Nevn seks problemer relatert til amming som fører til mastitt
- Poor latch and position
- Nipple excoriation or cracking
- Blocked milk ducts
- Oversupply of milk
- Infrequent feedings/rapid weaning
- Pressure on the breast (tight brasserie, car seatbelt)
Hva er lactogenesis II og når oppstår det?
Normal fysiologisk tilstand.
Oppstår mellom 2-4 dager postpartum.
Swelling of the mother’s breasts and the onset of copious milk production.
Hva forårsaker lactogenesis II?
Venøs og lymfatisk stase pga økt blodsirkulasjon, IKKE pga excessive milk volume
Symptomer på lactogenesis II
o Bilateral general swelling
o Tenderness – sometimes subfebrilia
o Engorgement makes good latch difficult
+ pain?
Behandling av lactogenesis II
o Frequent suckling – good latch
o Stimulate the nipple to start the ejection reflex
o Hand expression before breastfeeding makes the breast a little softer and improves the chance for a good latch
Kjennetegn på inflammatorisk mastitt uten patogen
o Milkstasis
o Blocked milk ducts
o Inflammatory mastitis/severe engorgement
Kjennetegn på infeksiøs mastitt
o Infection of the milk ducts and glands
o Interstitial infection with cellulitis
o Abscess
Behandling på inflammatorisk og infeksiøs mastitt
- Complete emptying of the breast
- Supportive care of the woman
Nevn de 5 stadiene ved mastitt
- Milkstasis
- blocked milk ducts
- inflammatory mastitis
- infectious mastitis
- abscess
Inflammatory mastitis - symptomer og funn
Red, tender, mild-moderate pain
Temp > 38.5 occurs
Malaise, nausea, flu-like symptoms
CRP slightly or moderately elevated
Behandling av inflammatory mastitis
Symptomatisk: Ibuprofen, paracetamol
Emptying of the breasts until soft every 2. hour.
Ongoing breastfeeding - hand expression and pumping.
Culture of the breastmilk
Supportive care and lactation support by lactation consultant
Skal det gis antibiotikabehandling ved inflammatorisk mastitt? Hvis ja, når?
- Emptying of the breast might resolve the problem
- Antibiotics if emptying for 12-24 hours doesn’t help – wait and see prescription? Or..
- Follow up visit or if condition worsens
- Follow up on result of breastmilk culture
- Antibiotics if duration of symptoms more than 24 hours and/or systemic affection, high temperature
Hvilken antibiotika mot inflammatorisk mastitt?
- Staph. Aureus (E. coli, Streptoccoccus)
- Prescribe a penicillinase resistant penicllin
Symptomer og tegn på infectious mastitis
- Occurs in the setting of breastfeeding problems that result in prolonged engorgement or poor drainage: blocked ducts, nipple trauma
- Pathogenic organisms gain access to stagnant milk through the nipple cracks and excoriations
- Pain, redness, fever, myalgias, malaise
- Langvarig problem – ikke noe som kommer over natten
