Postpartum mastitis presents with which signs, and what is the initial management?

• A. Breast tenderness, localized redness and warmth; continue breastfeeding, apply warm compresses, and treat with antibiotics as prescribed.
• B. Breast engorgement only; stop breastfeeding and use ice packs.
• C. Nipple fissure without infection; apply barrier cream only.
• D. Systemic fever without breast findings; observe and reassess in 48 hours.

Answer: (A)

Postpartum mastitis shows up as breast tenderness with redness and warmth over a localized area, often accompanied by fever or malaise. This pattern means there is an infection in the breast tissue, usually related to milk stagnation and possible nipple damage. The best first step in management is to keep the breast draining: continue breastfeeding from the affected breast (or pump to empty it) on a regular schedule. This helps clear the milk ducts and reduces pressure that can feed the infection. Warm compresses before feeds aid milk flow, and analgesics can ease pain. Start an antibiotic that is safe for a breastfeeding parent, as prescribed, to tackle the infection. If fissures exist, address nipple care to promote healing and prevent recurrent breaks. Improvement is typically seen within a couple of days; if symptoms persist or worsen, reassess for complications like an abscess or consider alternative diagnoses.