What should I do if acute mastitis does not subside with fever?

Written by Lin Yang
Breast Surgery
Updated on May 08, 2025
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We can go to a formal hospital's breast department for routine blood tests and ultrasound examinations. If the blood count exceeds ten thousand, with increased neutrophils and a left shift in the nucleus indicating severe inflammation, we can apply local moist heat. Around the inflammation, penicillin and saline can be injected to promote the resolution of the inflammation. Systemically, antibiotics can be used, including penicillin, cephalosporins, or erythromycin. Since antibiotics can be secreted into breast milk and affect the baby, it is advisable to avoid using tetracyclines, aminoglycosides, sulfonamides, and metronidazole. The duration of antibiotic use should be determined based on the condition, which requires regular re-examination of the blood routine and breast ultrasound.

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Written by Lin Yang
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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 Zhang Chao Jie
Breast Surgery
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Acute mastitis occurs how long after childbirth?

Acute mastitis can occur a few weeks after childbirth, usually within the first two to three weeks, although it can also appear later during the breastfeeding period. The key issue is to maintain the flow of breast milk and the patency of the milk ducts during breastfeeding. It is recommended to wash both nipples before breastfeeding, let the baby completely empty one breast first, then move on to the second breast. If the baby is full and doesn't finish the milk from the other breast, it's best to empty that breast either by using a breast pump or having the father extract the milk. For the next feeding, start with the other breast, which was the second breast previously used, and alternate accordingly. Additionally, nipple care is important; after the baby has finished feeding, express a little milk and apply it on the nipple surface. Before the next feeding, wash the nipple with clean water more diligently. This can help reduce the occurrence of acute mastitis.

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Breast Surgery
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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 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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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.