Mastitis Flashcards
What is mastitis?
Inflammation of breast tissue, and is a common complication of breastfeeding.
It can occur with or without associated infection.
What are the main 2 causes of mastitis?
Obstruction
Infection
How can obstruction leading to mastitis be prevented?
Can be caused by obstruction in the ducts and accumulation of milk. Regularly expressing breast milk can help prevent this occurring.
Mastitis can be caused by infection. How does this happen?
Bacteria can enter at the nipple and back-track into the ducts, causing infection and inflammation.
The most common bacteria is staph aureus.
How does mastitis typically present?
Breast pain and tenderness (unilateral)
Erythema in a focal area of breast
tissue
Local warmth and inflammation
Nipple discharge
Fever
Conservative management for obstructive mastitis?
Where mastitis is caused by blockage of the ducts, management is conservative, with continued breastfeeding, expressing milk and breast massage.
Heat packs, warm showers and simple analgesia can help symptoms.
What is done for mastitis treatment if conservative management is not effective or infection (e.g. febrile patient) is suspected?
Antibiotics should be started. Flucloxacillin is first line, or erythromycin if allergic to penicillin.
A sample of milk can be sent to the lab for culture and sensitivities.
Fluconazole may be used for suspected candidal infections.
In mastitis, breastfeeding is discouraged. True/false?
False
Women should be encouraged to continue breastfeeding, even when infection is suspected. It will not harm the baby and will help to clear the mastitis by encouraging flow.
If not treated, what rare complication can occur from mastitis?
A rare complication if not adequately treated, is a breast abscess. This may need surgical incision and drainage.
What problem can occur to the nipple after a course of antibiotics?
Candidal infection of the nipple can occur.
This can lead to recurrent mastitis, as it causes cracked skin on the nipple that create an entrance for infection. It is associated with oral thrush and candidal nappy rash in the infant.
Features of candidal infection of the nipple?
Sore nipples bilaterally, particularly after feeding
Nipple tenderness and itching
Cracked, flaky or shiny areola
Symptoms in the baby, such as white patches in the mouth and on the tongue, or candidal nappy rash
In the case of candidal infection of the nipple, what would be the treatment?
Both the mother and baby need treatment, or it will reoccur. Treatment is with:
Topical miconazole 2% after each breastfeed
Treatment for the baby (e.g. miconazole gel or nystatin)
