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Mastitis: Rapid Evidence Review.
Erin F Morcomb1, Carmen M Dargel1, Sydney A Anderson2
1Mayo Clinic College of Medicine and Science, La Crosse, Wis.
American Family Physician
|August 22, 2024
Summary
Lactational mastitis, common in postpartum women, is often inflammation, not infection. Conservative treatment like NSAIDs and direct infant feeding is usually effective, with antibiotics reserved for persistent symptoms.
Area of Science:
- Obstetrics and Gynecology
- Lactation Medicine
- Infectious Diseases
Background:
- Lactational mastitis affects approximately 10% of US women postpartum.
- Diagnosis is typically clinical, based on symptoms like fever and breast tenderness.
- Inflammation, rather than infection, underlies most mastitis cases.
Purpose of the Study:
- To review the diagnosis and management of lactational mastitis.
- To differentiate between inflammatory and infectious causes.
- To provide evidence-based treatment and prevention strategies.
Main Methods:
- Clinical diagnosis based on symptoms.
- Consideration of milk cultures for antibiotic guidance.
- Ultrasonography for abscess detection in specific cases.
Main Results:
- Conservative measures (NSAIDs, ice, direct feeding) are effective for inflammation.
- Antibiotics are reserved for cases unresponsive to conservative treatment.
- Probiotics lack evidence for mastitis treatment or prevention.
Conclusions:
- Most mastitis cases resolve with conservative management.
- Proper lactation techniques are crucial for prevention.
- Avoidance of aggressive breast massage and excessive pumping is recommended.
