Mastitis, metritis and agalactia (MMA) in sows

Mastitis, metritis and agalactia (MMA) is a complex condition that can lead to increased piglet mortality and reduced weaning weights. Find out how is diagnosed and treated – and how it can be prevented.

What is MMA?

Mastitis, metritis and agalactia (MMA) is a complex syndrome seen in sows shortly (12 hours to three days) after farrowing. It is caused by a bacterial infection of the mammary glands (udder) and/or the urogenital tract.

  • Mastitis is a bacterial infection of the udder. In many cases, only one or two glands are affected
  • Metritis is an infection of the uterus, presented as vulval discharges
  • Agalactia is a reduction, or total loss, of milk production by the sow. It is often not detected until the nursing litter show signs of hunger and/or weight loss

How is MMA in sows diagnosed?

Diagnosis is based on clinical signs, particularly lack of appetite in the sow and a reduction in the condition of the litter.

The udder can be palpated (felt) on both sides by running a hand under both lines of glands; individual glands that are affected will feel firm and hot.

The presence of mastitis can be confirmed by testing the milk; collection will require an oxytocin injection to stimulate milk let-down.

The litter should also be examined, as diarrhoea, septicemia or hypothermia may lead to decreased intake of milk and an excess of milk in the udder, which could trigger the drying-off process.

How is MMA treated?

  • In the first instance, consult your vet for advice on treating MMA
  • Treatment usually includes the use of antibiotics and medicines to reduce inflammation, and injecting products to stimulate milk production
  • Small doses of oxytocin can help, although shouldn’t be necessary if piglets are suckling regularly; if used early on, oxytocin may reduce the need for veterinary input
  • Treatment should be given as soon as MMA is diagnosed or if sow body temperature rises above 39.4°C, 12 to 18 hours post-farrowing
  • The sow should be encouraged to drink by regularly stimulating her to rise
  • Some sows recover without any treatment; however, by the time this happens, the litter will have suffered so it’s important to act fast
  • Once problem litters are identified, steps should be taken to avoid piglets becoming dehydrated, to provide an alternative source of energy and to stimulate milk production
  • Small piglets may need to be transferred quickly to another sow with good milk production

Preventative measures

  • The most effective prevention of MMA is good hygiene. The farrowing pen and the sow must be kept clean and dry to reduce bacterial challenges. This requires an effective cleaning and disinfection protocol
  • Sows that get more exercise before farrowing and in the early stage of lactation may be less prone to developing MMA
  • Avoid slippery floors, which are one of the main causes of reduced activity in lactating sows
  • Fat sows (body condition score 4+) are more disposed to MMA, as are those given excessive feed before farrowing
  • Ensure adequate water is always available to sows; lactating sows require 15–30 litres per day
  • To reduce the risk of metritis, strict hygiene must be practiced
  • If you must intervene, consider using protective clothing and equipment, e.g. disposable gloves
  • Consult your vet as to whether it is advisable to administer antibiotics after intervening. Keep the back of the sow clean and dry – make sure there are no leaking drinkers
  • Take advice from your vet/nutritionist.
  • Consider the genotype of your sows and feed appropriately. This is to ensure that you are not overstimulating milk production, which could lead to the udder not being emptied and triggering drying-off.