Concept about Mastitis – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Concept about Mastitis
Definition of mastitis
Mastitis is an infection in the tissue of one or both of the mammary glands inside the breasts. Mastitis usually affects women who are producing milk and breast-feeding.
Or
Inflammation of one or more mammary glands within the breast, usually in a lactating woman. Mastitis can be felt as a hard, sore spot within the breast. Mastitis can be caused by an infection in the breast or by a plugged milk duct.
Causes of mastitis
Breast-feeding is a learned skill, and poor technique can lead to milk being trapped in the breast, a main cause of mastitis. Other causes include:
- A blocked milk duct: If a breast doesn’t completely empty at feedings, one of the milk ducts can become clogged, causing milk to back up, which leads to breast infection.
- Bacteria entering into the breast: Bacteria from skin’s surface and baby’s mouth can enter the milk ducts through a break or crack in the skin of nipple or through a milk duct opening. Stagnant milk in a breast that isn’t emptied enough provides a breeding ground for the bacteria. The antibacterial properties of milk help protect baby from the infection.
Risk factors for mastitis include
- Breast-feeding during the first few weeks after childbirth.
- Sore or cracked nipples, although mastitis can develop without broken skin.
- Using only one position to breast-feed, which may not fully drain your breast.
- Wearing a tightfitting bra or putting pressure on your breast from using a seatbelt or
- carrying a heavy bag, which may restrict milk flow.
- Becoming overly tired or stressed.
- Previous bout of mastitis while breast-feeding.
- Poor nutrition.
Signs or symptoms may develop rapidly, and can include:
- An area of the breast becoming red and swollen.
- The affected area of the breast hurting when touched.
- The affected area feeling hot when touched.
- A burning sensation in the breast that is there continually, or only when breast-feeding.
The following symptoms are occasionally present:
- Anxiety and feeling stressed.
- Chills and shivering.
- Elevated body temperature.
- Fatigue.
- General aches and pains.
- A feeling of malaise.
Treatments for mastitis
Treatments for mastitis usually include a person taking an antibiotic to tackle the infection, and techniques to treat the blocked duct, if this is the cause.
The antibiotic may pass to the baby in the breast milk. The baby might pass runny stools and become restless. However, doctors say this does not affect the baby, and the effects will disappear as soon as treatment is over.
If the mastitis does not get better the individual should see a doctor again.
Drugs:
1. Antibiotics: Treating mastitis usually requires a 10- to 14-day course of antibiotics. Patient may feel well again 24 to 48 hours after starting antibiotics, but it’s important to take all the pills to minimize chance of recurrence.
2. Pain relievers: Doctor may recommend a mild pain reliever, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
3. Adjustments to breast-feeding technique: Make sure that the patient fully empty her breasts during breast-feeding and that the infant latches on correctly. Doctor may review breast-feeding technique with or may refer to a lactation consultant for help and ongoing support.
4. Self-care. Rest, continue breast-feeding and drink extra fluids to help body fight the breast infection.
Lifestyle and home remedies
If you have mastitis, it’s safe to continue breast-feeding and it helps clear the infection.
To relieve discomfort:
1. Continue to breast-feed as often and as long as baby is hungry.
2. Rest as much as possible, preferably in bed with baby, which will encourage frequent feedings
3. Avoid prolonged overfilling of breast with milk (engorgement) before breast-feeding
4. Vary the breast-feeding positions.
5. Drink plenty of fluids.
6. If the patient has trouble emptying a portion of breast, apply warm compresses to the breast or take a warm shower before breast-feeding or pumping milk
7. Wear a supportive bra.
Treatments for a blocked duct
The following self-care techniques can often resolve a blocked duct:
1. Ensure drinking plenty of liquids and resting.
2. Symptoms of pain and fever can be alleviated with acetaminophen (Tylenol). Some of this will pass through the breast milk, but not enough to harm the baby. Do not take aspirin while breast-feeding.
3. Feed the baby more frequently. If cannot feed the baby more often than expressing milk can be helpful.
4. During a feed, start with the affected breast to ensures it is drained more regularly.
5. After a feed, gently express any leftover milk.
6. Ask a doctor or nurse if the baby is attaching to the breast properly.
7. Try different feeding positions until one is found that is more effective at draining the breast.
8. Warming the breast with a heated compress before a feed can sometimes make it easier. for the baby to get the milk out.
9. Some stroking techniques can help with milk flow.
10. Wear very loose-fitting clothes until the mastitis has gone and avoid tight-fitting clothes thereafter.
Nursing intervention of mastitis
1. Give analgesics as indicated.
2. Provide comfort measures such as a warm soaks.
3. Use meticulous hand-washing technique and provide good skin care.
4. Regularly measure the patient’s temperature and assess the effectiveness of antipyretic agents.
5. Inspect the patient’s breast daily for signs of impaired skin integrity, such as cracks and fissures.
6. Advice the patient to take antibiotics as ordered.
7. Stress the need to take the entire prescribed amount even if symptoms improve in the meantime.
8. Reassure the patient that breast-feeding during mastitis won’t harm her infant because the infant is the source of the infection.
9. If only one breast is affected, instruct the patient to offer the infant his breast first to promote complete emptying and prevent clogged ducts.
10. Suggest applying a warm, wet towel to the affected breast or taking a warm shower to relax and improve her ability to breast feed.
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