Does acute mastitis require infusion?

Written by Zhang Chao Jie
Breast Surgery
Updated on September 13, 2024
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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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Written by Lin Yang
Breast Surgery
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Acute Mastitis Symptoms and Treatment

Patients with mastitis often feel pain in the breast, with localized redness, swelling, and fever. As the inflammation progresses, there can be chills, high fever, and increased pulse rate, often accompanied by swelling and tenderness of the lymph nodes on the affected side. A routine blood test can show a significant increase in white blood cells. For treatment, if there is swelling, it is recommended to stop breastfeeding and apply topical Levofloxacin. Blood tests should be checked, and if white blood cell count exceeds 10,000, intravenous antibiotics are advised. If below 10,000, oral anti-inflammatory drugs can be taken for symptomatic treatment. After three days, recheck the blood routine to decide on further symptomatic treatment.

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Early treatment of acute mastitis

In the early stages of mastitis where there is pain but no redness and swelling, applying heat and then having a lactation masseur clear any residual milk can be effective. However, if symptoms like high fever and chills occur, along with localized redness and swelling, it is advised to go to the hospital to have a complete blood count and an ultrasound. If the leukocyte count is under 10,000 and there is localized swelling, topical application of Rifanuo and oral anti-inflammatory medication can be curative, but it is necessary to stop breastfeeding. If the leukocyte count exceeds 10,000, intravenous antibiotics may be required, alongside cessation of breastfeeding. Then, using a breast pump to extract the milk can help in healing. (Please use medications under the guidance of a doctor.)

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The causes of acute mastitis include

The causes of mastitis are firstly bacterial invasion and secondly the accumulation of milk. The accumulation of milk mainly occurs during breastfeeding, due to the position of holding the child or unintentional bumps by the child, which cause damage to the milk ducts, constriction of the ducts, leading to a large amount of milk being trapped inside the ducts. Since milk is an excellent culture medium, it results in bacterial growth. Bacterial invasion usually occurs through cracked or fissured nipples, allowing bacteria to enter the milk ducts and into the breast tissue, causing mastitis. Another situation is a decrease in the body's immune system, for example, due to poor sleep or emotional stress. These are the main causes of acute mastitis.

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Written by Lin Yang
Breast Surgery
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The causes of acute mastitis

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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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.