- Mastitis is inflammation of the breast tissue that is usually caused by infection or by statis of milk in the ducts.
- An epidemic mastitis infection is derived from a nosocomial source, usually S. aures, and localizes in the lactiferous glands and ducts.
- An endemic mastitis infection occurs randomly and localizes in the periglandular connective tissue.
- Mastitis infections are largely preventable by prophylactic measures, such as good breast hygiene.
- Injury to the breast is the primary predisposing factor (e.g., overdistention, stasis, or cracking of nipples).
- The exact cause of stasis of milk in the ducts is not known.
- However, missed feedings, a bra that is too tight, or impaired infant suckling are contributory factors.
- Introduction of an infections organism from either the mother’s hands following improper washing or from the infant’s mouth is also contributory.
- In addition, cracked, blistered nipples allow a port of entry for infectious agents.
- Because symptoms usually do not occur until the third or fourth postpartum week (or even months later), teach the client to recognize signs and symptoms of mastitis and to report them to her nurse or physician. Clinical manifestations include:
- Elevated temperature, chills, general aching, malaise, and localized pain
- Increased pulse rate
- Engorgement, hardness, and reddening of the breasts
- Nipple soreness and fissures
- Swollen and tender axillary lymph nodes
1. Promote resolution of the infectious process.
- Observe for elevated temperature, chills, tachycardia, headache, pain and tenderness, firmness, and redness of the breast.
- Administer antibiotics, and explain importance of following through with the prescribed regimen even when symptoms subside.
- Offer comfort measures, such as small side pillows, icecaps, or heat application over localized abscess.
2. Provide client and family teaching.
- Explain how to prevent infection through meticulous handwashing and prompt attention to blocked milk ducts.
- Encourage the mother to do the following:
- Breast feed frequently
- Perform adequate breast and nipple care (e.g., adequate around-the-clock nonconstrictive support of the breast, gentleness during care, avoidance of harsh cleansing agents and decrusting the nipple, frequent breast pad changes, and intermittent exposure of nipples to the air)
- Recognize the signs and symptoms of infection.
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