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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Does acute mastitis require weaning?

In most cases of acute mastitis, it is not necessary to wean. However, weaning is mandatory when acute mastitis is accompanied by high fever, abscess, or nipple ulceration. Other than these conditions, it is often sufficient to temporarily stop breastfeeding from the inflamed breast for a few days. After treatment, breastfeeding can usually continue. During this temporary cessation, the milk from the affected breast should be expressed and discarded. Breastfeeding can continue with the other breast. Therefore, weaning is not easily recommended for acute mastitis.

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Does acute mastitis require milk dredging?

During acute mastitis, it is necessary to apply local heat and then clear the milk ducts by stroking them to drain excess milk. If milk stasis occurs in the ducts, it can aggravate inflammation and, in severe cases, lead to the formation of a breast abscess. Once a breast abscess forms, it requires incision and drainage, so it is essential to completely drain any residual milk during acute mastitis. For acute pancreatitis, prevention is more important than treatment. The specific methods include maintaining nipple cleanliness during breastfeeding, frequently washing the nipples with warm soapy water, developing good breastfeeding habits, breastfeeding regularly, ensuring that the milk is fully drawn each time, and if not, either manually expressing or using a breast pump. Additionally, avoid letting the baby sleep with the nipple in their mouth.

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How should acute mastitis be treated?

Firstly, it is essential to prevent the accumulation of milk and avoid damage to the nipples while keeping them clean. After each breastfeeding, wash the nipples with soap. If the nipples are inverted, frequently squeeze and pull them to correct this. It is important to establish a regular breastfeeding schedule to prevent the baby from sleeping without releasing the nipple. Each breastfeeding session should drain the milk completely; if there is any accumulation, massage or use a breast pump to extract all the milk. After breastfeeding, clean the nipples. If there is any damage or cracking on the nipples, timely treatment is necessary. For the care of the baby's oral cavity, local heat application and massage can be provided.

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Does acute mastitis require infusion?

In cases of acute mastitis, the specific situation must be considered. If it is a simple case of acute mastitis without a significant abscess, without particularly high white blood cell counts, and without pronounced fever, then it is not necessarily required to administer IV fluids. Local applications of magnesium sulfate compresses can be used, and in colder weather, these can be heated for a warm compress. Alternatively, traditional Chinese medicine such as Jin Huang powder can be applied externally and is often sufficient to resolve the issue. However, if the acute mastitis is accompanied by an increase in neutrophilic leukocytes, which requires verification through blood tests, and systemic symptoms such as fever and pain, then antibiotic treatment is necessary, typically administered through IV or orally, though IV is often faster. When acute mastitis is complicated by a breast abscess, not only is IV treatment needed, but also procedures for abscess drainage or incision and drainage. Currently, many minimally invasive methods for draining abscesses and other treatments are employed.

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What should I do about acute mastitis during lactation?

Firstly, let's assess the condition of acute mastitis by conducting a routine blood test and color ultrasound for further examination and diagnosis. If the white blood cell count exceeds 10,000, breastfeeding should be discontinued, and local anti-inflammatory symptomatic treatment should be applied. If the white blood cell count is below 10,000 but there is localized redness and swelling, external application of rifanuo and oral anti-inflammatory medications can be used. Breast massage by a professional or a family member can help clear the milk ducts. If there is a severe lump, it is recommended to stop breastfeeding and focus on anti-inflammatory symptomatic treatment. Observe whether the inflammatory lump can shrink; if it does, continue with local anti-inflammatory symptomatic treatment. If the severe lump continues to grow, it's advised to stop breastfeeding and proceed with local surgical treatment.