Mastitis during breastfeeding is a very annoying thing, not only is it painful for you, but it is also a big problem if you want to continue breastfeeding. If you want to continue breastfeeding, you are afraid that your child will eat the milk containing pus or drugs, which will affect your health; if you don’t breastfeed, it will be more difficult to solve the problem of bruised breasts and your child will cry. …… Before you figure out the impact of inflammation on breastfeeding, let’s take a look at how mastitis occurs during breastfeeding. Lactation mastitis generally occurs under two conditions: 1. The milk ducts are blocked and milk is stagnant in the breast. 2. Bacteria multiply up in the area of the stagnant milk. Mastitis generally goes through three stages, and the impact of breastfeeding on the health of the baby and the health of the mother is different in different stages. 1.Stage of milk stasis: within 1 day and up to 3 days after the blockage of milk ducts. A large amount of milk is trapped in the breast, and in the early stage thick milk is predominantly thick, with little bacterial content. Over time the bacterial content of the milk increases and can slowly become purulent. At this time, the structure of the milk ducts remains basically intact, and the milk and purulent material retained in the ducts can be discharged smoothly as long as the blockage in the ducts can be unblocked. The clinical presentation is dominated by a limited lump in the breast with normal or mildly reddened skin on the surface of the lump, but without significant edema and with increased pain on pressure. In some patients, white plugs blocking the milk holes can be found in the nipples. It may be accompanied by a bad chill, low fever or moderate fever or more. During this period, the key to treatment is to unblock the milk ducts and drain the stagnant milk by squeezing or pumping. It is necessary to drink plenty of water and eat a light diet, and antibiotics are usually not used. In the early stages of lactation, especially within 4 to 5 hours of the onset of lactation, the lactated milk has not deteriorated and can be safely nursed on the affected breast. The baby’s sucking is very strong and is an excellent way to unblock the milk ducts. By breastfeeding, not only is the baby fed, but the mother’s mastitis is also treated. As the blockage lengthens, the bruised milk will become more viscous and slowly turn to a yellowish or yellowish slightly greenish color. At this point the milk contains bacteria and pus, but it is not toxic and a healthy baby will not get sick from eating a small amount of this milk. However, if the baby is weak and sick, or if the parents cannot accept feeding the baby with this disgusting milk, they can try to drain the stagnant milk by squeezing, pumping or unblocking the milk ducts with a probe before nursing the baby. In short, patients with mastitis at this stage can continue to breastfeed, both on the healthy and affected side of the breast. 2. Early pus-forming stage: If the stagnant milk is not drained in time within 1 to 2 days, the inflammation of the breast tissue where the lump is located will increase and the milk ducts will be destroyed, forming many small pus cavities. At this time, the pus cannot be discharged through the nipple, whether by squeezing or suctioning. Because of the intense local inflammatory response, the breast lump may be larger than before, the pain may increase, and the skin may be flushed or edematous. The patient may be in poor spirits due to high fever, and milk production may be reduced. Treatment may require the use of antibiotics, antipyretics and analgesics, and possibly internal and external herbal remedies. During this phase, it is still important to keep the healthy breast and the ducts of the affected breast that are not affected by the inflammation open so that the milk drains smoothly to avoid worsening inflammation, but breastfeeding is not routinely recommended. Breastfeeding, especially when the patient has a high fever, is mentally and physically taxing, and breastfeeding from the affected breast can exacerbate pain and other discomfort and will not help the mother’s condition. Of course, we are not opposed to breastfeeding in patients with mild systemic and local symptoms, especially on the healthy side of the breast. The use of medications can have an impact on breastfeeding. Some of the medications that enter the breast milk may affect the health of the baby. Antibiotics used in acute mastitis are usually penicillins, cephalosporins and macrolides. Most penicillin and cephalosporin antibiotics are used without adverse effects on the baby, so you can breastfeed while taking them. Some babies who have consumed milk containing these antibiotics may have diarrhea, so nursing should be suspended for a period of time (the duration of the suspension depends on how quickly the drug is cleared from the body, so you will need to consult with your physician about the time to stop nursing) until the antibiotic is cleared from the mother’s system. A small number of cephalosporin antibiotics such as cefuroxime and cefixime and some b-lactam antibiotics such as amoxicillin clavulanate potassium, ampicillin sulbactam and cefoperazone sulbactam require suspension of breastfeeding during use. Macrolide antibiotics such as erythromycin, lincomycin and clindamycin can enter breast milk and there is no problem to breastfeed a healthy baby while taking the drug, but it should not be given to a baby with liver disease, diarrhea or allergy to the drug. Therefore, breastfeeding women should always consult with a professional about breastfeeding before using antibiotics. Commonly used antipyretic and analgesic drugs such as acetaminophen and ibuprofen do not have much effect on breastfeeding (but the drug instructions state that they are to be used with caution or prohibited, so consult your physician before using them). There are fewer studies on the effects of Chinese medicines, and not many adverse reactions have been observed clinically, but if there is diarrhea in the baby then breastfeeding should be suspended. 3. Abscess maturation: In about 5 days after the appearance of the mass, the small abscesses at the site of inflammation gradually merge into a large abscess. In most cases, the ducts leading from the abscess to the nipple are broken and occluded, and the pus cannot drain through the nipple. During abscess maturation the inflammation in the breast decreases, the pain and skin flushing of the lump decreases or disappears, the lump shrinks and becomes soft, and the fever subsides. At this stage, systemic medication is usually not needed, so breastfeeding from the healthy breast is not a problem. If the abscess on the affected breast is small and confined, breastfeeding can continue after the pus is aspirated with a syringe. However, if the abscess is large and an incision has been made to drain the abscess, there are many problems with continuing to breastfeed from the side breast. For example, the amount of milk is low and the baby has difficulty sucking; the wound exudates a lot and breastfeeding can stain the baby, remove accessories or contaminate the wound. It is not always appropriate to breastfeed from the affected breast, but it is still important to drain the excess milk from the affected breast by other means, otherwise new inflammatory lesions may develop. Finally, there is the problem that if the condition requires a return of milk, then no more milk will be produced.