O&G Cases · Postpartum care — lactation
A red breast that will not settle — lactational mastitis and abscess management station
Team-based emergency and procedural station: bacterial mastitis failing first-line therapy with a developing abscess. Tests recognition of the mastitis spectrum, the antibiotic doses, the threshold for imaging and drainage, source control, the decision to continue feeding, and communication with a frightened mother. Includes assessor timeline, marking domains, assessor key and fail criteria.
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Station brief
Format. Emergency and procedural management station, approximately 12 minutes. You are the obstetric registrar in the postnatal assessment unit. A nurse and a midwife are available; a breast surgeon and an ultrasound machine can be requested. The assessor runs the clock and feeds new findings.[1]
Candidate instruction. Lead the management of this woman. Verbalise your assessment, your antibiotic decisions with doses, your threshold for imaging and drainage, your source-control steps, and your communication with her about continuing to feed. Address the possibility that this is more than simple mastitis.[1][2]
References5ShowHide
- [1]Mitchell KB, Johnson HM, Rodríguez JM, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022 Breastfeed Med, 2022.PMID 35576513
- [2]Scardina L, Di Pumpo A, Di Leone A, et al. Management of lactational and non-lactational breast abscesses: an evidence-based framework to support breast surgeon decision-making Updates Surg, 2026.PMID 42334816
- [3]Irusen H, Rohwer AC, Steyn DW, Young T Treatments for breast abscesses in breastfeeding women Cochrane Database Syst Rev, 2015.PMID 26279276
- [4]Jahanfar S, Ng CJ, Teng CL Antibiotics for mastitis in breastfeeding women Cochrane Database Syst Rev, 2013.PMID 23450563
- [5]Hotham N, Hotham E Drugs in breastfeeding Aust Prescr, 2015.PMID 26648652