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| HEALTH & FITNESS |
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Breast abscess: consult a specialist without delay
Beware of baby-walkers
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Breast abscess: consult a specialist without delay
Breast abscess usually is an acute attack caused by bacterial infection but at times it may be chronic – long-standing one caused by tuberculosis, fungus, parasites and, rarely, by actinomycosis, syphilis, etc. The type of bacteria that most frequently produce acute breast infection is Staphylococcus Aureus. Bacteria usually enter through a crack in the nipple or in the skin of the breast. The resulting infection invades the fatty tissue of the breast, leading to swelling and pressure on the milk ducts. The initial stage of infection is the cellulitis stage, also known as mastitis. At this stage, the breast tissue is infected. As the disease progresses, liquefaction takes place resulting in the collection of pus; and this is the stage of breast abscess. A haematoma in the breast because of an injury can result in the collection of blood in the breast tissue, and this can get secondarily infected because of the presence of infection in the body and result in breast abscess if not adequately treated in time. Symptoms and signs At the mastitis or cellulitis stage the patient complains of pain at the site, may have fever, a generalied sense of malaise and discomfort. The breast is swollen, with redness and raised temperature, and is very painful to touch. As the disease progresses, fever increases, and there may be chills and rigours. The abscess site in the breast becomes more painful to touch. The area becomes harder than other areas of the breast — in medical terms, this is known as induration and suggests the underlying pus formation. It is necessary to diagnose the problem early so that prompt treatment may be undertaken, otherwise the size of the abscess cavity increases very rapidly, and may even occupy the whole breast or burst out through the skin. In case the infection is severe, lymph nodes in the arm pit of the same side may get enlarged and these may also be painful. In case the pus cavity is communicating with the duct, then pus discharge from the nipple may be noticed. Management In case the patient approaches a doctor early, the treatment will consist of the following: 1. Promptly start antibiotics, preferably in injection form, initially for two or three days and then one can switch over to the oral route. One can try any of these antibiotics — Augmentin, Erythromycin, Ofloxacin and Ciprofloxacin. May have to combine it with anti-inflammatory agents, analgesics (to control pain), and/ or antipyretics (for bringing down fever). 2. There is a difference of opinion among surgeons regarding local treatment — some advise hot fomentation, some cold compresses and others advise hot fomentation alternating with cold compresses. This has to be done at least three or four times a day. 3. In case the patient is breast-feeding her baby, then it can be continued. But it becomes difficult if the problem is near the nipple or the patient is having severe pain and discomfort. Under these circumstances, milk formation may be stopped by giving medicines or milk may be taken out either by a pump or manually, and this milk can be boiled and given to the baby through a bottle. Breast-feeding from the opposite site should continue. 4. The breast should be supported properly as pain is likely if the heavy breast hangs down. The treatment of breast abscess is surgical. The standard and well-established surgical treatment is incision and drainage of the abscess , preferably under general anaesthesia, so that the loculi (septa in the pus cavity) are broken and all the pus is drained out. The incision should be given at the dependent part of the abscess cavity; it should be reasonably large enough so that all parts of abscess cavity can be inspected and proper dressing undertaken. Following the operation, dressing is required daily and it takes 10 or 15 days for complete healing. Alternative procedure In this era of minimal surgery, an alternative surgical procedure of breast abscess management has also been practised by a few surgeons. The procedure is simple and consists of simple aspiration, preferably with a wide bore needle. All the pus is aspirated out and then an antibiotic is instilled in the cavity. All the steps mentioned above for the mastitis stage (including systemic antibiotics) are also carried out simultaneously. The patient may require repeated aspirations, at an interval of three or four days, depending upon the amount of pus present, and this requires patience on the part of both the surgeon and the patient. I have been handling breast abscess cases with this method for the last about 12 years and I am very much satisfied with the results. Risk factors for breast abscess A number of factors increase the risk of developing breast abscess, and these include: Not following a feeding schedule and not able to feed the baby properly — which means the breasts are not emptied of milk. Tight bra causing pressure on the milk ducts. Stress and exhaustion in new mothers. Early weaning from breastfeeding. Overweight. Having a history of previous breast abscess. Use of tobacco products. Reducing the risk of breast abscess A woman breastfeeding her child can take the following steps to minimise the risks of breast abscess: Frequent breast-feeding or manual expression of milk. Both breasts should be evacuated periodically so that milk does not stagnate in the breast Preventing drying, irritation or cracking of the nipples, and for this moisturising is the best method. Controlling the diabetes level. Weaning the baby slowly from breast-feeding over several weeks. Negligence results in disfigurement and persistence of pain. The writer is a former Senior Professor & Head of Surgery, PGI. Email: drsmbose@gmail.com |
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Beware of baby-walkers
“About 2000 children are killed everyday as a result of preventable injuries worldwide. For decades, baby walkers have been identified as potentially hazardous to children,” according to The Lancet, a medical journal.
In Medieval times, some Europeans and Asians religiously thought that in order to keep humans from imitating animals in anyway, babies should not be allowed to crawl. As an alternative, babies were strapped upright into baby seats and mobile walkers. Today more than one-third of all babies between 5 and 15 months use walkers. Baby-walkers are fun and keep your child alert, allowing mobility beyond a baby’s natural capability and faster than a parent’s reaction time. Babies almost universally love them, and parents love to use them because they may keep an otherwise fussy baby entertained, often for hours. There are several types of baby-walkers, but most people are familiar with the typical plastic base, a wheeled frame and a fabric seat that has leg holes to allow the child to scoot along the floor. This toy gives freedom of mobility to the child. Parents, however, feel that this helps the child in learning walking and doing exercise. Many parents say they use the walker because they feel it will keep their infant safe. Unfortunately, none of these beliefs are meaningful. Baby-walkers are one of the most dangerous inventions made for children, causing a lot of harm and heartache. Many infants are injured when they use a mobile infant walker. The hazards
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A baby can fall over
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Can rolls down stairs
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Can injure fingers and toes.
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Burns — can crash into hot surfaces, heater, bathtubs, etc., and get burnt by previously out-of-reach objects such as candles and cups of hot drinks.
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Drowning — can fall into a pool or bathtub or other water source.
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Poisoning — baby-walkers allow your baby to reach household poison such as perfume, alcohol and oil.
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Babies who use walkers tend to have an abnormal gait but this tends to resolve quickly with time.
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Walkers do not affect the time at which a child learns to walk. Studies have shown that if there is any effect on walking, it is rather a delay of a few weeks! l
Prevents infant from exploring and grabbing at things around them, which is mandatory to their early development.
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While rolling with its walker, the baby doesn’t understand the concept of uneven surfaces, steps and obstacles, because the walker cannot be operated on such surfaces. Thus, the baby tends to falsely believe that its world is flat.
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Harnessed in the safety of the walker, the baby gets the surprise of life when, suddenly out of the walker, it finds itself sprawled against the hard floor, where there is nothing to support it. Key tips for caretakers
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Since 75% of injuries are related to falls over the stairs, don’t use a baby-walker near stairs even if you have a gate on the stairs.
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Close the door or gate at the top of the stairs.
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Keep your child within your view.
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Keep children away from hot surfaces and containers.
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Beware of dangling appliance cords.
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Keep children away from toilets, swimming pool and water sources.
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Baby-walkers can actually delay when a baby begins to sit, crawl or walk unassisted as well as slow a baby’s mental and motor development. Most of the hazards aren’t because the walker itself is dangerous, but only that it makes your child more mobile before time, which can cause injuries if your house isn’t well child-proofed. The writer is a consultant paediatrician based in Jaipur. Email— drvivek_sharma@ rediffmail.com |
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Health Notes
Washington: People taking vitamins or supplements have greater chances of dying over a given period than those not taking them, a new study has revealed. In the new study, researchers gathered data on nearly 1,800 people between the ages of 62 and 74 who were participating in a prospective, population health study of the residents of one town in Finland. Over a 10-year period, 59 of the 221 people (26.6 per cent) taking a vitamin or supplement died, whereas 281 of the 1,553 people (18.1 per cent) of the non-users died. After the researchers took into account other factors that can affect a person’s risk of dying — such as age, gender and smoking — they found that people taking vitamins or supplements were 50 to 70 per cent more likely to die over the course of the study than those not taking them, said study researcher Dr. Tomi-Pekka Tuomainen of the University of Eastern Finland. —
ANI
Kids exposed to more antibiotics ‘more prone to allergic asthma’
Washington: Antibiotics may heighten incidence and severity of allergic asthma in early life, says a new research. A University of British Columbia study shows that certain antibiotics that affect intestinal bacteria also had a profound impact on allergic asthma. “It has long been suspected that kids exposed to more antibiotics — like those in developed countries — are more prone to allergic asthma,” said the study’s author, UBC microbiologist Brett Finlay. “Our study is the first experimental proof that shows how,” he said. —
ANI
Cardiovascular health factors that cut death risk
Washington: People who met more of seven recommended cardiovascular health behaviours or factors (such as not smoking, having normal cholesterol levels, eating a healthy diet), had a lower risk of death compared to those who met fewer factors, although only a low percentage of adults met all seven factors. This is the finding of a study that included a nationally representative sample of nearly 45,000 adults. The American Heart Association (AHA) recently published recommendations aimed at improving cardiovascular health and reducing deaths from CVD in the United States by encouraging the general population to meet seven defined ideal cardiovascular health behaviours or factors. — ANI
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Breast abscess is a bacterial infection of the breast, commonly seen in females. Although breast abscess can occur at any age (even in infancy or at puberty), most commonly, it is seen in young females and that also in lactating mothers.