Neonatal mastitis-clinical profile and outcome: a hospital based study

Authors

  • Reyaz Malik Department of Pediatrics, SKIMS Medical College, Srinagar, Jammu and Kashmir, India
  • Mohsin Rashid Department of Pediatrics, SKIMS Medical College, Srinagar, Jammu and Kashmir, India
  • Asif Ahmed Department of Pediatrics, SKIMS Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20202144

Keywords:

Breast abscess, Neonatal mastitis

Abstract

Background: Neonatal mastitis may occur de novo due to infection by various organisms, most notably Staphylococcus aureus. This condition usually responds well to treatment, but may sometimes progress to breast abscess formation.

Methods: This was a retrospective study. All the patients who were admitted in hospital with admission diagnosis of neonatal mastitis or breast abscess were included in this study. Various demographic, clinical and lab data were recorded and analyzed.

Results: Total 11 patients fulfilled the inclusion criteria and were included in the study. (7 females: 4 males). Swollen and red breast area was the most common presenting complaint, seen in 10 patients. One patient came with complaint of pus draining from the swollen breast. 2 patients were febrile. The age at presentation varied from 7 days to 30 days (median age 14 days). 7 patients had undergone breast massage at hands of their family members to express the witch’s milk. Pus culture from the 6 cases of breast abscesses grew Staphylococcus aureus in 3 cases and Coagulase negative staph (CONS) in 1 patient. Blood culture was sterile in 8 cases, grew CONS in two cases and MRSA in 1 patient. In all the cases where blood culture grew an organism, a lumbar puncture was also done but CSF analysis was normal in all the cases. Drainage of abscess and IV antibiotics led to resolution of disease in all patients and none of the patients developed any complications.

Conclusions: Neonatal mastitis and breast abscess is not an uncommon condition. Complications are very rare and the condition responds well to IV antibiotics. People should be made aware about the ill effects of cultural practice of breast massage to express witch’s milk in neonates. Early treatment of mastitis leads to better outcome and lesser chances of abscess formation.

References

Felsh KN, Merritt DF. Breast Concerns. In: Kliegman RM, editor. Nelson Textbook of Paediatrics. 20th ed. Philadelphia: Elsevier Saunders; 2016: 2615.

Stricker T, Navratil F, Sennhauser FH. Mastitis in early infancy. Acta Paediatr. 2005;94:166-9.

Brett A, Goncalves S, Luz A, Martins D, Oliveira H, Januario L, et al. Neonatal mastitis: 12 years of experience. Acta Med Port. 2012;25:207-12.

Masoodi T, Mufti GN, Bhat JI, Lone R, Syed A, Syed KA. Neonatal Mastitis: A Clinico-Microbiological Study. J Neo Surg. 2014;3(1):2.

Madlon-Kay DJ. ‘Witch's milk’: galactorrhea in the newborn. Am J Dis child. 1986;140:252-3.

Sharma D, Murki S, Pratap T. Mastitis Neonatorum: An Interesting and Uncommon Condition Seen in Infants. J Neonatal Biol. 2017;6:1.

Qureshi B. Cultural gynaecomastia. Lancet. 1997;350:1108.

Walsh M, McIntosh K. Neonatal Mastitis. Clin Pediatr (Phila). 1986;25:395‑9.

Ruwaili NA, Scolnik D. Neonatal mastitis - controversies in management. J Clin Neonatol. 2012;1:207-10.

Forbes TR. Witch's milk and witch's marks. Yale J Biol Med. 1950;22:219.

Devidayal. A male infant with gynecomastia-galactorrhea. J Pediatr. 2005;147:712.

Karagol BS, Karadag N, Dursun A, Okumus N, Zenciroglu A. Breast massage and neonatal mastitis: A case report. Cocuk Dergisi. 2012;12:95-7.

Rudoy RC, Nelson JD. Breast Abscess During the Neonatal Period A Review. Am J Dis Child. 1975;129(9):1031-4.

Efrat M, Mogilner JG, Iujtman M, Eldemberg D, Kunin J, Eldar S. Neonatal mastitis--diagnosis and treatment. Isr J Med Sci. 1995;31:558-60.

Downloads

Published

2020-05-22

Issue

Section

Original Research Articles