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 lactational mastitis and non-lactational 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 loop to the pituitary gland, reducing the secretion of prolactin and thus stopping 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 subsequent inflammation.
The cause of lactational mastitis is so clear, but the cause of non-lactational mastitis has long puzzled doctors specializing in breast conditions. The exact cause of non-lactational mastitis remains unclear, and it is currently uncertain whether it is a single condition or several conditions that lead to it. First-time mothers are more likely to develop the condition than experienced mothers. This is because first-time mothers lack breastfeeding experience, so they generally have a higher risk of developing mastitis. Experienced mothers, on the other hand, are more likely to 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. Low milk supply mainly occurs in the days following birth, but milk production is a gradual process from little to more, gradually increasing through the baby’s suckling and demand-based feeding.
The baby’s suckling is a stimulating process, triggering a neural reflex to the pituitary gland, increasing prolactin levels and thus boosting milk production. Therefore, the amount of milk a new mother produces has no relation to the risk of developing mastitis.
There are three main reasons for the occurrence of lactational mastitis:
1. Congenital factors: Such as abnormal development in new mothers, such as inverted nipples. Inverted nipples are caused by abnormal development of milk ducts, leading to the long-term accumulation of secretions and dirt in the nipples, making them difficult to clean. This can easily cause inflammation. Women with inverted nipples can undergo minor surgery to correct it, 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 affect health. However, if the baby has oral thrush, the transmission of bacteria through the baby’s mouth can increase the mother’s risk of developing mastitis.
3. Weakened immune system: Postpartum new mothers often lack rest and need to get up at night to feed, weakening their immune system and making it easier for pathogens to invade.