BREAST COMPLICATIONS

BREAST ENGORGEMENT

CRACKED RETRACTED NIPPLES

MASTITIS AND BREASTABSCESS

LACTATION FAILURE
 BREAST ENGORGEMENT
Breast engorgement occurs in the
mammary glands due to expansion and
pressure
exerted by the synth
What is engorgement?
Engorgement is caused by a build-up of
milk, blood and other fluids in the
breast tissuesis and storage of breast
milk.Breast engorgement is the painful
overfilling of the breasts with milk.
This is usually caused by an imbalance
between milk supply and infant demand .
 CAUSES

1. Due to exaggerated normal venous and

lymphatic engorgement of the breasts
which precedes lactation.this is turn
prevents escape of milk from the lacteal
system.

2. ONSET-Usually manifests after the milk

secretion starts.
 SYMPTOMS

1. Are swollen, firm, and painful. If

severely engorged, they are very
swollen, hard, shiny, warm, and slightly
lumpy to the touch.

2. May have flattened-out nipples. The dark

area around the nipple, called the
areola , may be very hard. This makes it
difficult for your baby to latch on.
3. Can cause slightly swollen and tender
lymph nodes in your armpits.
 PREVENTION

1. Breastfeed your baby frequently, 8-12

times in 24 hours. avoid supplements of
water or formula for the first 3-4
weeks.
2. Exclusive breastfeeding on demand.
3. Feeding in correct position.
4. To avoid prelactal feeds.
 TREATMENT

1. To support breast with a binder or brassiere.

2. Frequent suckling and mannual expression of any
remaining milk after each feed.
3. To administer analgesics for pain.
4. The baby should be put to the breast regularly
at frequent intervals.
5. In a severe case gentle use of a breast pump.
6. Gentle hand expression of milk to make the
breast soft so that the infant can latch
on.moist heat and cold compress to relieve
edema.
CRACKED AND RETRACTED
NIPPLE
 CRACKED AND SORE NIPPLE

Sore nipples are any persistent pain in the nipples that lasts
throughout the entire breastfeeding or hurts between feedings.
 Causes-

BABY NOT LATCHING ON PROPERLY- this is the number one

cause of sore nipples

Engorgement that makes the nipple too flat and firm to latch
properly

Early pacifier and bottle usage ,Sucking problems in the baby

Infections in the nipple or breast

Inappropriate nipple care routines or attempting to “toughen

up” the nipples before the baby is born

Improper breastpump usage

 TREATMENT

Correct attachment will provide immediate relief from pain and

rapid healing.

Purified lanolin with the mother's milk is applied3 to 4 times a

day to hasten healing.

In severe cases uses breast pump and infant is feed with

expressed milk.

Miconazole lotion is applied over the nipple as well as in the

baby's mouth if there is oral thrush.
RETRACTED OR FLAT NIPPLE
 RETRACTED NIPPLE

A nipple that cannot be compressed outward, does not protrude

or become erect when stimulated or cold.
MASTITIS
 MASTITIS

Mastitis (also called mammitis) is the inflammation of breast

tissue. S. aureus is the most common etiological organism
responsible, but S. epidermidis and streptMastitis is
inflammation of tissue in one or both mammary glands inside
the breast.

Mastitis usually affects lactating women - women who are

breastfeeding, producing milk. Hence, it is often referred to as
lactation mastitis.ococci are occasionally isolated as well.
 Causes of non-infectious mastitis

The baby is not attaching to the breast properly during feeding.The

baby has difficulties suckling the milk out of the breast.

The baby is being breastfed infrequently.

Milk ducts may be blocked because of pressure on the breast

caused by, for example, tight clothing.
Causes of infectious mastitis

Bacteria do not generally thrive in fresh human milk. However, if

the milk ducts are blocked and the milk stagnates the likelihood of
infection grows. Experts believe that bacteria which exist on the
surface of breast skin enter the breast through small cracks or
breaks in the skin. They also suggest that bacteria in the baby's
mouth may get into the mother's breast during a breastfeed.
 Two types of mastitis

There are two types of mastitis: non-infectious mastitis and

infectious mastitis.

Non-infectious mastitis-Non-infectious mastitis is usually

caused by breast milk staying within the breast tissue - milk
stasis - because of a blocked milk duct or a breastfeeding
problem. If left untreated, the milk left in the breast tissue can
become infected, leading to infectious mastitis.

Infectious mastitis-Infectious mastitis is caused by bacterial

infection. It is important to receive treatment immediately to
prevent complications, such as an abscess in the breast.
 Symptoms of mastitis

An area of the breast becomes red.

The affected area of the breast hurts when touched.

The affected area feels hot when touched.

A burning sensation in the breast which may be Sometimes,

the following symptoms may also be present:

Anxiety, feeling stressed

Chills, Elevated body temperature, Fatigue

General aches and pains

Shivering there all the time, or only when breastfeeding.

 Treatments for mastitis

Mother needs to make sure she is drinking plenty of liquids and

complete bed rest.

Feed the baby more frequently.If mother cannot feed the baby
more frequently, express the milk more often if the breasts feel
full.

Warming the breast before a feed can sometimes make it easier

for the baby to get the milk out.

Proper positioning, handwashing before each feed, cleaning the

nipples aftera nd before each feed and keeping them dry.

wear very loose-fitting clothes until the mastitis has gone. When
it has gone, avoid tight-fitting clothes.
Dicloxacillin is the drug (500mg) every 6 hours orally is started.

Erythromycin is an alternative to patients.

ANTIBIOTIC THERAPY CONTINUED FOR AT LEAST 7 DAYS.

ANALGESICS-Ibuprofen are given for pain.

Complications of mastitis

Recurrence-Women who have had mastitis are more likely to get

it again, compared to other women. In most cases recurrence is
due to late or inadequate treatment.

Abscess-If the mastitis is not treated properly there is a risk that

a collection of pus (abscess) can develop in the breast.
Abscesses usually require surgical draining.
 BREAST ABSCESS

A breast abscess is a painful collection of pus that forms in the

breast.

Most abscesses develop just under the skin and are caused by a
bacterial infection.Breast abscesses are painful, swollen lumps
that may also:

be red

feel hot

cause the surrounding skin to swell

cause a fever (high temperature)

 Causes of a breast abscess

Most breast abscesses occur as a complication of mastitis,

which is a bacterial infection that causes the breast to become
red and inflamed.

Treating a breast abscess

A breast abscess will need to be drained. Small breast

abscesses can be drained using a needle and syringe. If the
abscess is large, a small incision may be needed to drain the
pus.

For both procedures, a local anaesthetic will usually be given to

numb the skin around the abscess so MOTHER don't feel any
pain or discomfort.
Antibiotics given depending upon the culture report of pus.

Breastfeeding-recommend using a breast pump to express milk

from the affected breast.
THROMBOPHLEBITIS
 DEFINITION

It is a condition which occur when the condition is localised inIn

septic pelvic vein thrombophlebitis, infected blood clots develop in
one or several of the pelvic blood vessels. A thrombus is a blood clot;
phlebitis is an inflammation of a vein. the pelvis.

TYPES OF THROMBOPHLEBITIS-
OVARIAN VEIN THROMBOPHLEBITIS(OVT)

DEEP SEPTIC PELVIC THROMBOPHLEBITIS(DSPT)

What are the Consequences of Septic Pelvic Vein
Thrombophlebitis?

Septic pelvic vein thrombophlebitis is a potentially

dangerous condition. It can lead to the formation
of an abscess (collection of pus) in the pelvis and
infection in a blood clot which travels from the
pelvic vessels to the vessels in the lungs (septic
pulmonary embolization). This latter disorder may
prevent the delivery of sufficient oxygen to the
blood and may result in death.
 Signs and Symptoms of Septic Pelvic Vein
Thrombophlebitis?

fever;

abdominal pain, usually localized and restricted to the

side of the affected vein but may spread into the groin,
upper abdomen, or flank;

abdominal bloating and tenderness (most patients do not

want to be touched in the abdomen);

a tender, sausage-shaped mass near the umbilicus

(present in 50 to 70% of patients);

decreased or absent bowel sounds;

nausea,vomitingandincreased pulse rate (tachycardia)

 Diagnosis

To be evaluated for suspected septic pelvic vein

thrombophlebitis, you may undergo a CT scan (computerized
tomography) or MRI (magnetic resonance imaging).

An ultrasound examination can also help confirm the diagnosis

but is probably not as sensitive as a CT scan or MRI.
 MANAGEMENT

Anti coagulant therapy heparin therapy is started .

It is followed by wafarin orally.

Bed rest-restriction of movement until the clotting time hhas shown

signs of improvement.

Analgesics given

Antibiotics given

Monitor patient for side effect of anticoagulants.

 PULMONARY EMBOLISM

A pulmonary embolism (embolus) is a serious, potentially

life-threatening condition. It is due to a blockage in a
blood vessel in the lungs. A pulmonary embolism (PE)
can cause symptoms such as chest pain or
breathlessness but may have no symptoms and be hard
to detect. A massive PE can cause collapse and death.
PE usually happens due to an underlying blood clot in the
leg - deep vein thrombosis (DVT)
 PREDISPOSING FACTOR

C-SECTION

OBESITY

HIGH PARITY

IMMOBILITY

TRAUMA TO LEGS

SMOKING

LAB DIAGNOSIS-X-ray,

lung scanning

and angiography
 CLINICAL MANIFESTATIONS

MINOR PULMONARY EMBOLISM-Chest pain, dyspnoea

and hemoptysis.

MAJOR PULMONARY EMBOLISM-Dyspnoea, sudden

collapse hypotension, pyrexia, cyanosis

MANAGEMENT-Administer of oxygen and fowler's

position and I/V strptokinase(THROMBOLYTIC AGENT)

infusion of heparin, (morphine or diamorphine) to relieve

pain.

Monitor vital signs

Cava filters placement