Management of Mastitis

Initial Conservative Management

The American Academy of Pediatrics recommends continuing direct breastfeeding from the affected breast, as effective milk removal is essential for resolution, in patients with mastitis 1

Breastfeeding from the affected breast is safe unless the infant's mouth would contact purulent drainage from an abscess, and regular feeding or milk expression serves as an adjunct to antibiotic therapy, according to the American Academy of Pediatrics 1

Approximately 10% of mastitis cases progress to breast abscesses requiring drainage, and abscess drainage is required when conservative and antibiotic therapy fail, as reported in Pediatrics 1

The British Journal of Pharmacology recommends first-line antibiotics, such as Dicloxacillin or cloxacillin (flucloxacillin), which target Staphylococcus aureus, the most common bacterial cause of mastitis 2
For penicillin-allergic patients, the Clinical Infectious Diseases guidelines suggest alternative antibiotics, such as Cephalexin 500 mg orally every 6 hours (if no severe penicillin allergy) 3
The American Academy of Pediatrics recommends continued breastfeeding during antibiotic treatment, as it helps resolve the condition and does not pose a risk to the infant, with the transfer of dicloxacillin/cloxacillin to breast milk being minimal 4