What should I do if acute mastitis bursts?

Written by Lin Yang
Breast Surgery
Updated on April 25, 2025
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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 Lin Yang
Breast Surgery
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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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Written by Lin Yang
Breast Surgery
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Treatment methods for acute mastitis

The treatment methods for acute mastitis start with stopping breastfeeding. For those with mild symptoms or less severe conditions, breastfeeding can continue, but it is not advisable to breastfeed from the affected breast. Instead, a breast pump can be used to express the milk. Secondly, the breast can be supported with a bra. Thirdly, for local redness and swelling, hot compresses can be applied, or ichthyol ointment can be used topically, as well as Levonorgestrel topical application. If blood tests show elevated levels, systemic antibiotics should be used, with the choice of penicillins and cephalosporins for symptomatic treatment. If an ultrasound shows an abscess formation, it is recommended to perform an abscess incision and drainage procedure, or, if it's deeper, a thick needle can be used for aspiration to draw out the abscess.

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Integrative Medicine
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Can acute mastitis continue breastfeeding?

Acute mastitis is an acute suppurative infection, which can be divided into three stages according to its cause and pathological process: acute inflammatory stage, abscess formation stage, and ulceration stage. Corresponding treatments are applied at each stage. During the acute inflammatory phase, antibiotics such as penicillin should be used to control the progression of inflammation. Once an abscess forms, the main measure is to incise and drain pus in a timely manner, while also taking medicine to clear heat and detoxify. In the ulceration stage, proactive dressing changes and wound cleaning are necessary, along with internal use of heat-clearing and detoxifying medications, and decoctions that promote pus drainage. In principle, breastfeeding should be temporarily halted, and a breast pump should be used regularly to extract milk, ensuring smooth milk flow and preventing stasis. Additionally, wearing a supportive bra can help lift the breasts, and moist heat should be applied to the affected area for 20 to 30 minutes, three to four times a day. Afterwards, the nipples should be cleaned with diluted saltwater. (The use of medications should be conducted under the guidance of a doctor.)

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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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How should acute mastitis be treated?

Firstly, it is essential to prevent the accumulation of milk and avoid damage to the nipples while keeping them clean. After each breastfeeding, wash the nipples with soap. If the nipples are inverted, frequently squeeze and pull them to correct this. It is important to establish a regular breastfeeding schedule to prevent the baby from sleeping without releasing the nipple. Each breastfeeding session should drain the milk completely; if there is any accumulation, massage or use a breast pump to extract all the milk. After breastfeeding, clean the nipples. If there is any damage or cracking on the nipples, timely treatment is necessary. For the care of the baby's oral cavity, local heat application and massage can be provided.