Lactational Mastitis - Epidemiology, Etiopathogenesis, Clinical Presentation, Diagnosis and Management

Abstract

Introduction and purpose: Breastfeeding offers numerous health advantages for both infants and mothers and is recommended worldwide. Lactational mastitis is a frequent breastfeeding problem that may cause breast pain, systemic symptoms and early weaning. This review aims to provide an overview of current knowledge on lactational mastitis, emphasizing its epidemiology, etiopathogenesis, risk factors, clinical features, diagnostic criteria and treatment options, including the influence of human milk microbiota and probiotics.

Material and methods: A narrative review was carried out using databases such as PubMed/MEDLINE, Scopus, Web of Science and the Cochrane Library. The review included systematic reviews, meta-analyses, randomized controlled trials, observational studies and international guidelines.

State of knowledge: Lactational mastitis encompasses a range of inflammatory breast conditions with various causes, including milk retention, nipple trauma, bacterial infection and disruption of microbiota balance. Increasing evidence points to the importance of milk microbiota dysbiosis in disease development. Treatment focuses on early non-drug interventions, continuation of breastfeeding and selective use of antibiotics, while emerging data suggest that probiotics may be beneficial as adjunctive or preventive strategies.

Conclusions: Lactational mastitis should be recognized as a complex inflammatory disorder rather than a simple bacterial infection. Prompt non-pharmacological treatment, breastfeeding support and careful antibiotic use are key management components, while probiotics may represent a promising adjunct in selected cases, potentially reducing recurrence and supporting breastfeeding continuation.