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Mastitis

Amena Payami, Doctor of Osteopathic Medicine Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Mastitis is an inflammation of the breast parenchyma and possibly associated tissues (areola, nipple, subcutaneous [SC] fat).

  • Usually associated with bacterial infection (and milk sta...

DIAGNOSIS

  • Fever >38.5°C, malaise, and myalgia

  • Nausea ± vomiting

  • Localized breast tenderness, firmness, heat, swelling, and redness

  • Possible breast mass

HISTORY

Breast pain, “hot cords burning in chest w...

TREATMENT

  • A Cochrane review found that insufficient evidence exists to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis (2)[A]. If present <24 ho...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Rest for lactating mothers, up to bathroom. Admit to medical floor. If concern for sepsis or hemodynamic instability, admit to intermediate leve...

REFERENCES

1
Wilson E, Woodd S, Benova L. Incidence of and risk factors for lactational mastitis: a systematic review. J Hum Lact. 2020;36(4):673-686.
2
Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastit...

ADDITIONAL READING

SEE ALSO

Spencer, JP. Management of Mastitis in Breastfeeding Women. Am Fam Physician. 2008;78(6):727-731.  

SEE ALSO

Algorithms: Breast Discharge; Breast Pain 

CODES

ICD10

  • O91.11 Abscess of breast associated with pregnancy

  • O91.211 Nonpurulent mastitis associated with pregnancy, first trimester

  • O91.113 Abscess of breast associated with pregnancy, third trimester

  • ...

CLINICAL PEARLS

  • Emptying/draining of the breasts on a regular schedule (recommend following baby's cues, but going no more than 3-4 hours between feeds), avoiding constrictive clothing or bras that mi...

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