Does acute mastitis require milk dredging?

Written by Lin Yang
Breast Surgery
Updated on April 01, 2025
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During acute mastitis, it is necessary to apply local heat and then clear the milk ducts by stroking them to drain excess milk. If milk stasis occurs in the ducts, it can aggravate inflammation and, in severe cases, lead to the formation of a breast abscess. Once a breast abscess forms, it requires incision and drainage, so it is essential to completely drain any residual milk during acute mastitis.

For acute pancreatitis, prevention is more important than treatment. The specific methods include maintaining nipple cleanliness during breastfeeding, frequently washing the nipples with warm soapy water, developing good breastfeeding habits, breastfeeding regularly, ensuring that the milk is fully drawn each time, and if not, either manually expressing or using a breast pump. Additionally, avoid letting the baby sleep with the nipple in their mouth.

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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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What should I do if acute mastitis bursts?

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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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 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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Written by Shen Li Wen
Obstetrics and Gynecology
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How is acute mastitis examined?

When suspecting acute mastitis in women, a routine physical examination should first be conducted, including measuring body temperature to check for any elevation, examining if the breast shape is symmetrical on both sides, and observing any congestion or swelling of the local skin, as well as feeling for any fluctuating sensation upon touch. This fluctuating sensation actually indicates an intensified manifestation of mastitis, resulting in a dense breast. Additionally, check whether the lymph nodes under both armpits are swollen, perform a blood draw to analyze a complete blood count, and understand the blood picture and whether there is an increase in neutrophil classification. If there is a consideration of abscess in the breast, a color ultrasound examination of both breasts should also be conducted. Under ultrasound guidance, aspiration of secretions for culture can be performed, which is informative for understanding the pathogen and guiding future medication use.