Treatment methods for acute mastitis

Written by Lin Yang
Breast Surgery
Updated on September 16, 2024
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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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Written by Zhang Chao Jie
Breast Surgery
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What fruits to eat for acute mastitis?

For mastitis, it is primarily important to avoid spicy and stimulating foods, seafood, and lactation-promoting foods. Foods high in fat and sugar, spicy fried foods, and stimulant drinks like liquor and coffee should be avoided. If blood sugar levels are high, certain fruits high in sugar content should also be avoided. For those without diabetes, the issue is simpler; for example, consuming more tomatoes, especially cooked tomatoes, is advisable. The principle is to eat light and nutritious foods. Therefore, tomatoes, green vegetables, loofah, cucumbers, crown daisy, lotus root, and mung bean soup are good options. This also includes oranges, strawberries, apples, grapes, and kiwifruits which are suitable choices.

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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.

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Breast Surgery
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What should be noted for acute mastitis?

For acute mastitis, it is important to keep the nipples clean. The nipples should often be washed with soapy warm water, and rinsed with clean water before and after breastfeeding. Patients with inverted nipples should gently extrude the nipple before cleaning it, but should not use alcohol to clean the area, as alcohol can make the skin of the nipple and areola brittle and prone to cracking. It is important to develop good breastfeeding habits, breastfeeding on a regular schedule, and ensuring that all the milk is drawn out each time. If the milk cannot be fully expressed, it should be manually massaged out or extracted using a breast pump. Additionally, do not let the baby sleep with the nipple in their mouth. If there are any nipple injuries or cracks, stop breastfeeding, use a breast pump to extract the milk, and resume breastfeeding only after the wounds have healed.

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What IV drip is used for acute mastitis?

For the treatment of acute mastitis at the hospital, it usually involves blood tests to observe the blood picture. We look at whether the white blood cells and neutrophils are elevated. When these levels are elevated, doctors will recommend the use of antibiotics, which are commonly referred to as anti-inflammatory injections, but are actually antimicrobial drugs, targeting bacteria. The treatment mainly involves cephalosporins, and some may use fluoroquinolones, or even add anti-anaerobic bacteria drugs like metronidazole or tinidazole. How to use these specifically should definitely be under the guidance of a specialist. For instance, fluoroquinolones such as levofloxacin should not be used by individuals under 18 years old; instead, cephalosporins or erythromycin should be preferred.

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Breast Surgery
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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.