Az emlő patológiája

Caring for new mothers: diagnosis, management and treatment of nipple dermatitis in breastfeeding mothers.

Heller MM, Fullerton-Stone H, Murase JE.
Int J Dermatol. 2012 Oct;51(10):1149-61.


Breastfeeding is thought to be the most optimal form of infant nutrition. Nursing mothers are generally advised to continue breastfeeding until the infant is two years of age or beyond. Unfortunately, however, a majority of nursing mothers will discontinue breastfeeding much earlier than recommended. The most common reason for early discontinuation of breastfeeding is nipple pain. It is, therefore, essential that dermatologists know how to appropriately diagnose and effectively treat nipple pain associated with nipple dermatitis among nursing mothers. This review article provides a detailed discussion on the clinical features and management of various causes of nipple dermatitis during lactation, including problems with infant latch-on, congenital oral anomalies, plugged lactiferous ducts, atopic dermatitis, irritant contact dermatitis, allergic contact dermatitis, yeast infections, bacterial infections, herpes simplex virus, and Raynaud's phenomenon of the nipple.

Factors predicting early discontinuation of exclusive breastfeeding in the first month of life

Vieira GO, Martins CC, Vieira TO, de Oliveira NF, Silva LR.
J Pediatr (Rio J). 2010 Sep-Oct;86(5):441-4.


OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil.

The Absence of Candida albicans in Milk Samples of Women with Clinical Symptoms of Ductal Candidiasis

Thomas W. Hale, Tiffany L. Bateman, Malcolm A. Finkelman and Pamela D. Berens
BREASTFEEDING MEDICINE Volume 4, Number 2, 2009


Objective: The objective of this prospective study was to determine if Candida albicans is present in the milk of women suffering from symptoms of severe nipple and deep breast pain.

Oral Administration of Lactobacillus Strains Isolated from Breast Milk as an Alternative for the Treatment of Infectious Mastitis during Lactation

E. Jiménez, L. Fernández, A. Maldonado, R. Martín, M. Olivares, J. Xaus and J. M. Rodríguez

Applied and Environmental Microbiology, August 2008, p. 4650-4655, Vol. 74, No. 15

The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment.

Kvist LJ, Larsson BW, Hall-Lord ML, Steen A, Schalén C.
Int Breastfeed J. 2008 Apr 7;3:6.


BACKGROUND: The role of bacterial pathogens in lactational mastitis remains unclear. The objective of this study was to compare bacterial species in breast milk of women with mastitis and of healthy breast milk donors and to evaluate the use of antibiotic therapy, the symptoms of mastitis, number of health care contacts, occurrence of breast abscess, damaged nipples and recurrent symptoms in relation to bacterial counts.

An Update on the Recognition and Management of Lactational Breast Inflammation

From Journal of Midwifery & Women's Health

Christine M. Betzold, NP, CLC, MSN


Inflammation of the breast (mastitis) with or without infection or redness has a variety of etiologies and presentations that range from the fairly benign blocked duct to the more serious breast abscess. True infectious mastitis can present in a manner that is easily identifiable, or it can present in a subtle and ambiguous fashion. Some women are challenged with recurrent mastitis, and often the underlying etiology is never discovered.

Ankyloglossia in Breastfeeding Infants: The Effect of Frenotomy on Maternal Nipple Pain and Latch

Anjana Srinivasan, Carole Dobrich, Howard Mitnick, Perle Feldman
Breastfeeding Medicine. 2006, 1(4): 216-224.


Objective: The aim of this study was to measure the effectiveness of frenotomy in ankyloglossic infants, by quantifying the changes in latch and maternal nipple pain using standardized tools.

Severity of Mastitis Symptoms as a Predictor of C-Reactive Protein in Milk and Blood During Lactation

Catherine M. Fetherston, Jim I. Wells, Peter E. Hartmann
Breastfeeding Medicine. 2006, 1(3): 127-135.


Objective: To investigate the presence of C-reactive protein (CRP) in breast milk and any relationship between changes in CRP in breast milk and blood, and the severity of systemic and breast symptoms experienced during mastitis.

Relationships Between Symptoms and Changes in Breast Physiology During Lactation Mastitis

Catherine M. Fetherston, C.T. Lai, Peter E. Hartmann
Breastfeeding Medicine. 2006, 1(3): 136-145.


Objective: The objective was to investigate changes in milk composition that reflect variations in breast permeability, milk synthesis, and immune response in women before, during, and after mastitis.

Vasospasm of the Nipple Presenting as Painful Lactation

Sarah M. Page, MD and David S. McKenna, MD

Obstetrics & Gynecology 2006;108:806-808

Case Report


BACKGROUND: Breast pain is a common complaint among lactating women. Vasospasm of the nipple should be considered in the differential diagnosis of breast pain, particularly when no other signs of infection or trauma are encountered. This report demonstrates a case of vasospasm successfully treated with nifedipine.

Excretion of lactose in urine as a measure of increased permeability of the lactating breast during inflammation

Catherine M. Fetherston, Ching Tat Lai, Leon R. Mitoulas, Peter E. Hartmann

Acta Obstetricia et Gynecologica Scandinavica Volume 85, Number 1 / January 2006 pp20 - 25


Hypothesis. The increased excretion of lactose in urine will be an accurate predictor of increased breast permeability during inflammation of the breast and therefore could predict whether there is a relationship between the severity and type of symptoms suffered during mastitis and changes in breast permeability.

Prevention of and Therapies for Nipple Pain: A Systematic Review

Kristine Morland-Schultz and Pamela D. Hill

JOGNN*, 34, 428-437; 2005

Objective: To review the literature on nipple pain and to delineate effective strategies for the prevention and treatment of nipple pain in breastfeeding mothers.

Data Sources: Computerized searches on MEDLINE, Pre-MEDLINE, CINAHL, and the Cochrane Library.

A Heads Up for MRSA Mastitis

Notes from Dr. Hale

We are all hearing more and more about the new epidemic of Methicillin-Resistant Staph Aureus (MRSA). While the rate in the general public is still low, it is rising and it seems especially so in pediatric age patients where a higher prevalence seems to occur in settings that enable close contact between individuals, such as day-care centers.

Raynaud’s Phenomenon of the Nipple: A Treatable Cause of Painful Breastfeeding

Jane E. Anderson, MD, Nancy Held, RN, MS and Kara Wright, MD

Pediatrics 2004;113:e360–e364.

Maurice Raynaud first described the vasospasm of arterioles in 1862, and Raynaud’s phenomenon is now felt to be common, affecting up to 20% of women of childbearing age. Raynaud’s phenomenon has been reported to affect the nipples of breastfeeding mothers and is recognized by many lactation experts as a treatable cause of painful breastfeeding...

Mastitis - Causes and Management

A mastitis a mell gyulladásos állapota, amelyhez fertőzés társulhat. Általában a laktációval összefüggésben lép fel, ezért laktációs vagy puerperális mastitisnek is nevezik. Esetenként fatális lehet, amennyiben nem megfelelően kezelik. A mastitis súlyos szövődménye a melltályog, amely lokalizált gennygyülem a mell állományán belül. Ezek az állapotok számottevő nehézséget jelentenek, és jelentős költséggel járnak. A legújabb kutatások kimutatták, hogy a mastitis megnöveli a HIV szoptatás útján való átvitelének kockázatát.

Galactocele: three distinctive radiographic appearances

A Gómez, J M Mata, L Donoso and A Rams
Radiology 1986; 158:43-44


Three radiographic appearances of galactocele of the breast not, to our knowledge, described previously in the literature were studied in 11 patients.

Mammary nodules with distinct and separate hydro-fat levels were observed in five cases. A nodule containing mixed water and fat densities was seen in one patient, while in the five remaining patients, pneumocystograms revealed masses of a water density mixed with the injected air.

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