Course and treatment of milk stasis, noninfectious inflammation of the breast, and infectious mastitis in nursing women.

In nursing women with inflammatory symptoms of the breast, it has been possible on the basis of leukocyte counts of the milk and quantitative cultivation for bacteria to classify these cases into milk stasis (counts of less than 10(6) leukocytes and less than 10(3) bacteria per milliliter of milk), noninfectious inflammation (counts of greater than 10(6) leukocytes and less than 10(3) bacteria), and infectious mastitis (counts of greater than 10(6) leukocytes and greater than 10(3) bacteria). In the present study the duration and outcome of these cases were observed, and those without intervention were compared to those with treatment that consisted of systematic and intensive emptying of the breast, supplemented in some cases by antibiotic therapy as directed by susceptibility tests of the bacteria. The course of milk stasis was of short duration and the outcome was good independent of treatment. In cases of noninfectious inflammation the symptoms persisted for several days without treatment, and half of the patients developed infectious mastitis. Emptying of the breast resulted in a significant decrease in the duration of symptoms and a significantly improved outcome. Infectious mastitis without treatment was followed by a good result in only 15% of the cases, and 11% developed abscesses. Emptying of the breast increased the rate of a good outcome to 50% and significantly decreased the duration of symptoms. The addition of antibiotic therapy resulted in a good outcome in 96% of the cases and a further significant reduction of the persistence of symptoms.