Which recommendation should be given to a client with mastitis who is concerned about breast feeding her neonate?

Mastitis is when your breast becomes swollen, hot and painful.

It's most common in breastfeeding women, but women who are not breastfeeding and men can also get it.

Check if you have mastitis

Mastitis usually only affects 1 breast, and symptoms often come on quickly. They include:

  • a swollen area on your breast that may feel hot and painful to touch – the area may become red but this can be harder to see if you have darker skin
  • a wedge-shaped breast lump or a hard area on your breast
  • a burning pain in your breast that might be constant or only when you breastfeed
  • nipple discharge, which may be white or contain streaks of blood

You may also get flu-like symptoms, such as aches, a high temperature, chills and tiredness.

Things you can do

Do

  • soak a cloth in warm water and place it on your breast to help relieve the pain – a warm shower or bath may also help

  • rest and drink lots of fluids

  • take paracetamol or ibuprofen to reduce any pain or fever

  • if you are breastfeeding, continue to breastfeed

  • start feeds with the sore breast first

  • express milk from your breast in between feeds

  • massage your breast to clear any blockages – stroke from the lumpy or sore area towards your nipple to help the milk flow

Don’t

  • do not wear tight-fitting clothing or bras until you feel better

  • do not take aspirin

Non-urgent advice: See a GP if:

  • you do not feel better within 24 hours despite continuing to breastfeed
  • you get mastitis and you are not breastfeeding
  • your symptoms do not get any better 48 hours after taking antibiotics

Treatment for mastitis from a GP

A GP will usually prescribe antibiotics.

If you're breastfeeding a very small amount of the antibiotic may go into your breast milk. There is no risk to your baby, but it might make them irritable and restless.

What to do if mastitis comes back

If you are breastfeeding and keep getting mastitis, it might be due to problems with positioning and attaching.

If you have any breastfeeding problems, it's important to ask for help from a midwife, health visitor or a breastfeeding specialist as soon as possible.

Information:

You can also call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, daily)

Causes of mastitis

Mastitis is common in breastfeeding women as it can be caused by a build-up of milk.

Women who are not breastfeeding can also get mastitis, as can men. This can happen due to:

  • smoking – toxins found in tobacco can damage breast tissue
  • damage to the nipple, such as a piercing or skin condition like eczema
  • you have a breast implant
  • having a weak immune system due to a health condition like diabetes
  • shaving or plucking hairs from around your nipples

Page last reviewed: 29 October 2019
Next review due: 29 October 2022

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  • Low milk supply
  • Tongue-tie
  • Full breasts

Mastitis is an inflammation of the breast that can lead to infection. Mastitis can feel like you have the flu; you may feel hot and have body aches and pains.

Common causes

  • Poor attachment to the breast
  • Nipple damage
  • A long break between breastfeeds
  • Breasts that are too full
  • Blocked milk ducts
  • Stopping breastfeeding too quickly
  • Overly tight bra
  • A baby with tongue-tie who is having problems attaching to the breast

Signs and symptoms

  • A red, sore area on the breast
  • Flu-like symptoms – feeling hot and cold with aching joints

Prevention

  • Breastfeed as often as your baby needs (normally 8 to 12 times in 24 hours for a new baby).
  • Don’t miss or put off breastfeeds.
  • Wake your baby for a feed if your breasts become too full. If your baby doesn’t want to feed you may need to express a small amount of milk.
  • See a lactation consultant or maternal and child health nurse to make sure your baby is attaching and feeding well at your breast.
  • Offer both breasts at each feed. If your baby only feeds from one breast make sure to offer the alternate breast at the next feed.
  • Express a small amount of milk after feeds if your breasts still feel full – express only until your breasts feel comfortable.
  • Avoid giving your baby formula feeds or other fluids unless advised to by a midwife, nurse or doctor.
  • Avoid pressure on your breasts from clothes or from your fingers when feeding.
  • Try to get some rest during the day when your baby is asleep.

Treatment

It is important to start treatment at the first signs of mastitis.

  • Your breast milk is safe for your baby even if you have mastitis, so continue to breastfeed or express from the affected breast.
  • Place a heat pack or warm cloths on the sore area before feeding or expressing to help with your milk flow. If your milk is flowing easily then warm packs are not needed.
  • Gently massage any breast lumps towards the nipple when feeding or expressing or when in the shower or bath.
  • Continue to breastfeed or express your sore breast until it feels more comfortable.
  • Place a cool pack, such as a packet of frozen peas wrapped in a cloth, on the breast after feeding or expressing for a few minutes to reduce discomfort.
  • You can take tablets for the pain such as paracetamol or ibuprofen. They are safe to take while breastfeeding.
  • Drink plenty of water throughout the day (up to 8 glasses).
  • Rest as much as possible. Ask your partner, family or friends for help with household tasks.
  • If you don’t start to feel better after a few hours, you should see a doctor as soon as you can. When making the appointment tell the clinic you think you have mastitis.
  • If antibiotics are prescribed by your doctor, take as directed. It is safe to continue to breastfeed when taking these antibiotics.


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Which instruction should the nurse offer a client as primary preventive measures to prevent mastitis?

Explanation: As a primary preventive measure to prevent mastitis, the nurse should instruct the client to perform good handwashing before breastfeeding. The nurse should instruct the client to frequently breastfeed to prevent engorgement and milk stasis.

Which factor puts a Multiparous client on her first postpartum day at risk for developing hemorrhage *?

Which factor puts a multiparous client on her first postpartum day at risk for developing hemorrhage? Explanation: Multiparous women typically experience a loss of uterine tone due to frequent distentions of the uterus from previous pregnancies. As a result, this client is also at higher risk for hemorrhage.

Which meaning would the nurse assign to the observation that a client is voiding frequently in small amounts 8 hours after giving birth?

For approximately 8 hours after delivery, amount of urine at each void. Patients should void a minimum of 150 mL per void; less than 150 mL per void could indicate urinary retention due to decreased bladder tone post delivery (in the absence of preeclampsia or other significant health problems).

Which complication is most likely responsible for a late postpartum hemorrhage?

The most common causes of PPH are: Uterine atony: Uterine atony (or uterine tone) refers to a soft and weak uterus after delivery. This is when your uterine muscles don't contract enough to clamp the placental blood vessels shut. This leads to a steady loss of blood after delivery.