The causes of acute mastitis

Written by Lin Yang
Breast Surgery
Updated on September 07, 2024
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The main causes of mastitis are as follows: First, the accumulation of milk is due to improper breastfeeding techniques or incidental contact with the mammary glands by the child, which causes the milk ducts to close and ultimately leads to the accumulation of milk. Milk is an ideal culture medium that facilitates bacterial growth, leading to mastitis. Second, bacterial invasion occurs when there are cracks or abrasions on the nipple, allowing bacteria to travel along the milk ducts to reach and infect the mammary lobules. Lastly, a decrease in the patient's own immune system can also lead to bacterial infection.

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Written by Lin Yang
Breast Surgery
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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.

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Written by Zhang Chao Jie
Breast Surgery
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Does acute mastitis require infusion?

In cases of acute mastitis, the specific situation must be considered. If it is a simple case of acute mastitis without a significant abscess, without particularly high white blood cell counts, and without pronounced fever, then it is not necessarily required to administer IV fluids. Local applications of magnesium sulfate compresses can be used, and in colder weather, these can be heated for a warm compress. Alternatively, traditional Chinese medicine such as Jin Huang powder can be applied externally and is often sufficient to resolve the issue. However, if the acute mastitis is accompanied by an increase in neutrophilic leukocytes, which requires verification through blood tests, and systemic symptoms such as fever and pain, then antibiotic treatment is necessary, typically administered through IV or orally, though IV is often faster. When acute mastitis is complicated by a breast abscess, not only is IV treatment needed, but also procedures for abscess drainage or incision and drainage. Currently, many minimally invasive methods for draining abscesses and other treatments are employed.

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Written by Lin Yang
Breast Surgery
46sec home-news-image

The causes of acute mastitis

The main causes of mastitis are as follows: First, the accumulation of milk is due to improper breastfeeding techniques or incidental contact with the mammary glands by the child, which causes the milk ducts to close and ultimately leads to the accumulation of milk. Milk is an ideal culture medium that facilitates bacterial growth, leading to mastitis. Second, bacterial invasion occurs when there are cracks or abrasions on the nipple, allowing bacteria to travel along the milk ducts to reach and infect the mammary lobules. Lastly, a decrease in the patient's own immune system can also lead to bacterial infection.

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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.

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Written by Lin Yang
Breast Surgery
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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.