What to do if you have chest pain and fever during breastfeeding

Symptoms of chest pain and fever during breastfeeding are likely to be caused by mastitis. This stage is very important. The child's nutrition mainly comes from breastfeeding. Any abnormalities need to be resolved in a timely manner. It is also a hidden danger to one's own health. The key is to find out as soon as possible whether it is caused by mastitis and then treat it symptomatically. So, what should I do if I have chest pain and fever during breastfeeding? Let’s look at the solutions below.

Acute mastitis is an acute suppurative infection of the breast, an inflammation of the connective tissue in and around the mammary ducts. It often occurs in postpartum and lactating women, especially primiparas. Literature reports that 50% of acute mastitis occurs in primiparas, and the ratio of primiparas to multiparas is 2.4:1. It can occur at any time during lactation, but is most common 3 to 4 weeks after delivery, so it is also called puerperal mastitis.

Clinical manifestations

1. Stasis mastitis

It occurs in the early postpartum period (usually about 1 week after delivery). Because first-time mothers lack experience in breastfeeding, it is easy for milk to accumulate and not be emptied on time. The patient felt varying degrees of pain and swelling in both breasts and had a moderate fever (around 38.5°C). Examination of the breasts reveals fullness, redness (congestion) on the surface, and tenderness, but the symptoms usually disappear after the milk is expressed. However, if not treated in time, or if the nipple is small and is broken by the newborn's sucking, the retained milk may be contaminated by purulent bacteria. Therefore, excess milk must be drained and nipples must be kept clean.

2. Suppurative mastitis

It is usually caused by infection of staphylococci or streptococci through a ruptured nipple. As mentioned earlier, postpartum milk accumulation can easily lead to infection if it is not emptied in time. After bacteria invade the mammary ducts, they continue to invade the parenchyma, which can cause various types of suppurative mastitis.

(1) Inflammation spreads to the superficial lymphatic vessels, leading to erysipelas-like lymphangitis. The patient develops a sudden high fever, often accompanied by chills, breast tenderness, and red spots or lines on the local skin, which are characteristic of this type.

(2) The inflammation is confined to the connective tissue of the areola, forming a subareolar abscess.

(3) The infection spreads along the lymphatic vessels into the breast stroma, from the surface to the base, across the breast tissue. Interstitial abscess is formed due to suppuration of connective tissue. This type of abscess may be confined to a single breast lobule or may spread to the majority of the breast.

(4) The infection spreads rapidly, reaching deep into the loose connective tissue behind the breast between the base of the breast and the pectoralis major muscle, forming a retromammary abscess.

The area where inflammation or abscess is located will show redness, swelling and tenderness. The abscess area may feel fluctuating when pressed. If necessary, a test puncture can be performed to extract pus for bacteriological examination and a drug sensitivity test for reference in selecting antibiotics.

treat

1. Before abscess formation

(1) In the early stage, mothers with only milk stasis may have mild systemic symptoms and can continue breastfeeding. Active measures can be taken to promote smooth milk discharge and reduce stasis. Use a bandage or breast support to lift the breasts. Patients with milk stasis can continue breastfeeding and apply ice compresses locally to reduce milk secretion.

(2) Local treatment: For those with obvious breast swelling or lump formation, local hot compresses can help dissipate inflammation. Each hot compress should last for 20 to 30 minutes, 3 times a day. For severe cases, 25% magnesium sulfate wet compresses can be used.

(3) Antibiotics: Select antibiotics that are sensitive to Staphylococcus aureus and take them orally, by intramuscular injection, or by intravenous drip, depending on the condition.

2. Abscess has formed

Drainage should be done promptly. The incision is generally radial with the nipple and areola as the center. For shallow abscesses under the areola, an arc-shaped incision can be made along the areola. If the abscess is located behind the breast, an arc-shaped incision should be made in the skin fold 1 to 2 cm below the breast.