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 Li Li Jie
Obstetrics and Gynecology
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What should I do if I have acute mastitis?

If acute mastitis occurs, the first step is to promptly relieve the blockage of the milk ducts, ensuring smooth drainage of breast milk. This can be achieved through warm compresses, massage, and the use of a breast pump for most cases of acute mastitis. With early intervention, significant relief can usually be achieved. However, if the condition has been prolonged and is severe, it is advisable to visit a formal hospital. Prompt medical attention and diagnostic tests, such as a complete blood count and localized ultrasound, are needed to further understand the condition and administer appropriate antibiotic treatment. If an abscess forms in the breast, it should be surgically drained as soon as possible. Maintaining good hygiene, paying attention to a gentle diet, and adopting good living habits, such as going to bed early and waking up early, are also important.

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Written by Zhang Chao Jie
Breast Surgery
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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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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.

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Written by Zhang Chao Jie
Breast Surgery
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Which department should I go to for acute mastitis?

For acute mastitis, one should first consult the Department of Mammary Surgery or Thyro-Mammary Surgery. When some hospitals lack a specialized breast surgery department, patients typically consult the general surgery department or gynecology department. If it is during the night or none of the specialized departments are available, then the emergency surgery department should be consulted. Thus, there are multiple relevant departments for acute mastitis. In larger hospitals with specialized departments, one can directly consult the Department of Mammary Surgery or Thyro-Mammary Surgery. During off-hours, nights, weekends, or other emergency periods, it is appropriate to consult the emergency surgery department.

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Written by Lin Yang
Breast Surgery
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How many days does it take for the fever from acute mastitis to go away?

The fever associated with acute mastitis can subside within a few days, but it needs to be evaluated through ultrasound and a complete blood count; these tests can be performed in the breast department of a standard hospital. If the blood count exceeds 10,000, temporary fever reduction is possible, but inflammation can cause fever to recur. In such cases, local warm and moist compresses are recommended, and injections of saline combined with penicillin can be administered to help reduce inflammation. Systemic antibiotics such as penicillin and cephalosporins can be used. Since antibiotics can be secreted into breast milk and affect infants, the use of tetracyclines, aminoglycosides, sulfa drugs, and metronidazole should be avoided. After three days of intravenous treatment, a follow-up complete blood count should be conducted to determine whether anti-inflammatory symptomatic treatment should be discontinued.