The causes of acute mastitis

Written by Lin Yang
Breast Surgery
Updated on September 10, 2024
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The first cause is milk stasis, which occurs when, due to incorrect positioning during nursing or breastfeeding, a child inadvertently causes the milk ducts to close, leading to a significant accumulation of milk within these ducts. The milk inside the ducts provides an excellent medium for bacterial growth. The second cause is bacterial invasion, mainly through cracks and fissures in the nipple. Bacteria enter the milk ducts through these fissures or breaks, causing inflammation. The third cause is a decrease in the body's immune function, for example due to severe mental stress or lack of sleep. All of these are the primary causes of acute mastitis.

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Is hot compress effective for acute mastitis?

An important factor in acute mastitis is the accumulation of milk during breastfeeding, which leads to mastitis. Applying heat can be somewhat effective, as it helps to unblock the milk, thus further alleviating and controlling the symptoms of mastitis. However, heat application is mainly used in the initial stage of mastitis. If the condition progresses further, with more apparent systemic symptoms or pus formation, then heat application is not very effective. Further anti-infection treatment and, if necessary, incision and drainage surgery are needed to control the condition.

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Does acute mastitis require daily milk expression?

If acute mastitis is severe, breastfeeding is not advisable, and it is necessary to express milk daily. Prevention of acute mastitis is more important than treatment, especially during breastfeeding periods where it is crucial to keep the nipples clean. Frequently wash them with warm soapy water and clean the nipples before and after breastfeeding with 3% boric acid solution. For those with inverted nipples, gently extract the nipple before cleaning; however, do not use ethanol wipes as ethanol can make the nipple and areola skin brittle, which can lead to cracking. Develop good breastfeeding habits, nurse regularly, and ensure that the milk is thoroughly drawn out each time. If unable to completely draw out the milk, use hand massage to express it or a breast pump. Additionally, do not let the baby sleep with the nipple in their mouth. If there is nipple damage or cracking, stop breastfeeding and use a breast pump to express the milk until the wound heals, and then resume breastfeeding.

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What IV drip is used for acute mastitis?

For the treatment of acute mastitis at the hospital, it usually involves blood tests to observe the blood picture. We look at whether the white blood cells and neutrophils are elevated. When these levels are elevated, doctors will recommend the use of antibiotics, which are commonly referred to as anti-inflammatory injections, but are actually antimicrobial drugs, targeting bacteria. The treatment mainly involves cephalosporins, and some may use fluoroquinolones, or even add anti-anaerobic bacteria drugs like metronidazole or tinidazole. How to use these specifically should definitely be under the guidance of a specialist. For instance, fluoroquinolones such as levofloxacin should not be used by individuals under 18 years old; instead, cephalosporins or erythromycin should be preferred.

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Breast Surgery
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Can you breastfeed with a fever from acute mastitis?

For acute mastitis with fever, it is generally recommended to stop breastfeeding. For mild symptoms and less severe cases, breastfeeding is possible. However, do not breastfeed from the breast that is affected with redness, swelling, heat, and pain; instead, use a breast pump to extract the milk. For more severe symptoms or if an abscess has formed, breastfeeding must be discontinued. Further, a breast ultrasound should be performed to determine whether the issue is cystic or inflammatory. A complete blood count is also recommended to view the extent of the infection. If the count exceeds 10,000, intravenous antibiotics are necessary, and topical Levofloxacin can be applied locally. If the count is below 10,000, oral anti-inflammatory medications can be taken to treat the symptoms. (Please use medications under the guidance of a doctor.)

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Written by Lin Yang
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Treatment methods for acute mastitis

The treatment methods for acute mastitis start with stopping breastfeeding. For those with mild symptoms or less severe conditions, breastfeeding can continue, but it is not advisable to breastfeed from the affected breast. Instead, a breast pump can be used to express the milk. Secondly, the breast can be supported with a bra. Thirdly, for local redness and swelling, hot compresses can be applied, or ichthyol ointment can be used topically, as well as Levonorgestrel topical application. If blood tests show elevated levels, systemic antibiotics should be used, with the choice of penicillins and cephalosporins for symptomatic treatment. If an ultrasound shows an abscess formation, it is recommended to perform an abscess incision and drainage procedure, or, if it's deeper, a thick needle can be used for aspiration to draw out the abscess.