Breast Complications.pptx breast engorgement

Breast Complications.pptx breast engorgement, Mastitis, Nipple disorders

1. BREAST ANATOMY

2. Breast Complications The common breast complications in puerperium are: Breast engorgement Cracked and retracted nipple Mastitis and Breast abscess Lactation failure

3. Causes Exaggerated normal venous and lymphatic engorgement which precedes lactation. This in turn prevents the escape of milk from lacteal system. Primiparous mothers with inelastic breasts are likely to be involved. Engorgement is an indication that baby has not step into lactation phase.

4. Symptoms Considerable pain Feeling of tenseness or heaviness Present in one or both the breasts Generalized malaise Rise in body temperature Painful breast feeding

5. Prevention Avoid pre-lacteal feeds Initiate breast feeding early and unrestricted Exclusive breastfeeding on demand Feeding in correct position Correct latch on

6. Treatment Breasts binder Frequent suckling Manual expression of milk Administer analgesics Severe case breast pump can be useful

7. Breast Binders

8. Frequent Suckling of Breast

9. Manual Expression of Breast Milk

10. Breast pump in severe cases

11. Cracked and Retracted Nipple

12. Cracked Nipple The nipple may become painful due to Loss of surface epithelium with formation of raw area on the nipple A fissure situated either at top or base of the nipple.

13. Causes Unhygienic practices resulting in formation of crust Retracted nipple Trauma from baby's mouth due to incorrect latching Infection with candida albicans, S.aureus is often.

14. The condition may remain asymptomatic but becomes painful when infant sucks the nipple. When infected it may spread to the deeper tissue producing mastitis.

15. T reatment Correct latching Fresh human milk and saliva have got healing properties Purified lanolin with mothers milk is applied 4 times a day to hasten healing. Breast pump Miconazole lotion is applied for nipple and babies mouth because it may be caused due to oral thrush.

16. Prevention/Prophylaxis Local cleanliness during pregnancy and puerperium before and after each feeding.

17. It is commonly met in primigravidae . It is acquired

18. ACUTE MASTITIS Inflammation of the breast tissue, commonly caused by organisms Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus Viridans . The incidence of mastitis is 2-5% in lactating women and less than 1% in Non-lactating women.

19. RISK FACTORS Poor feeding practices Maternal Fatigue Cracked Nipple Untreated Breast Engorgement

20. Types and Mode of Infection

21. Infective Mastitis: depending on the site and involvement of organisms. Infection that involves breast parenchymal tissues leading to cellulitis. The lacteal system remains unaffected. Infection leading to lactiferous ducts developing into primary adenitis.( Lymphnode swelling)

22. Non-Infective Mastitis It may be due to milk stasis caused due to neglected breast engorgement or ineffective breast feeding resulting in milk stasis. Onset: 2-4 weeks after delivery or postpartum, However Acute Mastitis can occur several weeks after the delivery.

23. Generalized Malaise Headache Nausea Vomiting Fever (102 F) or more Chills and rigor Severe pain and tenderness Swelling in one quadrant of breast Red skin Hot and flushed. Leakage of drain either pus or blood.

24. Breast binder or support Plenty of oral fluids-intake Correct latching Breast feeding can be given from unaffected breast Dicloxacillin is the drug of choice – a dose of 500 mg every 6 hours orally is started. Erythromycin to those patients who are allergic. Continue therapy for 7 days. Analgesics for pain relief.

25. Breast Abscess

26. Definition Breast Abscess is defined as the collection of pus or drain breast in the tissue or the skin.

27. Symptoms Flushed breasts Brawny edema of skin Marked tenderness Swinging temperature Abscess or pus formation.

28. Management Pus drainage or abscess under General anesthesia by a deep radical incision from areolar margin to prevent injury to lactiferous ducts. Needle aspiration under ultrasound guidance.

29. Mechanical pumping of infected breast for at least 2 hourly. Recurrence risk about 10%

30. Puerperium Milk Production Adequate fluid intake Nurse or feed baby regularly Painful local lesion is to be treated Metoclopramide-10mg thrice daily, intranasal oxytocin and sulpiride have found to increase milk production.