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Acute mastitis
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.
Can acute mastitis be treated by stopping lactation?
It is not recommended to stop lactation during acute mastitis. Because breast milk is the best culture medium, bacteria have already caused local inflammatory invasion. If lactation is stopped at this time, the milk will accumulate in the milk ducts, leading to a large invasion of bacteria, which can eventually cause cellulitis. If untreated, it may lead to an abscess and then septicemia. Generally, for acute mastitis, breastfeeding is stopped, local heat application is necessary, and then a lactation masseuse or family member should be found to completely empty the residual milk, which needs to be done daily. Then, the use of antibiotics can achieve the purpose of treatment.
What should I do if acute mastitis does not subside with fever?
We can go to a formal hospital's breast department for routine blood tests and ultrasound examinations. If the blood count exceeds ten thousand, with increased neutrophils and a left shift in the nucleus indicating severe inflammation, we can apply local moist heat. Around the inflammation, penicillin and saline can be injected to promote the resolution of the inflammation. Systemically, antibiotics can be used, including penicillin, cephalosporins, or erythromycin. Since antibiotics can be secreted into breast milk and affect the baby, it is advisable to avoid using tetracyclines, aminoglycosides, sulfonamides, and metronidazole. The duration of antibiotic use should be determined based on the condition, which requires regular re-examination of the blood routine and breast ultrasound.
How is acute mastitis examined?
When suspecting acute mastitis in women, a routine physical examination should first be conducted, including measuring body temperature to check for any elevation, examining if the breast shape is symmetrical on both sides, and observing any congestion or swelling of the local skin, as well as feeling for any fluctuating sensation upon touch. This fluctuating sensation actually indicates an intensified manifestation of mastitis, resulting in a dense breast. Additionally, check whether the lymph nodes under both armpits are swollen, perform a blood draw to analyze a complete blood count, and understand the blood picture and whether there is an increase in neutrophil classification. If there is a consideration of abscess in the breast, a color ultrasound examination of both breasts should also be conducted. Under ultrasound guidance, aspiration of secretions for culture can be performed, which is informative for understanding the pathogen and guiding future medication use.
Acute mastitis lactation method
One very important cause of acute mastitis is the stagnation of milk, so it is essential to maintain the flow of breast milk after the onset of mastitis. Therefore, it is generally recommended to continue breastfeeding. Before and after breastfeeding, wash the nipples and the baby's mouth to keep the nipple and areola area clean. During breastfeeding, try to empty the breast as much as possible, and after breastfeeding, you can apply heat, massage, and express any remaining milk by pressing from the surrounding area towards the nipple. You can also use a breast pump to extract the remaining milk, which can help prevent infection. However, some cases of mastitis may not be relieved by these methods and may still require further treatment at a regular hospital.
Which department should I go to for acute mastitis?
For acute mastitis, one should first consult the Department of Mammary Surgery or Thyro-Mammary Surgery. When some hospitals lack a specialized breast surgery department, patients typically consult the general surgery department or gynecology department. If it is during the night or none of the specialized departments are available, then the emergency surgery department should be consulted. Thus, there are multiple relevant departments for acute mastitis. In larger hospitals with specialized departments, one can directly consult the Department of Mammary Surgery or Thyro-Mammary Surgery. During off-hours, nights, weekends, or other emergency periods, it is appropriate to consult the emergency surgery department.
What should I do if acute mastitis bursts?
An acute breast abscess has ruptured, and it should be treated in a formal hospital setting. Under general anesthesia through intravenous administration, the abscess area should be expanded to the normal tissue via an incision. Then, using color ultrasound for abscess localization, to avoid damaging the milk ducts and prevent fistula formation, the incision should follow the direction of the milk ducts, extending radially towards the areola. If there are multiple abscess cavities, the partitions between the cavities should be opened with a finger. If necessary, multiple incisions should be made, or successive operations for drainage of the abscess cavities might be required. Latex sheets or drainage tubes may be used.
Acute mastitis infusion for several days
Acute mastitis usually does not require intravenous fluids unless there is an accompanying fever, a significant increase in white blood cells, and obvious local redness, swelling, and pain in the breast. At this time, intravenous antibiotic therapy can be considered, generally for five to seven days, but once the white blood cells normalize and the local acute swelling subsides, consideration can be given to stopping the treatment. Of course, when acute mastitis is complicated by an abscess, the abscess requires separate treatment, usually by a specialist making a small incision or using a thick syringe needle to repeatedly aspirate the pus; the best method is certainly to aspirate the pus through a small incision. In such cases, the duration of intravenous fluid use may be appropriately increased.
How many days does it take for the fever from acute mastitis to go away?
The fever associated with acute mastitis can subside within a few days, but it needs to be evaluated through ultrasound and a complete blood count; these tests can be performed in the breast department of a standard hospital. If the blood count exceeds 10,000, temporary fever reduction is possible, but inflammation can cause fever to recur. In such cases, local warm and moist compresses are recommended, and injections of saline combined with penicillin can be administered to help reduce inflammation. Systemic antibiotics such as penicillin and cephalosporins can be used. Since antibiotics can be secreted into breast milk and affect infants, the use of tetracyclines, aminoglycosides, sulfa drugs, and metronidazole should be avoided. After three days of intravenous treatment, a follow-up complete blood count should be conducted to determine whether anti-inflammatory symptomatic treatment should be discontinued.
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.