Mastitis

Lactational mastitis is inflammation of breast tissue, usually beginning with milk stasis. Incomplete milk removal, a painful latch, or ineffective feeding can leave milk accumulating while surrounding tissue becomes inflamed and oedematous. The swelling can further narrow the ducts and make milk removal more difficult, creating a cycle of pain, inflammation, and stasis. Bacterial invasion may then convert inflammatory mastitis to infectious mastitis. Staphylococcus aureus is the most common organism identified in this setting. Fever and malaise do not, by themselves, prove bacterial infection; an uncomplicated presentation may initially be managed with supportive measures rather than immediate antibiotics. For the RPN, the clinical task is to assess both members of the feeding pair: the mother’s breast and systemic condition, and the infant’s ability to feed adequately. The RPN works within provincial scope, employer policy, and the plan established by the authorized prescriber or registered nurse. Focused assessment, accurate trending, comfort measures, medication administration when authorized, documentation, and timely escalation are the practical contributions that keep a localized problem from becoming a breast abscess or systemic illness.