Acute Mastitis Etiology

Written by Cui Yu Rong

Breast Surgery

Updated on September 23, 2024

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Acute mastitis generally refers to lactational mastitis, which can occur at any time during lactation, but is more common in the beginning stages of lactation in primiparous women. The most common causes of acute mastitis are milk stasis and bacterial invasion. Therefore, the prevention of acute mastitis mainly targets these two aspects. Besides enhancing the immune system of the mother, it is crucial to maintain good breastfeeding habits. This includes cleaning the nipples and the baby's mouth before and after feeding, keeping the nipple area clean, minimizing damage to the nipple area, and controlling bacterial invasion.

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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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Methods for reducing swelling in acute mastitis

Methods for reducing swelling in acute mastitis: First, determine whether the acute mastitis is caused by milk stasis or by bacterial invasion and decreased immune resistance. If it is simply due to milk stasis, nursing can still be continued if the symptoms are mild and the lesion is not severe. However, the affected breast should not be used for nursing, and a breast pump can be used to extract the milk. If the condition is caused by bacteria, it is recommended to apply local moist heat. Penicillin and other saline can be injected around the inflammation. Systemic antibiotics, such as penicillin or cephalosporins, can be used. However, since antibiotics can be secreted into the milk and affect the infant, the use of tetracyclines, aminoglycosides, and sulfa drugs should be avoided.

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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.

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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.