What is the treatment for mastitis?

From the Guidelines

Mastitis treatment involves continuing to breastfeed, with regular feeding or expression of milk as an adjunct to other treatment, and antibiotics may be indicated.

Treatment Overview

• The American Academy of Pediatrics recommends that mothers with mastitis continue to breastfeed, as regular feeding or expression of milk is an important part of the treatment 1.
• Approximately 10% of mastitis cases progress to breast abscesses, which require drainage, but breastfeeding can continue on the affected side as long as the infant’s mouth does not contact purulent material.
• Key points to consider in the treatment of mastitis include:
  • Continuing to breastfeed to help clear the blockage and prevent abscess formation
  • Expressing milk regularly, either by hand or with a pump, to relieve fullness and prevent further blockage
  • Using antibiotics if prescribed by a healthcare provider to treat any underlying infection
  • Applying warm compresses to the affected area to help relieve pain and discomfort

Important Considerations

• It is essential to note that mastitis is not a contraindication to breastfeeding, and mothers are encouraged to continue breastfeeding to help manage the condition.
• The treatment of mastitis should be individualized, taking into account the severity of the condition, the presence of any underlying infections, and the mother's overall health.
• Healthcare providers should be consulted for proper diagnosis and treatment, as some cases of mastitis may require more aggressive treatment, such as drainage of a breast abscess.

From the Research

Treatment Options for Mastitis

• The treatment for mastitis includes changing breastfeeding technique, often with the assistance of a lactation consultant 2
• Antibiotics effective against Staphylococcus aureus, such as dicloxacillin or cephalexin, are preferred when antibiotics are needed 2, 3
• Effective milk removal is a crucial part of the treatment and may make antibiotics superfluous 3
• Continued breastfeeding is encouraged in the presence of mastitis and generally does not pose a risk to the infant 2, 3, 4

Antibiotic Therapy

• There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis 5
• The choice of antibiotic therapy should be based on the suspected causative organism and its antibiotic sensitivity 3
• Dicloxacillin or cloxacillin are suggested as first-line drugs for bacterial mastitis caused by Staphylococcus aureus 3

Supportive Therapy

• Pain medication and supportive therapy, such as frequent, complete emptying of the breast, are important components of treatment 5, 4
• Proper treatment and instructions to the mother are crucial for a cure, successful duration of breastfeeding, and preventing complications for mother and baby 4

Potential Complications

• Breast abscess is the most common complication of mastitis, which can be prevented by early treatment of mastitis and continued breastfeeding 2, 4
• Improperly treated mastitis may cause the premature cessation of breastfeeding and suffering to both mother and baby 4