Patient's question:
Postpartum mastitis with a high fever of 39.5. Taking fever-reducing medication dropped it to 38.5. Can I use alcohol to bathe for cooling?Doctor's answer:
Hello, if the temperature doesn't drop below 38.5°C in this situation, it may still be necessary to continue physical cooling. Mastitis refers to an acute purulent infection of the breast, a common condition during the postpartum period, and one of the causes of postpartum fever. It is most common in breastfeeding women, especially first-time mothers. It can occur at any time during breastfeeding, with the onset being most common.Etiology and Pathogenesis
1. Milk Stasis: Milk stasis provides a favorable environment for the growth and reproduction of invading bacteria.
- ① Small or inverted nipples hinder breastfeeding.
- ② Excessive milk production with incomplete emptying, and the failure of the mother to promptly empty the excess milk from the breasts.
- ③ Obstructed milk ducts due to inflammation of the ducts themselves or blocked ducts by fallen fibers from bras.
2. Bacterial Invasion: When nipples are inverted, infants have difficulty suckling, which can cause damage to the nipple area, providing a major pathway for bacteria to invade through lymphatic vessels. Additionally, if infants frequently suck on the nipple while sleeping, inflammation in the infant's mouth can directly spread to the milk ducts, subsequently diffusing into the breast tissue and causing purulent infection. The most common pathogen is Staphylococcus aureus.
The condition may develop due to maternal anger, frustration, emotional distress, and unrelieved liver Qi, combined with a rich diet, heat accumulation in the stomach, disharmony between the liver and stomach, and the failure to release liver Qi, leading to heat retention in the Yangming meridians. This results in blocked meridians, impaired milk duct function, stagnant Qi and blood, and the formation of abscesses. Alternatively, cracked nipples, nipple deformities or inversion, pain during breastfeeding affecting full milk removal, excessive milk production with insufficient intake, improper weaning, or the accumulation of stagnant milk that does not dissipate, or external invasion by wind-heat toxins, can all lead to milk stasis, impaired milk duct flow, blocked ducts, and the accumulation of pus that turns into abscesses.
Clinical Manifestations
1. Acute Simple Mastitis: In the initial stage, it primarily involves breast swelling and pain, with localized skin warmth, tenderness, and the appearance of ill-defined hard lumps that are tender to touch.
2. Acute Purulent Mastitis: The local skin appears red, swollen, warm, and painful, with more pronounced hard lumps and increased tenderness. Patients may also experience chills, high fever, headache, weakness, and a rapid pulse.
3. Abscess Formation: Due to inadequate treatment or worsening of the condition, local tissue may necrotize and liquefy, with varying-sized infection foci merging to form an abscess. The abscess may be unilocular or multilocular.
Treatment
The best current treatment for mastitis is Traditional Chinese Medicine (TCM) and herbal therapy. It is recommended to use topical TCM herbal applications. Qiu-Yi-Tang ointment patches can treat mastitis, breast lumps, and breast pain. Through external application of the ointment, it promotes the unblocking of meridians, activates blood circulation, resolves stasis, reduces swelling and pain, and softens and dissolves hard lumps. It rapidly clears blocked milk ducts, eliminates inflammation, reduces swelling and pain; removes stagnant toxins from the breast, softens and absorbs proliferative tissue; and effectively activates glandular tissue, promoting normal cell differentiation, so that breast diseases do not recur. It has no adverse effects on the liver, stomach, or kidneys of patients, offering rapid, long-lasting, and side-effect-free relief.
Mastitis Care and Prevention
1. Avoid milk stasis.
2. Prevent nipple damage and seek timely treatment if any occurs.
3. Do not allow the baby to suck on the nipple while sleeping.
4. Eat more coarse grains.
5. Massage and maintain breast health during pregnancy.