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Mastitis, New recommendations ABM Protocol #36

ABM = Academy of Breastfeeding Medicine

ABM clinical Protocols serve as guidelines for the care of breastfeeding parents and babies.

You can find the list of references listed at the end of the protocol.

A few weeks ago, a protocol was released and the recommendations have changed.

I’ve been a nurse for almost two decades now, I have the experience of learning new protocols and I know that sometimes we need to change our practice because new research shows that what we’ve been doing is not optimal. Sometimes it can be confusing because we need to take a complete 180 degrees turn from what we’ve learned in the past and from what we were doing before.

My goal is to understand the new recommendations and why it has changed to implement and deliver the best care to the families that I support.

It is hard to summarise 14 pages in a few lines so I will keep it simple and give the main ideas.

Starting with a good assessment of the breast is essential. It is important to understand the root of the problem (oversupplies, dysbiosis…) to treat the symptoms and the causes. An understanding of the physiopathology is key.

-Priority is given to treating the edema that creates the engorgement by blocking the milk drainage. -We want to reduce the inflammation as much as possible. Redness does not always mean infection.

-Breast strong massages and vibrations are not recommended as they may damage the breast tissue. However, hand expression is a good skill to be able to perform to release pressure.

-Antibiotics should be used only for bacterial mastitis and not inflammatory mastitis.

-Mastitis can be very stressful, and the mental health of the lactating patent should be assessed and evaluated.

The treatment: BAIT

B- Breast rest (don’t overfeed or pump, No massage)

A- Advil 800mg Q8h for 48h

I- Ice 10 min Q30 min

T- Tylenol 1000mg Q8h for 48h


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