Last update June 7, 2022

Puerperal mastitis

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Mastitis is an inflammation of the breast that, if mishandled, can end up becoming infected. When there is infection, the most frequently implicated germ is Staphylococcus aureus (Cullinane 2022, Paricio 2017, Amir 2016, Espinola 2016, Baeza 2015, Amir 2014, Spencer 2008).

Coagulase negative staphylococci (CoNS) such as S. epidermidis are not associated with mastitis (Culinane 2022). There is also no evidence that bacterial biofilms are a cause of blocked ducts and mastitis. (Douglas 2022). Studies are needed to determine the aetiological role of Candida albicans, which appears to be a minority. (Amir 2014, Hanna 2011, Carmichael 2002, Brent 2001)

Damaged nipple, infrequent feedings, scheduled frequency or duration of feedings, missed feedings and poor latch are risk factors for mastitis. (Wilson 2020, Amir 2014)

Effective treatment requires resting of the mother, a frequent emptying of the breast, use of anti-inflammatory drugs and in case of no amelioration, it should be necessary a course of antibiotics that must be effectively active against Staphylococcus aureus. (Paricio 2017, Espinola 2016, Amir 2014, Cabou 2011, Spencer 2008). High-quality double-blind RCTs are needed to determine the use of antibiotics in mastitis. (Jahanfar 2013)

The nursing infant may be latched on to the inflamed breast without bad consequences for the child (Amir 2014, Lawrence 2013, WHO 2000). Emptying of the breast is important for treatment, with the baby being the most effective extractor. Better results are obtained with a continued lactation during the treatment with antibiotics. Incidentally, the baby may refuse sucking the breast because a salted flavor of the milk, in which case, it should be manually or mechanically pumped.

Medication used for the treatment of mastitis, such as antibiotics and anti-inflammatory drugs, is compatible with breastfeeding.

Breast milk culture is only indicated if (Paricio 2017, Espínola 2016, Amir 2014)

  • no response to antibiotic therapy within 48 hours
  • return or recurrence of mastitis
  • nosocomial mastitis (hospital-acquired)
  • patient allergic to beta-lactam antibiotics
  • region with excessive frequency of methicillin-resistant staphylococci
  • serious or unusual case of entry

As of the last review, there is no valid scientific evidence that the use of probiotics is effective in treating mastitis or breast pain in women (WHO 2022, Crepinsek 2020, Barker 2020, Paricio 2017, Espínola 2016, Amir 2016, Baeza 2015, Amir 2014). Its indiscriminate use can delay other treatments and be financially burdensome (WHO 2022, Amir 2016).Evidence that orally administered can get into the milk is lacking. (Elias 2011)

The use of presumably preventive probiotics during pregnancy was associated with an increased risk of mastitis and other complications of breastfeeding during the first month of breastfeeding. (Karlsson 2019)


See below the information of these related products:

  • Cefadroxil ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cephalexin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cloxacillin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Ibuprofen ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Paracetamol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Probiotics (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Puerperal mastitis is also known as Maternal Mastitis. Here it is a list of alternative known names::


Group

Puerperal mastitis belongs to this group or family:

References

  1. WHO. WHO recommendations on maternal and newborn care for a positive postnatal experience. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO. Consulted on June 6, 2022 Abstract Full text (link to original source) Full text (in our servers)
  2. Cullinane M, Scofield L, Murray GL, Payne MS, Bennett CM, Garland SM, Amir LH; CASTLE Study team.. Random amplified polymorphic DNA analysis reveals no clear link between Staphylococcus epidermidis and acute mastitis. Aust N Z J Obstet Gynaecol. 2022 Mar 1. Consulted on June 4, 2022 Abstract Full text (link to original source) Full text (in our servers)
  3. Wilson E, Woodd SL, Benova L. Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review. J Hum Lact. 2020 Nov;36(4):673-686. Abstract Full text (link to original source)
  4. Crepinsek MA, Taylor EA, Michener K, Stewart F. Interventions for preventing mastitis after childbirth. Cochrane Database Syst Rev. 2020 Sep 29;9:CD007239. Abstract Full text (link to original source)
  5. Barker M, Adelson P, Peters MDJ, Steen M. Probiotics and human lactational mastitis: A scoping review. Women Birth. 2020 Nov;33(6):e483-e491. Abstract
  6. Karlsson S, Brantsæter AL, Meltzer HM, Jacobsson B, Barman M, Sengpiel V. Maternal probiotic milk intake during pregnancy and breastfeeding complications in the Norwegian Mother and Child Cohort Study. Eur J Nutr. 2019 Sep 10. Abstract
  7. Paricio Talayero JM. Diagnóstico y manejo de la mastitis en la madre lactante. Actualización. IX Congreso Español de Lactancia Materna. Mesa 6: Abordaje del dolor al amamantar. Zaragoza, 2017 Full text (link to original source) Full text (in our servers)
  8. Amir LH, Griffin L, Cullinane M, Garland SM. Probiotics and mastitis: evidence-based marketing? Int Breastfeed J. 2016 Abstract Full text (link to original source) Full text (in our servers)
  9. Espínola-Docio B, Costa-Romero M, Díaz-Gómez NM, Paricio-Talayero JM; Comité de Lactancia Materna, Asociación Española de Pediatría.. Mastitis. Puesta al día. [Mastitis update.] Arch Argent Pediatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  10. Baeza C. Dolor en la mama lactante: claves etiológicas y manejo clínico (I). Monografías Clínicas en Lactancia Materna. Madrid: Centro Raíces 2015, p.3-13. 2015 Full text (link to original source) Full text (in our servers)
  11. Amir LH; Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #4: Mastitis, Revised March 2014. Breastfeed Med. 2014;9(5):239-243. Abstract Full text (link to original source) Full text (in our servers)
  12. Amir LH. y el Comité de protocolos de la Academy of Breastfeeding Medicine. Protocolo clínico de la ABM n.o 4: Mastitis, modi cado en marzo de 2014. Breastfeed Med. 2014;9(5):239-243. Abstract Full text (link to original source) Full text (in our servers)
  13. Jahanfar S, Ng CJ, Teng CL. Antibiotics for mastitis in breastfeeding women. Cochrane Database Syst Rev. 2013 Feb 28; Abstract Full text (link to original source)
  14. Lawrence RM. Circumstances when breastfeeding is contraindicated. Pediatr Clin North Am. 2013 Feb;60(1):295-318. Abstract
  15. Hanna L, Cruz SA. Candida mastitis: a case report. Perm J. 2011 Abstract Full text (link to original source) Full text (in our servers)
  16. Elias J, Bozzo P, Einarson A. Are probiotics safe for use during pregnancy and lactation? Can Fam Physician. 2011 Abstract Full text (link to original source) Full text (in our servers)
  17. Cabou A, Babineau S, St Anna L. Clinical inquiry: what's the best way to relieve mastitis in breastfeeding mothers? J Fam Pract. 2011 Abstract Full text (in our servers)
  18. Spencer JP. Management of mastitis in breastfeeding women. Am Fam Physician. 2008 Abstract Full text (link to original source) Full text (in our servers)
  19. Carmichael AR, Dixon JM. Is lactation mastitis and shooting breast pain experienced by women during lactation caused by Candida albicans? Breast. 2002 Abstract
  20. Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001 Abstract
  21. WHO-World Health Organization. Mastitis: Causes and Management. Publication number WHO/FCH/CAH/00.13. World Health Organization, Geneva, 2000. Abstract Full text (link to original source) Full text (in our servers)
  22. OMS. Organización Mundial de la Salud. Mastitis. Causas y manejo. Organización Mundial de la Salud, 2000 - Licence: CC BY-NC-SA 3.0 IGO Abstract Full text (link to original source) Full text (in our servers)

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