MASTITIS
PROBLEM
You have an infection in your breast tissue, not your breast milk.
CAUSE
The most common organism causing mastitis is Staphylococcus aureus. The immediate source of the organism is almost always the nursing infant’s nose and mouth. Mastitis often develops in the presence of breast injury, such as cracked nipples.
PREVENTION
A.Prevent injury to the breast:
1.Avoid overdistension of the breasts; feed infant or use the breast pump frequently (every 2–4 hours).
2.Avoid clogged milk ducts by applying moist heat to the breasts and massage.
3.Avoid rough manipulation of the breast; pump carefully.
4.Avoid cracking of nipples by proper positioning of the infant’s mouth on the nipple during feeding. The baby’s mouth should cover the entire areola (dark brown part of the nipple area).
Patient Teaching Guide Postpartum: Breast Engorgement and Sore Nipples.
B.Personal hygiene measures:
1.Avoid soap on the nipples; cleanse nipples with warm water only.
2.Avoid decrusting the nipple of dried colostrum or milk.
3.Use purified lanolin cream after each breastfeeding for sore, cracked nipples. (If lanolin is purified, there is no need to remove it prior to the next feeding.)
4.Use good hand-washing techniques before handling the breast and before and after breastfeeding.
TREATMENT PLAN
A.Complete course of antibiotics. Be aware that antibiotics may cause a yeast infection.
B.Continue breastfeeding even on the antibiotics. It is not uncommon for your baby to develop thrush
(looks like white patches on your baby’s mouth and tongue). You may also be prescribed Nystatin cream to apply to your breasts to help prevent thrush.
(see Patient Teaching Guide Postpartum: Breast Engorgement and Sore Nipples
). Breast massage may be needed, too.
(see Patient Teaching Guide Postpartum: Breast Engorgement and Sore Nipples
).
Activity: Increased rest is recommended. Try to lie down for a nap when the baby goes to sleep.
Diet: There are no dietary restrictions; continue your regular diet and avoid gas-producing foods that may upset your baby’s tummy (cabbage, chocolate, beans, pizza, and spicy foods). Increase fluid intake by drinking at least 10 to 12 glasses of water a day. Use caffeine in moderation (eliminate if possible).
Medications: Continue your prenatal vitamins while breastfeeding.
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
Take all of your antibiotics even if you feel better.
You Have Been Prescribed: Miconazole OR clotrimazole OR Mycolog cream for your breasts and nipples.
You Need to Apply It:
A.After each feeding, apply the cream to each nipple and areola of your breast.
B.Before feeding, wipe off the excess cream with a warm washcloth (do not use soap for your breast because it causes excessive drying and cracking).
You Have Been Prescribed ____________________________ for a yeast infection.
You Need to Use It: ___________________________________________________________
You Need to Notify the Office If:
A.You have a temperature that does not decrease within 2 days and resolve within 4 days of taking the antibiotics.
B.You have pain that is not controlled with acetaminophen or ibuprofen.
C.Your baby develops thrush. Notify your baby’s healthcare provider for medication.
D.Other: ___________________________________________________________ .
Phone: ____________________________
PATIENT TEACHING GUIDE