Revista Clínica de Medicina de Familia
Print version ISSN 1699-695X
VAYAS ABASCAL, Rocío and CARRERA ROMERO, Luis. Update on management of infectious mastitis during the breastfeeding period. Rev Clin Med Fam [online]. 2012, vol.5, n.1, pp.25-29. ISSN 1699-695X. http://dx.doi.org/10.4321/S1699-695X2012000100005.
Premature termination of breastfeeding is of multifactorial origin, but mastitis is the most important medical reason for early, unwanted weaning. The current study is an updated review of etiology, diagnosis and therapeutics of this disease. We found few studies on the microbiology of human milk and a lack of randomized, controlled trials evaluating effective treatment of mastitis. In routine clinical practice, diagnosis and treatment of this disease are not based on scientific evidence, leading to underdiagnosis and frequent therapeutic mismanagement, with harmful consequences: cessation of breastfeeding, breast abscess or sepsis. Diagnosis of mastitis continues to be based on visual inspection of the breast and breastmilk cultures are rarely performed. Treatment should be based on effective extraction of the milk, with continued breastfeeding, analgesic/anti-inflammatory drugs and rational use of antibiotics. However, the drug regimen is usually empirically chosen, based on physician´s preference and without scientific evidence to support the decision. The main conclusion of our review is that breastmilk culture is an essential diagnostic tool that should be used for all breastfeeding women with breast pain. It facilitates correct diagnosis of mastitis, its etiology and is the key to establishing proper treatment based on antibiotic sensitivity of the causative agent.
Keywords : Mastitis; Breast Feeding; Microbiological Analysis; Treatment.