Written by Dr.M.D.Mazumdar, MD
A breast abscess is caused by infection of the engorged glandular system of the breasts. Around 1 woman in 10 who are breastfeeding suffer from engorgement of the breasts. Of these, around 3 in 100 develop mastitis in spite of being on antibiotics.
Mastitis means an inflammation of the breast tissue. In its more serious form, there may be a single pocket or multiple pockets of pus in the breast tissue - this is then called a breast abscess.
The breasts are composed of 20 lobules surrounded by pockets of fat. These lobules produce milk from the mother's blood after the delivery of the baby.
Immediately after delivery, the breasts produce a thin yellowish liquid known as 'colostrum". The amount of colostrum produced at this time is quite adequate for the newborn baby .
But from about 3 -4 days after delivery, the amount of milk secreted increases. If the milk is not removed by the baby by suckling and it stagnates inside the breasts, breast engorgement can occur. This stagnant milk is a rich media for the growth of bacteria, leading to the development of mastitis and breast abscess.
Infection in breast abscess is usually caused by a bacteria known as staphylococcus aureus. It enters the breast from an infected cracked nipple, either from the nasopharynx of an infected baby or more commonly, from the infected hands of nurses, midwives, doctors or the mother herself.
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If the abscess is not treated immediately, there is breakdown of the tissues involved in the abscess. There is collection of pus under the skin and the area becomes soft and fluctuant.
Sometimes the breast abscess may burst spontaneously and pus may be seen dribbling from an open pus point on the abscess. Bursting of the abscess, whether spontaneous or surgical, causes a reduction of the intensity of the pain.
Sometimes the only symptom may be a soft tender lump on the breast. The lump does not diminish in size after breastfeeding. On pressure, soft fluctuating pus will be felt - pressure will cause intense pain.
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