Mastitis treatment protocol

Abstract

Mastitis occurs on average in 10% of nursing mothers, most often in the early weeks postpartum. Its etiopathogenesis involves mechanical and infectious factors. A key role is played by poor attachment of the infant at the breast. The diagnosis is based on history and breast examination; culture of a milk sample is sometimes indicated. Therapeutic decisions are based on assessment of symptom intensity and the mother’s condition. An essential part of treatment is to ensure frequent milk removal through the mammary gland. In cases of ineffective infant sucking, milk removal by pumping is recommended. Cooperation with a lactation clinic may be advantageous. The basic treatment is administration of nonsteroidal anti-inflammatory drugs (NSAD). In some cases, especially with a concomitant nipple fissure, Staphylococcus-targeted antibiotic therapy is required. Prevention measures include skin-to-skin contact after birth, proper and frequent breastfeeding (at least 8 times a day) and hand washing by the mother and healthcare staff. Recent reports suggest the use of lactic acid bacteria isolated from the breast milk of healthy women for improvement of milk duct microbiota as a prophylactic and therapeutic measure, but this requires further studies.

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