Between 10 % and 33 % of breastfeeding
women develop lactation mastitis. Infectious mastitis occurs when
accumulated milk allows bacteria to grow.
Risk factors:
1.
Reduced number of feeds, leading to milk accumulation.
This may be due to:
- Partial bottle feeding.
- Painful breasts.
- Preferred breast, leading to milk accumulation in the
other.
2.
Trauma to breasts.
Management:
1. First-line management:
- Encourage the woman to continue breastfeeding.
- Assessment of breastfeeding technique by an
appropriately trained, skilled person who can assess feeding pattern,
positioning, attachment, sucking behaviour and breast fullness. Because
mastitis is thought to result partly from inadequate milk removal from the
breast, optimizing breastfeeding technique is likely to be beneficial.
- Manual expression of milk to empty the breast after
feeding.
- Increasing feeding frequency.
- The mastitis was preceded by deep nipple wounds that
were treated with topical and oral antibiotics, and the woman was
receiving topical antibiotics when she developed mastitis. Treatment with
oral antibiotics resolved the mastitis.
2.
Surgical management, is indicated
for breast abscesses, occur in around 3 – 7 % of women with puerperal
mastitis. Stopping breastfeeding
suddenly in mastitis increases the risk of developing an abscess. Other
risk factors include obesity and smoking.
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