A breastfeeding mother presents on postpartum day 18 with a unilateral erythematous, tender, wedge-shaped area on the breast and fever of 38.5 degrees C. There is no fluctuant mass. Which is the most appropriate management?
- A Stop breastfeeding from the affected breast and apply a compression bandage
- B Immediate incision and drainage followed by suppression of lactation
- C Flucloxacillin with continued frequent emptying of the affected breast ✓
- D Oral cabergoline until the inflammation settles
Correct answer: C. Flucloxacillin with continued frequent emptying of the affected breast
Explanation
Lactational mastitis is most commonly caused by Staphylococcus aureus entering through nipple cracks. Treatment is an anti-staphylococcal penicillin such as flucloxacillin combined with continued breastfeeding or expression, because drainage of milk promotes resolution and abrupt cessation predisposes to abscess formation. Incision and drainage is reserved for a formed breast abscess, which this patient does not have.
Reference: DC Dutta's Textbook of Obstetrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.