Mastitis — DRCOG MCQ

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HardPostnatalMastitisDRCOG

A 28-year-old woman three weeks postpartum has a painful red breast, fever and flu-like symptoms while breastfeeding. What is the most appropriate management?

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Correct answer: D — Continue breastfeeding and start antibiotics if systemically unwell

The best answer is “Continue breastfeeding and start antibiotics if systemically unwell”. Continue breastfeeding and start antibiotics if systemically unwell is the best answer because the vignette is testing Mastitis and the recommended approach is consistent with NICE CKS Mastitis. The other Specifically, Arrange routine GP review after the next period, Refer for routine gynaecology review, Advise oral analgesia and routine follow-up, Book a non-urgent community midwife appointment would be suboptimal in this scenario. In DRCOG-style primary care questions, the safest answer is usually the step that matches the acuity and gestation rather than symptomatic treatment alone. Postnatal symptoms must be separated into normal recovery, conditions suitable for community treatment and time-critical maternal deterioration. Haemodynamic compromise, severe hypertension, sepsis features, heavy bleeding or urinary retention require prompt escalation. Breastfeeding can usually continue during treatment for uncomplicated mastitis and should be supported rather than stopped reflexively.

Reference: NICE NG194: Postnatal care: https://www.nice.org.uk/guidance/ng194/chapter/Recommendations