From the Guidelines
The treatment for antepartum mastitis typically involves antibiotics, pain management, and supportive measures. When considering the management of antepartum mastitis, it's crucial to prioritize the health and well-being of both the mother and the fetus, focusing on minimizing morbidity, mortality, and optimizing quality of life. Given the potential for complications such as abscess formation or systemic infection that could impact pregnancy outcomes, prompt and effective treatment is essential. The first-line antibiotic treatments often recommended include dicloxacillin 500 mg orally four times daily or cephalexin 500 mg orally four times daily for 10-14 days 1. For patients allergic to penicillin, alternatives like clindamycin 300-450 mg orally four times daily can be considered. Pain management is also a critical component, with options including acetaminophen or ibuprofen at standard dosing. Continued breastfeeding or milk expression from the affected breast is advised to prevent milk stasis and potential abscess formation. Additional supportive measures such as warm compresses applied to the affected area for 15-20 minutes before feeding, adequate rest, hydration, and wearing a supportive, non-underwire bra are also beneficial. It's important to monitor the patient's response to treatment closely, and if symptoms worsen after 48 hours, fever persists, or signs of abscess formation appear, prompt medical reevaluation is necessary to adjust the treatment plan as needed.
From the Research
Treatment for Antepartum Mastitis
The treatment for antepartum mastitis is crucial to prevent complications and ensure a successful pregnancy outcome. Some key points to consider include:
- Early recognition and treatment of mastitis to avoid complications such as breast abscess formation 2, 3
- Use of antibiotics effective against common skin flora, such as Staphylococcus and Streptococcus 4, 5
- Importance of proper lactation technique and breastfeeding practices to reduce the risk of mastitis 4, 5
- Aggressive treatment, including parenteral antibiotics and local skin care, may be necessary in severe cases 3
Management of Antepartum Mastitis
The management of antepartum mastitis can be derived from experience with puerperal mastitis, and includes:
- Early recognition of symptoms, such as focal tenderness, fever, and malaise 2, 3
- Search for predisposing factors and causative organisms 3
- Aggressive treatment with antibiotics and supportive therapy 4, 5, 3
- Importance of continued breastfeeding, if possible, to prevent cessation of breastfeeding and promote a successful duration of breastfeeding 5, 6
Potential Complications
If left untreated or improperly treated, antepartum mastitis can lead to complications such as: