don’t develop mastitis while breastfeeding but do after weaning. The so-called weaning is essentially allowing milk to accumulate in the breasts, triggering a neural feedback to the pituitary gland, which reduces the secretion of prolactin and thus stops milk production. If the breast becomes blocked for some reason during this time, milk accumulates. Since milk is the best bacterial culture medium, the accumulated milk provides abundant nutrients for bacteria, leading to faster bacterial proliferation and inflammation.
The cause of lactation mastitis is so clear, but the cause of non-lactation mastitis has long puzzled doctors specializing in breast conditions. The exact cause of non-lactation mastitis remains unclear, and it is currently uncertain whether it is a single condition or several conditions that lead to it. First-time mothers have a higher risk of developing this condition compared to experienced mothers. This is because first-time mothers lack breastfeeding experience, so they generally have a higher risk of developing the condition. Experienced mothers, on the other hand, usually recognize the early signs of postpartum mastitis and seek medical help promptly, leading to a lower risk of developing the condition. First-time mothers are more likely to develop the condition within the first month after giving birth. For new mothers with low milk supply, this often occurs in the first few days postpartum, as milk production typically increases gradually through the baby’s suckling and demand-based feeding.
The baby’s suckling process is a stimulating mechanism that, through neural reflex to the pituitary gland, increases prolactin levels and enhances milk production. Therefore, the amount of milk a new mother produces has no relation to the risk of developing the condition.
There are three main causes of lactation mastitis:
1. Congenital factors: Such as abnormal development in new mothers, such as inverted nipples. Inverted nipples result from abnormal development of milk ducts, leading to prolonged accumulation of secretions and dirt in the nipples, which cannot be cleaned properly. This makes the nipples prone to inflammation. Women with inverted nipples can undergo minor surgery to correct the issue, which improves appearance without affecting breastfeeding.
2. Poor behavioral habits: Many new mothers allow babies to suck on their nipples to fall asleep. The human mouth contains a large number of bacteria, which generally do not pose a health risk. However, if the baby has oral thrush, the bacteria can spread from the baby’s mouth to the mother, increasing the risk of mastitis.
3. Weakened immune system: Postpartum, new mothers often lack rest and need to get up at night to feed, which weakens their immune system and makes them more susceptible to bacterial infections.