Integrated Maternal and Newborn Care Basic Skills Course ...

Breast Abscess
Breast abscesses occur when mastitis is not appropriately or adequately treated, or if it is not
treated in a timely manner. Intervention at the first signs of mastitis may prevent the condition
from worsening and developing into a breast abscess.
Symptoms
• firmness
• very tender breast
• overlying erythema
• fluctuant swelling in the breast
• draining pus
Management
• Treat with antibiotics:
o Cloxacillin 500 mg by mouth 4 times per day for 10 days, or
o Erythromycin 500 mg by mouth 3 times (in severe cases up to 4 times) per day for 10
days.
• Drain the abscess:
o General anesthesia is usually required. Hence, the mother may need to be referred
to an appropriate center.
o Make the incision radially, extending from near the alveolar margin towards the
periphery of the breast to avoid injury to the milk ducts.
o Wearing high-level disinfected gloves, use a finger or tissue forceps to break up the
pockets of pus.
o Loosely pack the cavity with gauze.
o Remove the gauze pack after 24 hours and replace with a smaller gauze pack.
• If there is still pus in the cavity, place a small gauze pack in the cavity and bring the edge
out through the wound as a wick to facilitate drainage of any remaining pus.
• Encourage the woman to:
o Continue breastfeeding on the normal side and express out milk from the affected
side.
o Support her breasts with a binder or brassiere.
o Apply cold compresses to the breasts between feedings to reduce swelling and pain.
• Give paracetamol 500 mg by mouth as needed.
• Follow up three days after initiating management to ensure response.
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Integrated maternal and newborn care
Basic skills course