Treatment of Mastitis
Treatment of mastitis focuses on easing symptoms, treating infection (if present), and preventing complications like abscesses or stopping breastfeeding. Most cases, especially in lactating women, are treated with a mix of medical care, breastfeeding support, and self-care. For non-lactating individuals, treatment depends on the cause and severity of the condition.
1. Continue Breastfeeding or Milk Expression
One of the key parts of treating mastitis in breastfeeding women is to keep emptying the affected breast often. Although it might seem painful, this is important to prevent milk buildup and worsening inflammation.
Breastfeed every 2–3 hours to drain the breast well.
Start on the affected side so the baby’s stronger initial suck can help.
Try different nursing positions to empty all the ducts properly.
If latching is painful or not working, use manual expression or a breast pump to help.
Stopping breastfeeding suddenly can lead to more milk buildup, worsening symptoms, or even causing abscesses.
2. Antibiotic Therapy
Infectious mastitis is usually caused by Staphylococcus aureus, and antibiotics are essential when an infection is present.
First-line oral antibiotics:
- Flucloxacillin (500 mg four times a day for 10–14 days)
- Dicloxacillin (similar to flucloxacillin)
Alternatives for those allergic to penicillin:
- Erythromycin
- Clindamycin
- Cephalexin (if the allergy isn’t severe)
Considerations:
If there’s no improvement after 48–72 hours or in recurring cases, culture-directed therapy may be needed.
Breastfeeding is safe during antibiotic treatment, as most antibiotics are safe for nursing infants.
3. Pain Relief and Anti-inflammatory Medication
Pain and inflammation are common in mastitis, and managing these symptoms is crucial for recovery.
- Paracetamol helps reduce fever and overall discomfort.
- Ibuprofen or other NSAIDs are great for reducing breast inflammation and swelling.
Taking medication regularly works better than using it just when needed. These medicines are generally safe while breastfeeding.
4. Hydration and Rest
Rest is essential for both lactating and non-lactating individuals to help the body fight infection and recover from inflammation.
- Drink enough fluids to support milk production and overall health.
- Rest or reduce activity for the first few days to help healing.
- Seek help with household chores or baby care during this time, especially for new mothers.
If rest is neglected, recovery may take longer, and complications may increase.
5. Warm Compresses and Massage
Applying warmth and using gentle massage can help milk flow and reduce blocked ducts.
- Use a warm compress or shower on the affected area before breastfeeding or pumping.
- Gently massage the breast in circular motions from the outer breast toward the nipple to help move milk.
Avoid pressing too hard, as this can damage the tissue.
Combining warmth, massage, and regular feeding/pumping is effective for symptom relief and resolution.
6. Treatment of Breast Abscess (if present)
If mastitis develops into a breast abscess, the treatment plan must include drainage along with antibiotics.
- Ultrasound-guided needle aspiration is usually the first choice.
- For larger or stubborn abscesses, surgical incision and drainage may be needed.
Breastfeeding or pumping is still encouraged, though you may need to avoid the abscess area.
Drainage brings significant pain relief and helps clear the infection faster.
7. Lactation Consultation and Prevention of Recurrence
A lactation consultant can help with effective latching and feeding schedules to prevent mastitis from coming back.
Key tips include:
- Ensuring a deep and comfortable latch.
- Avoiding missed feeds or long gaps between them.
- Switching nursing positions regularly.
- Watching for cracked nipples, which are entry points for bacteria.
Lactation consultants may also suggest therapeutic ultrasound, proper positioning, and checking for tongue-tie in infants.
8. Non-lactational Mastitis Treatment
For non-lactating individuals, treating mastitis focuses on finding and addressing the underlying cause.
- Broad-spectrum antibiotics are used if there’s a bacterial infection.
- Surgery might be needed for abscesses or fistulas.
- Smoking cessation is advised, especially if periductal mastitis is present.
- Steroids may be used for autoimmune or granulomatous mastitis, based on biopsy results.
In these cases, seeing a breast specialist or surgeon is often necessary.
9. When to Seek Immediate Medical Attention
Most cases of mastitis improve with basic treatment, but you should get medical help if:
- A high fever lasts for more than 48 hours.
- Severe pain or fast-spreading redness develops.
- Pus or foul-smelling discharge appears.
- A hard, fluctuant lump suggests an abscess.
- You have signs of systemic illness, like chills, feeling unwell, or nausea.
Getting prompt medical attention can prevent hospitalization and lower the risk of complications.
10. Home Remedies: Helpful or Harmful?
While some traditional remedies like cabbage leaves, herbal compresses, or acupuncture are popular, they don’t have strong scientific support.
- Cabbage leaves: May help cool the area, but long-term use can reduce milk supply.
- Herbal teas and supplements: Safety while breastfeeding is uncertain, so consult a healthcare provider.
- Alternative therapies: Should only be used alongside medical treatment, not as a replacement.
Relying solely on home remedies could delay recovery or worsen the condition.
Summary
In summary, treating mastitis involves easing pain, clearing infections, and supporting breastfeeding. Antibiotics, continued milk removal, anti-inflammatory medications, and self-care are the main treatments. For more complicated or non-lactating cases, targeted treatments like drainage, referrals to specialists, or biopsies might be needed. Early and thorough treatment can prevent complications like abscesses or stopping breastfeeding, helping both maternal health and infant nutrition.
