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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Methods for reducing swelling in acute mastitis

Methods for reducing swelling in acute mastitis: First, determine whether the acute mastitis is caused by milk stasis or by bacterial invasion and decreased immune resistance. If it is simply due to milk stasis, nursing can still be continued if the symptoms are mild and the lesion is not severe. However, the affected breast should not be used for nursing, and a breast pump can be used to extract the milk. If the condition is caused by bacteria, it is recommended to apply local moist heat. Penicillin and other saline can be injected around the inflammation. Systemic antibiotics, such as penicillin or cephalosporins, can be used. However, since antibiotics can be secreted into the milk and affect the infant, the use of tetracyclines, aminoglycosides, and sulfa drugs should be avoided.

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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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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 is acute mastitis?

Acute mastitis is an acute purulent infection of the mammary gland, commonly occurring in women during the postpartum breastfeeding period, especially more frequently seen in primiparous women. It usually occurs within three months after delivery, particularly in the third and fourth weeks postpartum. Therefore, it can also be referred to as postpartum mastitis or lactational mastitis. The main causes are due to bacterial invasion, stagnation of milk, and a decrease in the body's immune function. The primary pathogens are generally Staphylococcus aureus, with occasional cases involving Streptococcus. In such instances, it is recommended to conduct a routine blood test for the mammary gland and an ultrasound to determine the severity of the mastitis.

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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.