Patient will infectious mastitis present as → a breastfeeding woman 3 weeks postpartum complaining of a painful area of the breast that is reddened and warm. The patient feels very fatigued with a fever generally > 101 ° F and chills. She reports a burning pain present constantly or at times only while breastfeeding. On exam, the patient appears ill. Breast examination shows an erythematous right breast with a palpable mass, induration, erythema, and tenderness to palpation.
Patient with congestive mastitis presents as → a primigravida with bilateral, painful breast engorgement
Mastitis is a condition in which bacteria enter the breast tissue through a milk duct or a fissure in the skin, caused by breastfeeding. Mastitis usually occurs within the first few weeks of breastfeeding but may occur later on.
- Mastitis occurs mainly in BREASTFEEDING WOMEN. Rarely, this condition occurs in women who are not breastfeeding.
- Infectious vs. congestive mastitis (unilateral vs. bilateral)
- Infectious (unilateral) - Unilateral, fever, chills and color change
- Congestive (bilateral) - Bilateral breast engorgement that usually occurs in primigravidas
***Inflammatory breast cancer presents with breast tenderness and color change, but fever and chills are not usually present
Diagnosis is clinical – if an abscess is suspected and ultrasound may be warranted
Treat with dicloxacillin 250 mg QID x 10 days for staphylococcus
- Patients should be encouraged to continue breastfeeding and apply warm/cold compresses to the infected area along with oral NSAIDs
stop breast-feeding and have the mother express her breast milk until the infection is cleared
continue breast-feeding and treat the mother with hot compresses and antibiotics
continue breast-feeding and treat both the mother and the infant with antibiotics
discontinue breast-feeding for now and provide antibiotics to the mother
discontinue any further breast-feeding and perform an incision and drainage immediately
check her latch-on and determine if the baby is positioned properly
encourage her to use different breast-feeding positions to massage different milk ducts
make sure she is getting adequate rest and hydration and is not waiting too long between feeds (or pumping
check her nipples for cracks, fissures, or signs of fungal infection
all of the above