mastitis

Question 1

bacterial mastitis

Answer 1

the progression from breast inflammation and ductal narrowing to an infection requiring antibiotic management to resolve
staph aureus is the most common infectious cause

Question 2

breast abscess

Answer 2

localised collection of pus in the brast tissue which may occur as a complication of mastitis

Question 3

inflammatory mastitis

Answer 3

occurs when ductal narrowing in the breast increases and this area of the breast becomes inflamed, warm, pink/red and painful

Question 4

mastitis

Answer 4

an inflammation of the breast that may or my not develop into a bacterial infection

Question 5

signs and symptoms of inflammatory mastitis

Answer 5

systemic symptoms may occur as a result of the inflammatory response such as fever, chills, tachycardia, and muscle pain
if managed early, early inflammatory mastitis may resolve without the need for antibiotics

Question 6

signs and symptoms of bacterial mastitis

Answer 6

worsening redness and firmness of the breast tissue due to increasing inflammation and persistent systemic symptoms of fever and tachycardia beyond 12-24 hours
these signs and symptoms may have rapid onset

Question 7

can you breastfeed with bacterial mastitis

Answer 7

bacterial mastitis is not contagious or a contraindication to breast feeding, the mother is encouraged to continue to breastfeed and continue to use standard cleaning of her expressing and feeding equipment

Question 8

methods for management of inflammatory mastitis

Answer 8

1. cold packs to reduce inflammation
2. NSAIDs and analgesia
3. continue breastfeeding and expressing
4. deep massage NOT recommended
5. rest, fluids, support with domestic duties
6. ?therapeutic US
7. seek prompt medical consultation if increasing inflammation and persistent systemic symptoms beyond 12-24 hours

Question 9

breastfeeding and expressing tips to help manage inflammatory mastitis

Answer 9

prior to feeding and expressing, encourage very gentle movements towards the underarm to promote lymphatic drainage
continue unrestricted brastfeeding with correction to position and attachement
continued milk removal is important during breast inflammation to prevent overfilling of the breasts, relive symptoms and protect the milk supply
breastmilk is easily downregulated by breast inflammation and poor milk removal
express the breasts by hand or with an electric breast pump to comfort and to meet the baby’s neds if the baby is not breastfeeding or not breastfeeding well

avoid incorrect breast sheild size which may cause tissue damage and further inflammation
lactating breasts require support, encourage comfortable appropriately fitted bra

Question 10

management principles for bacterial mastitis

Answer 10

ensure prompt medical consultation
collect midstream expressed breast milk (EBM) sample and nipple swabs for MC&S
continue breastfeeding
antibiotics, flucloxacillin
cold therapy, NSAIDs, analgesia
mastitis consumer fact sheet
?therapeutic US
consider breast abscess if not resolved after 48 hours, refer to diagnostic US

Question 11

signs and symptoms of breast abscess

Answer 11

similar to those with mastitis with increased localised swelling, pain and tenderness in the breast
risk factors include inadequately treated mastitis and abrupt weaning during acute mastitis

Question 12

management principles for breast abscess

Answer 12

diagnostic US for confirmation, sizing, and a guide to drainage
continue breastfeeding
NSAIDs and analgesia
breast surgeon for aspiration/drainage
MC&S of the breast aspirate will ensure antibiotic sensitivity