New recommendations on mastitis spectrum diagnosis and treatment

The Academy of Breastfeeding Medicine (ABM) has released new recommendations for the diagnosis and treatment of the mastitis spectrum. These recommendations are published in the journal Breastfeeding Medicine.

Mastitis is a common maternal complication of lactation and contributes to early cessation of breastfeeding. Mastitis, or inflammation of the mammary gland, is not a single condition, but rather a spectrum of conditions that result from ductal inflammation and stromal edema.

Katrina Mitchell, MD, from Ridley-Tree Cancer Center, Sansum Clinic, Santa Barbara, CA, and coauthors, on behalf of the ABM, discuss the pathophysiology, diagnosis, and management of each condition in the mastitis spectrum in ABM Clinical Protocol #36.

Recommendations for spectrum-wide conditions include reassuring mothers that many mastitis symptoms will resolve with conservative care and psychosocial support; continuing to feed the infant on demand; minimizing breast pump usage; and avoiding the use of nipple shields.

The authors also review medical interventions to decrease inflammation and pain and treat hyperlactation or breast milk oversupply. Interventions include the use of antibiotics to treat bacterial mastitis, therapeutic ultrasound, and the use of probiotics.

"This comprehensive and detailed Protocol will serve as a practical guide for clinicians who will be managing one of the most common clinical problems in nursing mothers," says Arthur I. Eidelman, MD, Editor-in-Chief of Breastfeeding Medicine.