What is the treatment for mastitis (inflammation of the breast tissue)?

From the Guidelines

Mastitis treatment should involve continuing to breastfeed or express milk from the affected breast, along with antibiotics and supportive measures, to prevent milk stasis and abscess formation, as recommended by the American Academy of Pediatrics 1.

Key Considerations

• Mastitis is typically caused by skin flora like Staphylococcus aureus, and prompt treatment is essential to prevent complications.
• Breastfeeding or expressing milk from the affected breast should be continued to prevent milk stasis and abscess formation.
• Antibiotics, such as dicloxacillin or cephalexin, may be prescribed for 10-14 days to treat the infection.
• Supportive measures, including warm compresses, cold packs, and pain relief medications like ibuprofen or acetaminophen, can help manage symptoms.

Treatment Approach

• For mild to moderate mastitis, antibiotics and supportive measures are usually sufficient.
• For severe cases or concerns about MRSA, alternative antibiotics like clindamycin may be used.
• It is essential to monitor symptoms and seek medical attention if they worsen or if a breast mass develops, as this may indicate abscess formation requiring drainage.

Benefits of Continued Breastfeeding

• Continued breastfeeding or milk expression can help prevent milk stasis and abscess formation.
• Breastfeeding also provides numerous benefits for the infant, including reduced risk of SIDS, infant mortality, and various infections, as well as potential long-term benefits like lower risk of asthma, eczema, and obesity 1.

From the Research

Mastitis Treatment

• The treatment of mastitis includes changing breastfeeding technique, often with the assistance of a lactation consultant 2.
• When antibiotics are needed, those effective against Staphylococcus aureus (e.g., dicloxacillin, cephalexin) are preferred 2.
• As methicillin-resistant S. aureus becomes more common, it is likely to be a more common cause of mastitis, and antibiotics that are effective against this organism may become preferred 2, 3.
• Continued breastfeeding should be encouraged in the presence of mastitis and generally does not pose a risk to the infant 2.

Antibiotic Treatment

• The incidence of mastitis caused by MRSA is unknown, but likely increasing 3.
• Recent evidence suggests that MRSA has become the prominent pathogen in mastitis, and physicians caring for patients with mastitis need to be aware of this bacteriologic shift to treat appropriately 3, 4.
• Methicillin resistance was identified in 44.7% of S. aureus strains, with 80.9% of cases of abscess and 19.1% of cases of mastitis 4.

Breast Abscess Treatment

• Breast abscess is the most common complication of mastitis, and can be prevented by early treatment of mastitis and continued breastfeeding 2.
• Once an abscess occurs, surgical drainage or needle aspiration is needed 2.
• Breastfeeding can usually continue in the presence of a treated abscess 2.