When it comes to mastitis, you may have heard the best course of action is simply a course of antibiotics. The problem with this is… antibiotics are not always necessary! First, let’s talk about why we don’t always need antibiotics. There are TWO different types of mastitis. The first type is what we call non-infective/inflammatory. This is when there is a blockage of the milk duct and surrounding inflammation of the breast tissue. It looks and feels the same as it’s counterpart INFECTIVE mastitis. The real difference between the two is whether there is bacteria causing the inflammation. In infective mastitis, antibiotics are a great tool as the antibiotics fight off the bacteria in the breast tissue. But if we only have inflammatory mastitis when there is NO bacteria, antibiotics don’t really have a purpose!
On a surface level… not much. BUT the problem with using antibiotics when they aren’t needed is it can lead to bacteria becoming RESISTANT to antibiotics. What does this mean exactly? Essentially what happens is the bacteria can learn and then they adapt so the antibiotics can’t affect them. This can lead to infections that are very difficult for your medical professional to treat!
The simple answer is if it’s not an infection yet, antibiotics just aren’t needed. The best action plan is to monitor your symptoms, if there is no change after 12-24 hours antibiotics might be the next step to take. In other good news as well, when we stop prescribing antibiotics unnecessarily, we see a decrease in the number of resistant infections as well!
The cause of inflammatory mastitis is milk stasis – where the milk flow is obstructed. This creates irritation and inflammation of the surrounding tissue. Therefore, the best approach is to aim at getting that milk moving again. We want to be able to get rid of any blockages, and surrounding congestion to help minimise the inflammation. We can do this with hands-on techniques like massage, movement practice (stretching and using our joints to encourage fluid movement), and if you’re in the clinic we can use therapeutic ultrasound too (which you can read about HERE).
Overall, we’re definitely PRO antibiotics BUT only if the antibiotics are genuinely needed to help treat an infection!
You might also be interested in reading Do you always need antibiotics for mastitis?
Abadi, A., Rizvanov, A. A., Haertle, T., & Blatt, N. L. (2019). World Health Organization Report: Current Crisis of Antibiotic Resistance. BioNanoScience, 9.
Betzold, C. M. (2007). An Update on the Recognition and Management of Lactational Breast Inflammation. Journal of Midwifery & Women’s Health, 52(6).
Fiore, D. C., Fettic, L. P, Wright, S. D., & Ferrara, B. R. (2017). Antibiotic overprescribing: Still a major concern. The Journal of Family Practice, 66(12).