09.03 Mastitis

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Overview

  1. Bacterial infection associated with breastfeeding

Nursing Points

General

  1. Most commonly occurs in breastfeeding mothers
    1. Can occur at any time during lactation
    2. Most commonly occurs 2-3 weeks after delivery

Assessment

  1. Flu-like symptoms
    1. Aches
    2. Chills
    3. Febrile
  2. Pain, tenderness
  3. Localized edema, redness

Therapeutic Management

  1. Continue to promote lactation despite mastitis – it is safe
  2. Either manually express or utilize a breast pump at least q4hr
  3. Administer pain meds and antibiotics if indicated
  4. Support breasts with bra without underwire, which can irritate the already inflamed breast and potentially clog ducts

Nursing Concepts

  1. Infection Control
  2. Comfort
  3. Nutrition

Patient Education

  1. Take antibiotics as prescribed
  2. Continue to breastfeed
  3. Use warm compresses

Reference Links

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Video Transcript

In this lesson I will explain mastitis and how you will provide care for this patient.

Ok let’s get a few basics on mastitis out of the way. So mastitis is a bacterial infection that most commonly occurs in breastfeeding mothers. It can occur anytime but most commonly a few weeks after delivery.

So what is our patient going to look like. She will have flu-like symptoms so aches,chills, febrile. There will be pain, tenderness, localized edema, and redness at the site. This is really occurring because there is a blocked milk duct that then milk gets stuck in and grows bacteria. So that is why you get a tender area and redness. It will be localized at that site. We never see our patients get mastitis because it happens after they are home but I had it with both of mine and it just comes on so suddenly. I remember feeling a little achy and so tired and couldn’t really figure out what was wrong because my throat didn’t hurt, no stuffiness or anything and then suddenly had a temperature of 102. I had the super tender red spot so all the classic symptoms. So off I went to get an antibiotic. This image here is a very severe case where an abscess has formed at the nipple. So usually you will have a reddened area on the breast where the infection is starting. If left untreated or just a severe case an abscess can form at that spot that needs to be drained. Ok let’s look at our therapeutic management.
How are we going to treat this patient? She must continue to breastfeed or pump. Breastfeeding is best because it is natural so it will empty breasts the best, but she needs to keep milk moving so whatever her choice is. It is safe to still feed, however if an abscess forms it is sometimes contraindicated by physicians. The abscess needs to be drained so they might advise the mother to not feed while it heals. She will still need to hand express milk from that side if she wishes to continue to breastfeed after it has healed. The milk might taste different to the baby from that side because of the pus that can be present. She can absolutely still continue to feed on the unaffected side like normal if she chooses.Warm compresses can help with comfort and with milk flow as well. She will be given antibiotics that she must take and finish. Pain medications as well like ibuprofen can help.with the pain and discomfort. So make sure she is educated on all of this as well.

Ok so what have we learned? Mastitis is a bacterial infection in the breast that comes on suddenly with flu like symptoms. So aches, chills, high temperature. There will be a red tender spot at the breast usually. These patient need to continue to breastfeed to help keep milk flowing and moving. One complication that can develop is an abscess so when there is an abscess breastfeeding is contraindicated but otherwise they need to keep feeding. And the patient must take antibiotics as treatment.

Make sure you check out the resources attached to this lesson and review symptoms and management. Now, go out and be your best selves today. And, as always, happy nursing.

Read more

  • Question 1 of 6

A nurse is caring for a breastfeeding mother that has developed a fever, chills, and a tender hot spot on her breast. What information should the nurse include in education for the client? Select all that apply.

  • Question 2 of 6

A nurse receives a call from a breastfeeding mother who is concerned she may have mastitis. Which of the following symptoms would be indicative of possible mastitis? Select all that apply.

  • Question 3 of 6

A nurse is educating a postpartum client after a diagnosis of mastitis. Which statement by the client indicates the need for further education?

  • Question 4 of 6

A nurse is teaching a breastfeeding class to expectant mothers. One mother asks how to prevent mastitis. Which statement by the nurse would be the most appropriate?

  • Question 5 of 6

A nurse is teaching a postpartum client about how best to prevent mastitis. Which of the following statements by the client indicates that more teaching is necessary?

  • Question 6 of 6

A postpartum client who is exclusively breastfeeding has a tender spot on her breast and a temperature of 102°F. Which of the following diagnoses should the nurse expect?

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