Mastitis is inflammation of the breast tissue, usually unilateral after the milk flow is established.

It is caused by streptococcal or staphylococcal invasion of the breast tissue through cracks or fissures around the nipple. It may be obtained from the infant’s nose or throat. The infant probably acquired it while in the nursery.

a. Signs and Symptoms.

(1) Erythema over the infected breast.

(2) Marked breast engorgement.

(3) Acute breast pain, tenderness.

(4) Fever and chills.

(5) Ancillary lymph gland enlargement.

b. Medical Treatment.

(1) Antibiotic therapy and analgesic therapy.

(2) Periodic cultures of breast milk.

(3) Intravenous fluids.

(4) Possible I&D, if abscesses.

(5) Discontinued breast-feeding for a short time depending on antibiotic used and closeness of abscess site to nipple.

c. Nursing Care.

(1) Apply ice or heat to painful, swollen breast depending on the stage of infection. Ice should be avoided if the mother plans to resume or continue breast-feeding.

(2) Encourage increased fluids.

(3) Inform mother to wear a support bra.

(4) Have the mother pump her breast until nursing resumes. Pumping the breast should be avoided if the mother plans to bottle-feed.

(5) Retrain mother in breast care techniques and feeding techniques.

(6) Instruct mother on the importance of handwashing.