What are signs of mastitis and initial management?

• A. Tender, warm breast with fever; continue breastfeeding, apply warm packs, and start antibiotics such as dicloxacillin or cephalexin
• B. Stop breastfeeding immediately to prevent infection
• C. No treatment needed if fever absent
• D. Avoid warm packs and only use cold compresses

Answer: (A)

Signs of mastitis involve a tender, warm breast with possible redness and fever, often accompanied by malaise. This combines local inflammation from milk stasis with infection risk, so the focus is on both draining the milk and treating the infection.

Initial management aims to keep milk flowing and address the infection. Continue breastfeeding from the affected breast (and/or the other breast as comfortable) to drain milk and relieve engorgement. Apply warm packs to the affected area to ease milk flow and reduce discomfort, and consider gentle massage during feeds. Start antibiotics that cover common pathogens, such as dicloxacillin or cephalexin, as soon as mastitis is suspected. Analgesics and rest are helpful, and contact a clinician if symptoms persist or worsen after 24 to 48 hours.

Stopping breastfeeding would worsen milk stasis and is not recommended. Fever can be present with mastitis even if not always, so no treatment isn’t appropriate. Avoiding warm packs in acute mastitis reduces the chance to relieve congestion, so cold compresses alone aren’t sufficient.