OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also:

• milk and dairy products
• post-partum / puerperial complications
• Australian Therapeutic Guidelines including drugs in pregnancy for WH users
• Australian Breastfeeding Association - breast and nipple care
• Australian Breastfeeding Association - breast feeding main index
• Australian Prescriber 2011 - analgesics in pregnancy and breastfeeding

• the patient who is breastfeeding raises several issues to be considered including choice of medications (and investigations such as nuclear medicine) which are safe for the infant.
• see Australian Therapeutic Guidelines

• RWH patient information sheet - mastitis

• start Rx early
• apply heat packs, gentle massage any lumps
• continue breastfeeding (milk is safe for the infant) or express milk

• Continue to breastfeed and/or express
• Prior to feeding or expressing apply warmth (heat pack) to the affected area to improve milk flow
• Following massage/ breastfeeding / expressing, apply a cool pack for a few minutes to reduce discomfort
• analgesia eg Paracetamol or Ibuprofen
• Maintain a good fluid intake (up to 8 glasses of water per day)
• rest as much as possible (but don't get a DVT!)
• usually will need antibiotics (eg. iv or o flucloxacillin - safe for infant but may cause some diarrhoea)
• consider admission if very unwell
• consider diagnostic ultrasound if suspicion of breast abscess which may need surgical drainage
  • usually breast abscesses in lactating women are managed by O&G staff, whilst those in non-lactating women are managed by general surgery or a breast unit.