Does acute mastitis require daily milk expression?

Written by Lin Yang

Breast Surgery

Updated on October 28, 2024

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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 Lin Yang

Breast Surgery

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Acute mastitis is caused by what?

Mastitis is generally considered to be caused by the accumulation of milk, which occurs during breastfeeding when the posture or unintentional actions by the child cause damage to the milk ducts, leading to an accumulation of milk within them. Since milk serves as an excellent culture medium, this can lead to bacterial infection. The second point is that if there are cracks or fissures on the nipple, bacteria can infect in reverse, leading to significant infections by Staphylococcus aureus, which can also cause mastitis. The third point concerns a weakened immune system, for example due to mental stress or lack of sleep. These are the main causes of acute mastitis.

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Breast Surgery

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Acute Mastitis Symptoms and Treatment

Patients with mastitis often feel pain in the breast, with localized redness, swelling, and fever. As the inflammation progresses, there can be chills, high fever, and increased pulse rate, often accompanied by swelling and tenderness of the lymph nodes on the affected side. A routine blood test can show a significant increase in white blood cells. For treatment, if there is swelling, it is recommended to stop breastfeeding and apply topical Levofloxacin. Blood tests should be checked, and if white blood cell count exceeds 10,000, intravenous antibiotics are advised. If below 10,000, oral anti-inflammatory drugs can be taken for symptomatic treatment. After three days, recheck the blood routine to decide on further symptomatic treatment.

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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.

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Written by Lin Yang

Breast Surgery

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Can you breastfeed with a fever from acute mastitis?

For acute mastitis with fever, it is generally recommended to stop breastfeeding. For mild symptoms and less severe cases, breastfeeding is possible. However, do not breastfeed from the breast that is affected with redness, swelling, heat, and pain; instead, use a breast pump to extract the milk. For more severe symptoms or if an abscess has formed, breastfeeding must be discontinued. Further, a breast ultrasound should be performed to determine whether the issue is cystic or inflammatory. A complete blood count is also recommended to view the extent of the infection. If the count exceeds 10,000, intravenous antibiotics are necessary, and topical Levofloxacin can be applied locally. If the count is below 10,000, oral anti-inflammatory medications can be taken to treat the symptoms. (Please use medications under the guidance of a doctor.)

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Written by Lin Yang

Breast Surgery

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What should be noted for acute mastitis?

For acute mastitis, it is important to keep the nipples clean. The nipples should often be washed with soapy warm water, and rinsed with clean water before and after breastfeeding. Patients with inverted nipples should gently extrude the nipple before cleaning it, but should not use alcohol to clean the area, as alcohol can make the skin of the nipple and areola brittle and prone to cracking. It is important to develop good breastfeeding habits, breastfeeding on a regular schedule, and ensuring that all the milk is drawn out each time. If the milk cannot be fully expressed, it should be manually massaged out or extracted using a breast pump. Additionally, do not let the baby sleep with the nipple in their mouth. If there are any nipple injuries or cracks, stop breastfeeding, use a breast pump to extract the milk, and resume breastfeeding only after the wounds have healed.