Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007



Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007
Textbook Problem

Chronic Mastitis


This was an unremarkable first pregnancy for 29-year-old Barbara Ann. Barbara Ann has reported experiencing “a little” breast enlargement during her pregnancy.

Her infant is first put to the breast at 2 hours postpartum, and the infant latches well according to mom, and suckles vigorously. The infant nurses every 2 hours over the first 3–4 days postpartum. Barbara Ann’s breasts became noticeably fuller during the third postpartum day, and by the fourth postpartum day they are painfully engorged. In addition, Barbara Ann reports painful, burning, cracked nipples. The engorgement makes it difficult for her baby to latch at the breast. The baby becomes irritable, and Barbara Ann experiences a significant amount of pain. A lactation consultant gives Barbara Ann guidelines for engorgement management.

On day 5, the engorgement is still causing discomfort. Barbara Ann’s nipples have become more cracked and painful. The lactation consultant notes that the infant’s latch has become shallow and tight, probably in an attempt to control the flow of milk. However, the infant shows all the signs of adequate intake, including 10 very wet and 5 soiled diapers during the 24 hours prior to the consultation.

By day 7 postpartum, Barbara Ann has mastitis. She is treated with a 7-day course of dicloxacillin. A lactation consultant assists her in achieving a proper infant latch.

By day 14, Barbara Ann is feeling much better. The mastitis has resolved, and her nipples are healing. She still has tenderness during infant feedings and a healing crack on the right side. Her breasts are still uncomfortably full and are occasionally swollen and tender.

At 3 weeks postpartum, Barbara Ann develops an inflamed area on the right breast that remains red and tender despite applying warmth and massage to the area. The lactation consultant helps Barbara Ann to position the infant in a way that allows drainage of the inflamed area and recommends she pump the affected side to relieve the discomfort. The crack on the right nipple has improved, but is still not completely healed. Barbara Ann continues to show signs of oversupply, such as breasts feeling uncomfortably full, even after feeding, and excessive milk leakage between feedings. The lactation consultant provides Barbara Ann with techniques to decrease her overproduction.

After 10 days of persistent burning pain in the nipple area, Barbara Ann is treated with fluconazole for a yeast infection. Seven days after starting the fluconazole, a topical nystatin ointment is prescribed for her nipples and an oral suspension for her infant.

At 7 weeks postpartum, Barbara Ann calls the lactation consultant to report another flare-up of mastitis. Her health care provider prescribes a 10-day course of dicloxacillin. Barbara Ann is still treating her nipples with nystatin ointment. At 8 weeks postpartum her mastitis resolved; her nipple pain is still present, but improving. Barbara Ann is nursing the infant on one side only per feeding and reports that the infant latches better when she is in a more reclined position.


List at least two possible nutrition diagnoses for this case.

Summary Introduction

To list: Two possible nutrition diagnoses for the given case study.

Introduction: Chronic mastitis is a breast disease that leads to prolonged inflammation. This disease occurs if the mother avoids breastfeeding. Breastfeeding is the most important and natural way to feed a new born baby. Mother’s milk provides all the nutrition and immunity to the baby that is needed during the first six months and breastfeeding satisfies their hunger and thirst and provides the proper amount of protein, minerals, and immunity to the child, which helps to deal with the environment.


Person B was pregnant at the age of 29 and during her pregnancy and she has reported experiencing a breast enlargement. After two hours of postpartum, the infant is put to the breast and the infant handled well according to mom. The infant nurses over in every two hours on the initial 3-4days of postpartum. Person B noticed a fuller breast during the third day of postpartum and gradually she felt a painful engorgement by the fourth postpartum day. During this time, she also reported a painful, burning, and cracked sensation on her nipples. At this time, the infant was unable to latch properly at the breast. This led to an irritable sensation for the infant and painful sensation for Person B. Person B consulted a lactation consultant and followed an engorgement management. On the fifth day, the engorgement caused discomfort. The nipples of Person B became more cracked and painful because the latch of infant has become shallow and tight . In case of the infant, all symptoms showed the adequate intake of nutrition. By seventh day of postpartum, Person B had mastitis and consulted a lactation consultant for treatment. By day 14, her symptoms became very less and she felt much better. At the third week, she had inflammation during feeding infant and a healing crack...

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