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Breast Abscess / Infection

Intro

Call your health care provider as soon as you feel any suspicious lump, whether you are breastfeeding or not. Call for an appointment if you experience the following:

You have any abnormal discharge from your nipples.
Breast pain is making it difficult for you to function each day.
You have prolonged, unexplained breast pain.
You have any other associated symptoms that you are worried about such as redness, swelling, pain that interferes with breastfeeding, or a mass or tender lump in the breast that does not disappear after breastfeeding.
If you are breastfeeding, call your doctor if you develop any symptoms of breast infection so that treatment may be started promptly.

You may need to be evaluated in a hospital's emergency department if the breast pain is associated with other signs of an infection (such as a fever, swelling, or redness to the breast) and if your health care provider cannot see you promptly. Go to the emergency department if you experience any of the following:

A persistent high fever greater than 101.5°F (38.6°C)
Nausea or vomiting that is preventing you from taking antibiotics as prescribed
Pus draining from the breast
Red streaks extending toward your arm or chest
Dizziness, fainting, or confusion

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Self-Care at Home

After you see a doctor, try the following to help your breast infection heal well.

  • Pain medication: Take acetaminophen or ibuprofen for pain. These medicines are safe while breastfeeding and will not harm your breastfeeding baby. Your doctor may prescribe a prescription strength pain reliever if your pain is severe and not relieved with over-the-counter medication.
  • In mild cases of mastitis, antibiotics may not be prescribed at all. If you are prescribed antibiotics, finishing the prescription even if you feel better in a few days is very important.
  • Frequent feedings: Do not stop breastfeeding from the affected breast, even though it will be painful. Frequent emptying of the breast prevents engorgement and clogged ducts that can only make mastitis worse.

If needed, you can use a breast pump to completely empty the breast.
The infection will not harm the baby because the germs that caused the infection probably came from the baby’s mouth in the first place. An alternative to this is to pump the affected breast to relieve the milk and discard the milk. Breastfeed from the unaffected side and supplement with infant formula as needed.

Pain relief: A warm compress applied before and after feedings can often provide some relief. A warm bath may work as well.

If heat is ineffective, ice packs applied after feedings may provide some comfort and relief.
Avoid using ice packs just before breastfeeding because it can slow down milk flow.
Drink plenty of water—at least 10 glasses a day. Eat well-balanced meals and add 500 extra calories a day while breastfeeding. Dehydration and poor nutrition can decrease milk supply and make you feel worse.

Mastitis does not cause cancer, but cancer can mimic mastitis in appearance. If a breast infection is slow in going away, your health care provider may recommend a mammogram or other tests to rule out cancer .

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Follow-up

If you have a breast infection, you will usually be seen for a recheck in 24-48 hours.

  • Take all antibiotics as prescribed.
  • Take your temperature three times a day for the first 48 hours after treatment begins. Watch for fever.
  • Call your doctor if you develop a high fever, vomiting, or increasing redness, swelling, or pain in the breast.
  • Follow up with your doctor in one to two weeks to make sure that the infection has gone away. If the infection spreads or an abscess develops, you may require IV antibiotics or surgical treatment.
Prevention

Sometimes mastitis is unavoidable. Some women are more susceptible than others, especially those who are breastfeeding for the first time. In general, good habits to prevent mastitis include the following:

  • Breastfeed equally from both breasts.
  • Empty breasts completely to prevent engorgement and blocked ducts.
  • Use good breastfeeding techniques to prevent sore, cracked nipples.
  • Avoid dehydration by drinking plenty of fluids.
  • Practice careful hygiene: Handwashing, cleaning the nipples, keeping your baby clean.

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