What should I do if I have acute mastitis?

Written by Li Li Jie
Obstetrics and Gynecology
Updated on October 22, 2024
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If acute mastitis occurs, the first step is to promptly relieve the blockage of the milk ducts, ensuring smooth drainage of breast milk. This can be achieved through warm compresses, massage, and the use of a breast pump for most cases of acute mastitis. With early intervention, significant relief can usually be achieved. However, if the condition has been prolonged and is severe, it is advisable to visit a formal hospital. Prompt medical attention and diagnostic tests, such as a complete blood count and localized ultrasound, are needed to further understand the condition and administer appropriate antibiotic treatment. If an abscess forms in the breast, it should be surgically drained as soon as possible. Maintaining good hygiene, paying attention to a gentle diet, and adopting good living habits, such as going to bed early and waking up early, are also important.

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How to Prevent Acute Mastitis

The key to preventing acute mastitis lies in avoiding milk stasis, preventing nipple injury, and maintaining cleanliness. It is essential to frequently wash both nipples with warm water and soap. If the nipples are inverted, they can often be corrected by pinching and pulling. It is important to establish a regular breastfeeding schedule, ensuring that the baby does not sleep with the nipple in their mouth. After each breastfeeding session, the milk should be fully drained; if there is any accumulation, massage or use a breast pump to remove the milk completely. The nipples should be cleaned after breastfeeding. If there is any damage or cracking on the nipple, it should be treated promptly. Attention should also be paid to the oral hygiene of the baby.

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Can acute mastitis continue breastfeeding?

Acute mastitis is an acute suppurative infection, which can be divided into three stages according to its cause and pathological process: acute inflammatory stage, abscess formation stage, and ulceration stage. Corresponding treatments are applied at each stage. During the acute inflammatory phase, antibiotics such as penicillin should be used to control the progression of inflammation. Once an abscess forms, the main measure is to incise and drain pus in a timely manner, while also taking medicine to clear heat and detoxify. In the ulceration stage, proactive dressing changes and wound cleaning are necessary, along with internal use of heat-clearing and detoxifying medications, and decoctions that promote pus drainage. In principle, breastfeeding should be temporarily halted, and a breast pump should be used regularly to extract milk, ensuring smooth milk flow and preventing stasis. Additionally, wearing a supportive bra can help lift the breasts, and moist heat should be applied to the affected area for 20 to 30 minutes, three to four times a day. Afterwards, the nipples should be cleaned with diluted saltwater. (The use of medications should be conducted under the guidance of a doctor.)

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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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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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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.