[Guideline summary] Clinical protocol for managing mastitis from the Academy of Breastfeeding Medicine

2 min read /
General Nutrition Obstetrics / Gynaecology Paediatrics Public health

The Academy of Breastfeeding Medicine has revised its clinical protocol on mastitis, a common complication during lactation that contributes to early cessation of breastfeeding. Summary of spectrum-wide recommendations were listed below.

Anticipatory guidance and behavioral interventions

  • Reassure lactating mothers that many mastitis symptoms will resolve with conservative care and psychosocial support
  • Educate mothers suffering from mastitis on normal breast anatomy and postpartum physiology in lactation
  • Feed infants on demand and do not aim to ‘empty’ breasts during feeding
  • Minimize the use of breast pump
  • Avoid using nipple shields
  • Wear a supportive bra that can appropriately fit the body
  • Avoid deep massage of lactating breasts
  • Avoid using saline soaks, castor oil and other topical products       
  • Avoid routine sterilizing pumps and household items

Medical interventions

  • Decrease inflammation and pain
  • Cure associated nipple blebs and avoid unroofing
  • Cure hyperlactation or human milk ‘oversupply’
  • Use therapeutic ultrasound
  • Reserve antibiotics for bacterial mastitis
  • Consider probiotics
  • Evaluate for perinatal mood and anxiety disorders

Please refer to the full article for condition-specific recommendations including recurrent mastitis, abscess, subacute mastitis, etc.

Link to the full article:


Mitchell KB et al. Academy of breastfeeding medicine clinical protocol #36: the mastitis spectrum, revised 2022. Breastfeed Med. 2022;17(5):360-376.

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