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Chapter: Obstetric and Gynecological Nursing : Abnormal Puerperium

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Breast Infections

1. Acute Puerperal Mastitis 2. Breast Abscess

Breast Infections

 

 

1. Acute Puerperal Mastitis

 

Is inflammation of the breast and externally painful and may lead to abscess formation.

 

The most common infectious organism is staphylococcus aureus. The most likely source of the infection is the baby and out breaks of skin and eye infections among babies are frequently due to staphylococcus aureus. Organisms are transmitted by cross infection and can easily affect a whole part.

 

Sign and symptoms

 

·        Occurs after the 8th postnatal day

 

·        The onset is rapid with a sharp rise in temperature which can reach as high as 400C.

 

·        Rapid pulse

 

·        Throbbing pain and tenderness in the affected breast.

 

·        A wedge shaped, indurated and reddened area of the breast is seen on examination

 

Investigation and treatment

 

 

·        A sample of breast milk is sent for bacteriological examination and abroad spectrium antibiotic is given until the causative organism is known

·        Breast feeding should be suspended if pus is found in the milk and the pump or hand expression.

·        The breast must be gently supported and large pads of cotton wool used to protect the painful infected area.

·        If the infection is mild, breast feeding may be continued as the anti infective properties of the milk protect the baby.

 

2. Breast Abscess

 

 

Acute puerperal mastitis may lead to abscess formation. If this occurs the affected breast is extremely painful, edema` is usually present and the breast becomes tense and red. The axially glands become tender and enlarged. The abscess must be incised and drained to prevent spread into other areas of breast which would cause damage.

 

Prevention

 

The best method of treatment lies in prevention. Attention to hand washing and hygiene will both lower the incidence of infection among babies and reduce risk of breast infection in mothers. Nurses, mid wives and doctors must maintain cleanliness and wash their hands before attending to a mother or a baby.

 

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