From the Research
The first-line treatment for neonatal mastitis is antibiotics that cover Staphylococcus aureus, as indicated by the most recent study 1.
Key Considerations
- The treatment should target the most common pathogen, Staphylococcus aureus, which is responsible for the majority of cases of neonatal mastitis 2, 1.
- Antibiotics such as dicloxacillin or cephalexin are typically used, with a dosage of 25-50 mg/kg/day divided into four doses for 7-10 days 1.
- In cases of severe infection or if MRSA is suspected, clindamycin or trimethoprim-sulfamethoxazole may be used instead 2, 3.
- Warm compresses should be applied to the affected breast 3-4 times daily for 10-15 minutes to improve circulation and promote healing 4, 1.
- It's essential not to squeeze or massage the breast as this may worsen the infection 2, 5.
- If fluctuance is present, indicating abscess formation, surgical drainage may be necessary 4, 2.
- Parents should be advised to monitor for fever, increased redness, swelling, or irritability, which may indicate worsening infection requiring immediate medical attention 1, 3.
Additional Recommendations
- Evaluation for serious bacterial infection (SBI) is likely unnecessary in most afebrile, well-appearing infants with mastitis 3.
- Intravenous antibiotics should be used for this condition, guided by gram stain or culture sensitivity once available 2.
- Incision and drainage gives uniformly good results, though multiple sittings of needle drainage may obviate the need for incision drainage 2.
- Therapy can be shifted to oral drugs once clinical improvement is seen 2, 1.