The issue of mastitis, an inflammation (swelling) in the breast that is usually caused by an infection, has gained attention as more people share their experiences with this often-under-discussed condition.

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Stella Tushabe, Rwanda’s first female saxophonist, recently shared her testimony. She said, "I'm not sure what caused it. Maybe I got too busy during the festive season and reduced the number of times I expressed milk. It started with chills and joint pain. A few days later, the pain in one of my breasts became unbearable.”

Tushabe said when she went to see the doctor, he confirmed that she had mastitis, an inflammation of breast tissue that may involve an infection, commonly affecting women who are breastfeeding.

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According to Aimee Mireille Uwineza, a specialist in obstetrics and gynaecology, mastitis can cause breast pain, swelling, redness, fever, and chills.

She explained that it can make mothers feel run down, even leading to premature weaning—the process of switching a baby’s diet from breast milk to other foods and drinks.

Mastitis commonly occurs within the first three months of breastfeeding and up to a third of women breastfeeding may develop mastitis.

Milk stasis—a build-up of milk within the breast, caused by factors such as improper attachment of the baby to the breast, difficulties with suckling, infrequent feeding, or missed feeds—can result in blocked ducts.

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Additionally, bacterial entry into the breast may cause an infection, leading to infective mastitis; caused by infections either in the outer skin of the breast or within the glandular tissue of the breast. It may develop into the formation of a breast abscess if left untreated.

Uwineza further explained that non-breastfeeding women may also be susceptible to mastitis if there is damage to the nipple, such as through cracking or soreness, or due to nipple piercings. It can also occur in women who are not lactating and even in men.

Research also suggests that smoking increases the risk of periductal mastitis, a type that affects women who have not been pregnant and lactating.

Symptoms to be aware of include; breast swelling, thickening of breast tissue or a breast lump, continuous pain or a burning sensation, skin redness (often wedge-shaped), feeling generally unwell, and fever. If any of these symptoms arise, it is advised to seek medical attention promptly.

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Upon diagnosis, the primary treatment for mastitis is a course of antibiotics, typically lasting ten days. It is vital to complete the entire course to minimise the risk of recurrence. If symptoms persist after the antibiotic treatment, a follow-up visit to the doctor is recommended.

However, in addition to medication, self-help measures recommended are rest and proper hydration, along with the use of over-the-counter pain relievers like paracetamol or ibuprofen to manage pain and fever. Avoiding tight-fitting clothing, including bras, until symptoms improve can also alleviate discomfort.

"Breastfeeding, even during an infection, does not harm the baby and can actually help relieve symptoms,” Uwineza emphasised, advising that increasing the frequency of feeding, expressing milk after each feed, and expressing milk between feeds can be beneficial in managing mastitis.

Women who breastfeed can take several measures to reduce their risk, such as exclusively breastfeeding for around six months if possible, encouraging frequent feeding when breasts feel overfull, ensuring the proper attachment of the baby during feeds, allowing the baby to finish feeds naturally, avoiding abrupt weaning, and minimising pressure on the breasts from tight clothing.