Early postpartum acute mastitis treated with TCM evidence-based treatment

  Acute mastitis is an acute purulent infection caused by the infiltration of bacteria into the breast tissue, mostly in nursing women who have not yet reached the full term after childbirth. In Chinese medicine, it is called canker sores, which are usually caused by broken nipples, external attack of wind or stagnation of milk, blockage of milk channels and heat. Our department adopts internal Chinese medicine, external Chinese medicine and breast drainage techniques to treat patients with acute mastitis in early postpartum period, and the efficacy is definitely reported as follows: ① Internal Chinese medicine: Guahuaguo burdock soup plus reduction. If the pain is severe, add 15g of frankincense and 15g of myrrh; if the lump is hard, add 15g of zhebei and 15g of soapberry. The decoction will be made into oral decoction by the preparation room of the hospital, 1 dose/day, 2 times/day, 100ml/time, taken orally. ②Therbal external application. 50g of Chinese herbal medicine mangosteen is mixed into a paste with pure water and then applied to the affected breast for 20min, 1 time/day. ③Breast massage. Give local hot compress for 10 min before each massage. pay attention to the appropriate temperature when hot compressing, to prevent burns. Before massage, apply local lubricant (such as petroleum jelly, sesame oil, etc.) to the breast to prevent skin damage; then hold up the breast with the left hand, use the right hand five fingers or wooden comb from the breast around to the nipple direction massage or combing again, about 50 to 100 times / times, then use the fingers finger belly using kneading, pushing, squeezing, grasping techniques to gently massage the affected breast hard swollen lumps, massage and then use the fingers to hold the areola and nipple gently lift several times. After the massage, the areola and nipple are gently lifted and pulled several times with the fingers to expand the milk ducts of the nipple to achieve the purpose of smooth drainage. Teach the patient or family members, 2 times/day.  Acute mastitis is called canker sore in Chinese medicine, and the key to treatment is early. If you master the principles of early treatment and active and effective methods, you can basically be cured and avoid the pain caused by breast-feeding. In the early stage, most of the cases are caused by milk stagnation, emotional and mental disorders, poor diet, or external wind [2]. Clinically, the internal use of Chinese herbs to clear the liver and stomach and disperse the lumps of breast milk, with the addition and subtraction of Guahuo burdock soup, and the external use of wet compresses and breast massage can make the lumps dissipate and drain the breast milk smoothly.  In clinical practice, attention should also be paid to psychological guidance and communication with patients to relieve their mental tension; patients should be instructed to use a breast pump to suck out the accumulated milk regularly to relieve pain, and in case of difficulty in sucking, they should be encouraged to persist, but each sucking time should not be too long; the diet should be light and easy to digest, and high-fat, high-protein and milk-producing products such as soups should be consumed sparingly to reduce milk secretion; to keep milk secretion smooth, and in the early stage, it is generally not recommended to stop breastfeeding. The woman should be encouraged to continue breastfeeding to facilitate the discharge of stagnant milk.  For patients who are recovering from acute mastitis, they should be instructed to develop good hygiene habits. The first thing to do is to pay attention to nipple hygiene and wash with warm boiled water before and after breastfeeding. Secondly, develop the habit of breastfeeding regularly, try to empty the milk each time you breastfeed, use a breast pump or massage with your hands if necessary to prevent stagnation, and use a suitable bra to hold the breast up. Again, pay attention to the oral hygiene of the child and do not let the baby sleep with the nipple.