MASTITIS most forcefully) on the unaffected

nipple.
 organism that causes mastitis comes from
the nasal–oral cavity of the infant
 In these instances, the infant has usually
acquired a Staphylococcus aureus
infection while in the hospital.
 Candidiasis can also be spread this way.
 By sucking on a nipple, the infant
 infection of the breast
introduces the organisms into the milk
 may occur as early as the seventh
ducts, where they proliferate (breast milk
postpartal day or not until the baby is
is an excellent medium for bacterial
weeks or months old
growth).
 organism causing the infection usually
 epidemic breast abscess
enters through cracked and fissured
 several women discharged from the
nipples
hospital at the same time have similar
 Therefore, measures that prevent cracked
infections
and fissured nipples also help prevent
mastitis.
 These measures include:
ASSESSMENT
 Making certain the baby is positioned
correctly and grasps the nipple  usually unilateral
properly, including both nipple and  epidemic mastitis
areola  because it originates with the
infant, may be bilateral
 The affected breast is:
 Painful
 Swollen
 Reddened
 Fever accompanies these first
symptoms within hours
 Breast milk becomes scant

THERAPEUTIC MANAGEMENT

 Treatment consists of antibiotics effective

 Releasing a baby’s grasp on the nipple
against penicillin resistant staphylococci
before removing the baby from the
such as:
breast
 dicloxacillin
 Washing hands between handling
 cephalosporin
perineal pads and touching the breasts
 Breastfeeding is continued, because
 Exposing nipples to air for at least part
keeping the breast emptied of milk helps
of every day
to prevent growth of bacteria.
 Using a vitamin E ointment to soften
 Some women find an infected breast too
nipples daily
painful to allow their infant to suck and
 If a woman has one cracked and one
prefer to express milk manually from the
well nipple, encourage her to begin
affected breast until their antibiotic has
breastfeeding (when the infant sucks
 taken effect and the mastitis has
diminished (about 3 days).
 Cold or ice compresses and a good
supportive bra
 help with pain relief until the
process improves
 Warm, wet compresses may be ordered
 to reduce inflammation and edema
 If therapy is started as soon as symptoms
are apparent, the condition runs a short
course of about 2 or 3 days.
 If left untreated
 a breast infection  localized
abscess
 may involve a large portion of the
breast and rupture through the
skin, with thick, purulent drainage,
necessitating incision and drainage
of the abscess
 If an abscess forms, breastfeeding on that
breast is discontinued.
 However, a woman is encouraged to
continue to pump breast milk until the
abscess has resolved,
 to preserve breastfeeding
 Some women find that the infected breast
is too tender to do this.
 They can be reassured that formula
feeding will be an acceptable alternative
for their child.
 Neither mastitis nor breast abscess leaves
any permanent breast disease.
 A woman can be assured that such an
incident is not associated with
development of breast cancer and does
not interfere with future breastfeeding
potential