Acute Mastitis Symptoms and Treatment

Written by Lin Yang
Breast Surgery
Updated on September 01, 2024
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Patients with mastitis often feel pain in the breast, with localized redness, swelling, and fever. As the inflammation progresses, there can be chills, high fever, and increased pulse rate, often accompanied by swelling and tenderness of the lymph nodes on the affected side. A routine blood test can show a significant increase in white blood cells. For treatment, if there is swelling, it is recommended to stop breastfeeding and apply topical Levofloxacin. Blood tests should be checked, and if white blood cell count exceeds 10,000, intravenous antibiotics are advised. If below 10,000, oral anti-inflammatory drugs can be taken for symptomatic treatment. After three days, recheck the blood routine to decide on further symptomatic treatment.

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Written by Lin Yang
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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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What should I do about acute mastitis during lactation?

Firstly, let's assess the condition of acute mastitis by conducting a routine blood test and color ultrasound for further examination and diagnosis. If the white blood cell count exceeds 10,000, breastfeeding should be discontinued, and local anti-inflammatory symptomatic treatment should be applied. If the white blood cell count is below 10,000 but there is localized redness and swelling, external application of rifanuo and oral anti-inflammatory medications can be used. Breast massage by a professional or a family member can help clear the milk ducts. If there is a severe lump, it is recommended to stop breastfeeding and focus on anti-inflammatory symptomatic treatment. Observe whether the inflammatory lump can shrink; if it does, continue with local anti-inflammatory symptomatic treatment. If the severe lump continues to grow, it's advised to stop breastfeeding and proceed with local surgical treatment.

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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.

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How to reduce fever in acute mastitis

For fever in acute mastitis, it is first recommended to obtain a complete blood test to check if white blood cells and neutrophils are elevated. Of course, there are basic conservative methods and medication treatments for fever reduction. The conservative approach includes drinking plenty of water, preferably warm. Secondly, local application of magnesium sulfate can be used, with concentrations ranging from 33%-50%. During hot weather, it can be applied directly as a wet compress on the inflamed breast. It is important to thoroughly clean the breast, especially the nipple, before breastfeeding to prevent the baby from ingesting magnesium sulfate, which can cause diarrhea in infants. Thirdly, if the blood test shows an increase in white blood cells and neutrophils, intravenous antibiotics are used, commonly referred to by people as anti-inflammatory injections. Using antibacterial medications at this time can rapidly reduce fever. The fourth method is to temporarily use fever-reducing medications, which, along with magnesium sulfate, are available at pharmacies. However, for antibiotics, it is best to go to a hospital.

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Does acute mastitis require daily milk expression?

If acute mastitis is severe, breastfeeding is not advisable, and it is necessary to express milk daily. Prevention of acute mastitis is more important than treatment, especially during breastfeeding periods where it is crucial to keep the nipples clean. Frequently wash them with warm soapy water and clean the nipples before and after breastfeeding with 3% boric acid solution. For those with inverted nipples, gently extract the nipple before cleaning; however, do not use ethanol wipes as ethanol can make the nipple and areola skin brittle, which can lead to cracking. Develop good breastfeeding habits, nurse regularly, and ensure that the milk is thoroughly drawn out each time. If unable to completely draw out the milk, use hand massage to express it or a breast pump. Additionally, do not let the baby sleep with the nipple in their mouth. If there is nipple damage or cracking, stop breastfeeding and use a breast pump to express the milk until the wound heals, and then resume breastfeeding.