Matitist

Question 1

Mastitis

Answer 1

Definition; an inflammation of the breast tissue, can occur when a blocked duct does not clear, or when a build up causes swelling or inflammations

Question 2

Signs and Symptoms

Answer 2

Redness or swelling and warm
Pain that is often localised to one area
Lump in the area
Fever over 38.5c
Malaise

Question 3

Causes; Engorgement

Answer 3

Excessive milk build up, causing milk stasis taht can lead to blocking of the milk ducts resulting in mastitis

Question 4

Causes; Ineffective attachment

Answer 4

If attachment in ineffective the milk will not be removed effective- causing the milk build up and milk stasis

Question 5

Causes; Bacteria

Answer 5

Bacteria can enter into the crack so the nipples from clothing or babies mouth leading to inflammation of the milk ducts. The inflammation in turn restrict the milk flow leading to them being blocked causes milk stasis. Bacteria being present also increases the risk of infection to grow and develop

Question 6

Causes; Pressure

Answer 6

Tight fitting clothing (bras or a finger pressure) can create milk stasis. This leads to blocked ducts

Question 7

Management

Answer 7

Postnatal daily check to assess condition of breast- may be though woman’s explanation you suspect mastitis
With consent inspect breasts, palpate to help diagnosis
Enquire about feeding history and observe a feed
Offer methods of support to ease and prevent from reoccurring
Provide worsening advice and consider treatment options
Encourage to continue breastfeeding and pumping to help relive engorgement
Explain feeding cues, effective attachment and hand expression
Show different potions that might help target milk ducts that are clogged
Breast massage and compression
Warm therapy ( pre and in between feeds)
Cold therapy (post feed)
Loose clothing
Rest and hydration

Question 8

Follow up

Answer 8

Arrange a GP appointment 12-24hrs after using self help measures. If mastitis isn’t treated properly can lead into infective mastitis and lead to breast abscess.
If a lump is persistent seek urgent same day GP appointment or call NHS 111
Urgent medical attention is required if woman is unwell, dizzy, vomiting, slur speech as these can be signs mastitis is leading to sepsis

Question 9

Treatment

Answer 9

Before administering medication check;
Name and DOB
Name band
Drug kardex and notes
Up to date weight
Known allergies
Drug is prescribed and signed
Drug does and route is correct
Consent is gained
Watch while patient takes medication

Question 10

Medication: Paracetamol

Answer 10

For pain orally
<50kg 500mg every 4 hours, up to 6 times in 24 hours with a maximum of 3 grams in 24 hours
or
1 gram 3 times in 24 hrs with a maximum of 3 grams in 24 hours
>50kgs 1 gram veery 4 hours up to 4 times in 24 hours- max 4g in 24hrs
Contraindications- allergies

Question 11

Treatment: Ibuprofen

Answer 11

For pain and inflammation orally
Dose- 400mg 3 times interval’s of 6 hrs max 1.2g in 24hrs
Contraindications- Allergy and Asthma

Question 12

Treatment: Antibiotics

Answer 12

These need to be medically prescribed
Oral ABX
-Flucloxacilin 500mg 4 times a day up to 14 days
-If a woman is allergic to penicillin- Erythromucin 250-500mg 4x a day or clarithromycin 500mg 2x a day up to 14 days

If Symptoms persist for more than 24hrs commence IV ABX