What should I do if I have acute mastitis?

Written by Li Li Jie
Obstetrics and Gynecology
Updated on October 22, 2024
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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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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.

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What medication is used for acute mastitis?

Acute mastitis typically requires three types of medications: topical medications, oral medications, and intravenous medications. Topical medications, also known as local medications, are mainly used to reduce swelling, such as 33% to 50% magnesium sulfate or traditional Chinese medicine topical applications made in Chinese medicine hospitals. Oral medications generally consist primarily of antibiotics, focusing on cephalosporins and erythromycin. Intravenous medications are used when acute mastitis is more severe and oral antibiotics are ineffective, requiring intravenous antibiotic infusions. It is crucial not to purchase medications arbitrarily at pharmacies but to follow the recommendations of a doctor.

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Does acute mastitis require milk dredging?

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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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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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.