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Is fever associated with COVID-19 in lactating women?

Updated: 2020-03-30


Lactational mastitis is one of the most common problems encountered by women following childbirth and it is most common three to four weeks postpartum. In addition to localized swelling of the breast, it may also be accompanied by systemic inflammatory reactions -- that is, chills, headaches, systemic aches, fatigue and fever where the body temperature is 37.3 C or higher.

These symptoms coincide with the important symptoms of recent novel coronavirus cases and are therefore prone to cause some panic among new mothers. Here are some simple features to tell you whether symptoms such as postpartum fever are caused by breast problems or related to COVID-19.

1. Epidemiological history (critical).

(1). COVID-19:

  • History of travel to or residence in Wuhan and surrounding areas, or in other communities where cases have been reported within 14 days prior to onset of the disease.

  • Contact with lab-confirmed infected patients (with positive results from a nucleic acid test) within 14 days prior to the onset of the disease.

  • In contact with patients who have fever or respiratory symptoms from Wuhan and its surrounding areas, or from communities where confirmed cases have been reported within 14 days before the onset of the disease.

  • Clustered cases (two or more cases with fever and/or respiratory symptoms in a small area such as families, offices, schools, workshops, etc within two weeks.)

(2). Lactational mastitis:

None of the above situations.

2. Symptoms other than fever.

(1). Lactational mastitis:

  • Breast pain.

  • Local redness and swelling of the breast, accompanied by elevated skin temperature.

  • Breast problems such as milk deposition, chapped nipples, damaged skin.

  • Abscess formation may be accompanied by local breast fluctuations.

(2). COVID-19:

  • Dry cough, nasal obstruction, runny nose, sore throat and other respiratory symptoms, severe cases of shortness of breath, dyspnea.

  • Vomiting, diarrhea, etc.

3. Auxiliary examination.

(1). Lactational mastitis:

  • Routine blood test shows elevated white blood cell or neutrophil count, or elevated C-reactive protein.

  • Color ultrasonic examination shows local inflammatory changes such as anechoic or mixed echoes in the breast.

(2). COVID-19:

  • Routine blood test shows normal or decreased white blood cell count and normal or decreased lymphocyte count.

  • Lung has COVID-19 imaging characteristics such as multiple small patches, ground glass opacity, infiltrating shadows.

Generally speaking, mild mastitis symptoms can continue breastfeeding; do not interrupt or give up breastfeeding.

If the treatment effect of oral drugs is not good, or even breast pain is aggravated and persistent high fever and local breast fluctuation occur, it is necessary to go to regular medical institutions for professional treatment and guidance.