(B)- Lactational Mastitis

Question 1

What can mastitis be caused by?

Answer 1

Obstruction
Regular expression can help prevent this

Infection
Most common cause is Staphylococcus aureus

Question 2

How does mastitis present?

Answer 2

• Breast pain and tenderness (unilateral)
• Erythema in focal area of breast tissue
• Local warm and inflammation
• Nipple discharge
• Fever

Question 3

How is mastitis managed?

Answer 3

Conservative
If due to blockage
- Continued breastfeeding
- Expressing milk
- Breast massage
- Heat packs and warm showers
- Analgesia

Antibiotics
If conservative not effective
- Flucloxacillin, erythromycin if allergic to penicillin
- Fluconazole for suspected candida infections

Question 4

Should breastfeeding be continued in mastitis?

Answer 4

Yes

Infection will not harm the baby and will help to clear by encouraging flow

Where breastfeeding is difficult, they can express milk

Question 5

What can occur if mastitis is not treated adequately?

Answer 5

Breast abscess

Question 6

What can cause of candida of the nipple?

Answer 6

Often after antibiotics

Question 7

What does candida of the nipple lead to?

Answer 7

Recurrent mastitis

Causes cracked skin on nipple

Question 8

What is candida of the nipple associated with?

Answer 8

In the infant

Oral thrush
Candida nappy rash

Question 9

How does candida infection of the nipple present?

Answer 9

• Sore nipples bilaterally, especially after feeding
• Nipple tenderness and itching
• Cracked, flaky or shiny areola
• Symptoms in baby

Question 10

How is candida of the nipple treated?

Answer 10

Both mother and baby need treatment or it will reoccur

• Topical miconazole 2% to nipple after each breastfeed
• Oral miconazole gel or nystatin for baby