Red flag to remember
Report a fluctuant, increasingly painful mass (possible abscess needing drainage).
What is mastitis?
It typically results from milk stasis and bacterial entry (often Staphylococcus aureus) through a cracked nipple. The hallmark is a localized, red, warm, tender, often wedge-shaped area on one breast accompanied by flu-like symptoms.
Key points to remember
- Usually unilateral with a hard, red, warm, painful area and systemic flu-like symptoms (fever, chills, malaise, body aches).
- Milk stasis from infrequent emptying, plugged ducts, or cracked nipples predisposes to infection.
- Continuing to breastfeed or pump is encouraged because keeping the breast emptied promotes healing.
- Treatment is a full course of antibiotics (e.g., dicloxacillin or cephalexin), analgesics, rest, and fluids.
- Warm compresses before feeding aid milk flow; cool compresses after feeding reduce pain and swelling.
- An untreated or worsening infection can progress to a breast abscess requiring drainage.
Signs & symptoms
- Red warm tender wedge-shaped area
- Fever, chills, flu-like, malaise
Nursing priorities
- Encourage frequent, complete breast emptying by continued nursing/pumping, starting on the affected side.
- Administer the full prescribed antibiotic course and analgesics; teach completing all antibiotics.
- Apply warm compresses before feeding and cool compresses afterward, and promote rest and fluids.
- Assess and teach correct latch and breast care to prevent recurrence.
- Monitor for a localized fluctuant mass suggesting abscess.
Labs & values
WBC may be elevated with infection (normal ~5,000-10,000/mm3)
Patient teaching
- Keep breastfeeding or pumping frequently; emptying the breast helps it heal and the milk is safe for the baby.
- Complete the entire antibiotic course even after feeling better.
- Prevent recurrence with proper latch, frequent feeding, varied positions, and prompt care of cracked nipples; rest and increase fluids.
Red flags: report now
- Report a fluctuant, increasingly painful mass (possible abscess needing drainage).
- Report high or persistent fever or worsening symptoms despite 48-72 hours of antibiotics.
- Never advise stopping breastfeeding on the affected side; abrupt weaning worsens stasis.
References
Clinical references for this topic
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