A 27-year-old primipara presents on day 10 postpartum with fever, chills, and a unilateral wedge-shaped area of erythema and tenderness in the right breast. She has been feeding well. What is the most appropriate advice regarding breastfeeding?

• A Stop breastfeeding from both breasts until antibiotics are completed
• B Resume feeding only after milk cultures are negative
• C Feed only from the unaffected breast and suppress lactation on the affected side
• D Continue frequent breastfeeding or expression from the affected breast along with antibiotics ✓

Explanation

This is acute lactational mastitis, most commonly caused by Staphylococcus aureus entering through nipple cracks. Emptying of the breast by continued feeding or expression is part of treatment, and stopping drainage worsens engorgement and abscess formation. Milk from a treated mother is safe for the baby, and cloxacillin or flucloxacillin is compatible with breastfeeding. Abscess formation requires drainage, but this patient has no fluctuant mass.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.