MASTITIS IN THE NEWBORN Inflammation of the mammary gland nearly always occurs in a functionating organ. Hence, acute inflammations of the breast some times occur in the newborn just as in women in the puerperium and during lactation. In the child the disease occurs only from the 1st to the 3rd week of life. At the beginning of the attack the breast becomes tender and gradually becomes reddened, and the skin over it oedema tous. The vicinity of the gland protrudes as a whole and gradually suppurative softening takes place followed by spontaneous rupture, unless opened surgically. The disease is often accompanied by very high fever, restlessness, anorexia, vomiting and liquid stools. Mastitis must be attributed to infection by micro-organisms; according to Lange, bacteria are present physiologically in the lacteal ducts of the new born (just as has been demonstrated in adult women). Through trauma these organisms, which are harmless as long as the epithelium is intact, wander into the tissues and set up their inflammatory reaction. Ulcers and fissures of the nipple are possibly also portals of entry for these bacteria.
The diagnosis is easily made. It is hardly possible to mistake it tor physiological lactation and retention of the secretion, since with the latter, ()Alma. redness and tenderness are wanting.
The prognosis is good; complications such as extensive phlegmo nous cellulitis with resultant sepsis are very rare and preventible by rational treatment. The gland is partially destroyed by inflammatory processes and this is of importance for the female, since women who have gone through attacks of mastitis as children, later, in their puer perium, have poorly developed breasts, unsuitable for nursing.
Prophylaxis and prevent the occurrence of mastitis, the breast of the newborn infant should he protected from all manner of trauma. For this reason expressing the contents of the gland is unqualifiedly interdicted and the secreting gland should be pro tected from pressure by the application of sterile cotton buffers. With the appearance of the first symptoms of inflammation a dressing should he applied. Gauze compresses soaked in liquor alumini acetatis (P. G.) diluted S-10 times or in half-strength aqua plumbi, or in 50 per cent. alcohol, are applied to the diseased breast, covered with oiled-silk and fixed by means of a hinder.
If fluctuation is demonstrable, incision is indicated. The incision should be made as near the periphery of the gland and as small as possi ble, and to insure the cutting of the fewest number of ducts, it should run in a radiating direction from the nipple. after incision the wound should be dressed with dermatol or airol, and sterile gauze or possibly with moist dressings. Recovery follows in a few days. It is possible that the application of the suction apparatus, according to Bier, will have a favorable effect in cases of mastitis of the newborn, just as has been shown for the same disease in mothers.