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Mastitis

Anne C. Adams, MD and Montiel T. Rosenthal, MD Reviewed 06/2019
 


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 and malaise

  • Nausea ± vomiting

  • Localized breast tenderness, heat, swelling, and redness

  • Possible breast mass

HISTORY

  • Breast pain

  • “Hot cords burning in chest wall”

  • Consider yeast inf...

TREATMENT

A Cochrane review found that insufficient evidence exists to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis (3)[A]. If present <24 hou...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Rest for lactating mothers, up to bathroom 

DIET

  • Encourage oral fluids.

  • Multivitamin, including vitamin A

PATIENT EDUCATION

  • Encourage oral fluids.

  • Rest is essential.

  • Reg...

REFERENCES

1
Crepinsek MA, Crowe L, Michener K, et al. Interventions for preventing mastitis after childbirth. Cochrane Database Syst Rev.  2012;(10):CD007239. [View Abstract on OvidMedline]
2
Buck ...

ADDITIONAL READING

Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician.  2008;78(6):727–731. [View Abstract on OvidMedline] 

SEE ALSO

Algorithms: Breast Discharge; Breast Pa...

CODES

ICD10

  • N61 Inflammatory disorders of breast

  • O91.22 Nonpurulent mastitis associated with the puerperium

  • O91.23 Nonpurulent mastitis associated with lactation

  • N60.19 Diffuse cystic mastopathy of unspec...

CLINICAL PEARLS

  • Complete emptying of the breasts on a regular schedule, avoiding constrictive clothing or bras that might obstruct breast ducts, meticulous attention to nipple care, “adequate rest,” a...

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