How is acute mastitis examined?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on May 01, 2025
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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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Can acute mastitis be treated with hot compresses?

Acute mastitis can be treated with hot compresses, which can reduce local pain, dilate the milk ducts, and facilitate the expulsion of milk. To completely cure mastitis, it is essential to visit a hospital for examination. Under a doctor's guidance, taking antibacterial drugs for anti-infection treatment is recommended. For women who are breastfeeding, the priority in treating mastitis is to empty the breast milk first; thereafter, taking antibacterial drugs for anti-infection treatment is advisable. For severe cases of mastitis, it may be necessary to perform puncture aspiration or incision and drainage to achieve optimal treatment results. Patients with mastitis should pay attention to their diet and eat lightly in daily life, avoiding particularly greasy foods. It is advisable to eat light meals, vegetables, and fruits.

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Acute Mastitis Etiology

Acute mastitis generally refers to lactational mastitis, which can occur at any time during lactation, but is more common in the beginning stages of lactation in primiparous women. The most common causes of acute mastitis are milk stasis and bacterial invasion. Therefore, the prevention of acute mastitis mainly targets these two aspects. Besides enhancing the immune system of the mother, it is crucial to maintain good breastfeeding habits. This includes cleaning the nipples and the baby's mouth before and after feeding, keeping the nipple area clean, minimizing damage to the nipple area, and controlling bacterial invasion.

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Can I eat eggs with acute mastitis?

Patients with acute mastitis can eat eggs, but should not consume them in excess, as too many can lead to increased accumulation of body fat and elevated cholesterol levels. Prevention is more important than treatment for mastitis, and specific methods include maintaining nipple cleanliness during lactation. Frequently wash with warm, soapy water, and nipples can also be washed with 3% boric acid water before and after breastfeeding. For those with inverted nipples, gently squeeze out the nipple before washing. It is important to develop good breastfeeding habits, breastfeed on a schedule, and ensure that all the milk is drawn out each time. If the milk cannot be fully expressed, use hand massage or a breast pump. Additionally, do not let the baby suckle while sleeping. If there is nipple damage or cracking, stop breastfeeding, use a breast pump to extract milk, and resume breastfeeding once the wound has healed.

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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.

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Does acute mastitis require weaning?

In most cases of acute mastitis, it is not necessary to wean. However, weaning is mandatory when acute mastitis is accompanied by high fever, abscess, or nipple ulceration. Other than these conditions, it is often sufficient to temporarily stop breastfeeding from the inflamed breast for a few days. After treatment, breastfeeding can usually continue. During this temporary cessation, the milk from the affected breast should be expressed and discarded. Breastfeeding can continue with the other breast. Therefore, weaning is not easily recommended for acute mastitis.