The causes of acute mastitis

Written by Lin Yang
Breast Surgery
Updated on September 10, 2024
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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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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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Written by Lin Yang
Breast Surgery
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What are the symptoms of acute mastitis?

During the onset of acute mastitis, symptoms often include high fever and chills, and the affected breast may enlarge and become firm, with throbbing pain that becomes more apparent during breastfeeding. This is usually accompanied by an increase in local skin temperature, redness and swelling, and tenderness. If the area softens over a short period, an abscess may have formed. If the infection is not controlled, it can lead to systemic infection or sepsis. Patients often have swollen lymph nodes, and blood tests show elevated neutrophil counts in white blood cells.

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Written by Cui Yu Rong
Breast Surgery
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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.

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Written by Lin Yang
Breast Surgery
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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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Written by Shen Li Wen
Obstetrics and Gynecology
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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.