Mastitis Flashcards
Incidence of mastitis and acute mastitis in PP women
10-33%
2-3%
Incidence of breast abscess in those with mastitis
3%
Mastitis signs
Hot, firm, erythematous unilateral swelling of the breast
Pathophysiology of infective mastitis
Engorged breasts become colonized by bacteria, infection of commensal flora, occurring by retrograde spread through a lactiferous duct or a traumatized nipple
Common pathogens
Staph aureus Staph epidermis is Ground A, B, and F strep Haemophius influenzas E-coli
Risk factors
Poor BF technique
Failure to alternate between breasts during feeds - cause nipple fissures, cracks
Not wearing a well-fitting maternity support bra
Abrupt discontinuation of BF
Past hx mastitis
Complications of untreated mastitis
Breast abscesses
NEC
TSS
Anatomy of the secretory elements in the mammary glands in pregnant women
Breast composed of glandular and fatty tissue, supported by coooper’s ligaments
Glandular tissue has 15-20 lobes, containing clusters of alveoli, which make up lobules -site of BM synthesis and storage
-myoepithelial cells surrounding the alveoli contract and eject milk from the duckies that lead from the alveoli
-ductile join up to form lactiferous ducts which then drain the milk towards the Arellano
Lactogenesis 1
Breast size increases —>epithelial cells differentiator into secretory cells for milk production
Large gaps between alveolar cells
Prolactin simulates the secretory cells of the alveoli; secretory cells begin to produce small amounts of colostrum
High levels of progesterone inhibits lactation
Lactogenesis II
Delivery of the placenta triggers progesterone drop and increase in prolactin
The junction complexes between alveoli close
Breast milk production occurs
Lactogenesis III
Secretion of breast milk controlled by the autocrine system
Prolactin levels rise with infant suck
In response to sucking, oxytocin causes the letdown
Involution
Alternate nutrition - milk production is decreased
Weaning involves apoptosis with the death of the secretory epithelium
