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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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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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.

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The causes of acute mastitis include

The causes of mastitis are firstly bacterial invasion and secondly the accumulation of milk. The accumulation of milk mainly occurs during breastfeeding, due to the position of holding the child or unintentional bumps by the child, which cause damage to the milk ducts, constriction of the ducts, leading to a large amount of milk being trapped inside the ducts. Since milk is an excellent culture medium, it results in bacterial growth. Bacterial invasion usually occurs through cracked or fissured nipples, allowing bacteria to enter the milk ducts and into the breast tissue, causing mastitis. Another situation is a decrease in the body's immune system, for example, due to poor sleep or emotional stress. These are the main causes of acute mastitis.

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Is hot compress effective for acute mastitis?

An important factor in acute mastitis is the accumulation of milk during breastfeeding, which leads to mastitis. Applying heat can be somewhat effective, as it helps to unblock the milk, thus further alleviating and controlling the symptoms of mastitis. However, heat application is mainly used in the initial stage of mastitis. If the condition progresses further, with more apparent systemic symptoms or pus formation, then heat application is not very effective. Further anti-infection treatment and, if necessary, incision and drainage surgery are needed to control the condition.

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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.