Medical Ethics Oral Presentation

Length

4–5 minutes

Audience

Patient or family member

Prompt

Deliver a formal oral presentation in which you educate a patient or family member about a condition related to the endocrine or reproductive system.

• Clearly identify the condition and your central message

• Explain relevant medical terminology in accessible language

• Be well-organized (introduction, body, conclusion)

• Demonstrate confident and purposeful delivery

• Emphasize understanding, clarity, and compassion

Response

Introduction

There are a lot of complications with pregnancy.

But the medical changes and dangers associated with pregnancy don't abruptly stop once the baby is born.

I'm hear to talk about one specific complication that's possible following a pregnancy: lactational mastitis.

Lactational mastitis is inflammation of the breast tissue and may cause pain, fever, and difficulty breastfeeding.

It's the most common form of mastitis, and affects up to 30% of breastfeeding women.

Lactogenesis

During pregnancy, a women's body will prepare for lactation in a 3-stage process known as lactogenesis.

The first stage begins during the second trimester of pregnancy, and lasts until shortly after birth.

This is where hormonal changes prepares the breasts for lactation.

Stage two starts a couple of days after the baby is born and lasts until approximately 2 weeks postpartum.

This is where milk transitions from early milk, known as colostrum, into mature milk and the production and volume produced increases.

Stage three, known as the maintenance stage, occurs for the duration of lactation.

This is where mature milk is produced according to the child's demands.

Risk when not breastfeeding

The risk of lactational mastitis starts with the onset of lactation during the second trimester of pregnancy.

Although some milk may be present before the baby is born, it is quite rare to develop mastitis while pregnant.

The risk for mastitis is more common among mothers who choose to breastfeed their child, and the risk continues while breastfeeding is ongoing.

Causes

Lactational mastitis is often caused by a poor drainage of milk from the breast.

As milk pools in breast tissue, it creates hotspots for bacteria to grow and can open doors for an infection.

For women who are direct breastfeeding with their baby, this can be caused by a poor latch and missed feedings.

Similarly, for women who are using a breast pump, a poor flange size and missed pumping sessions can also lead to mastitis.

Tight bras are another potential cause, where put pressure on and constrict milk ducts, potentially leading toward blockages.

Any blockage of the milk ducts will allow bacteria, which enters through the nipples, to grow and inflame surrounding tissues.

Prevention

Because of this, it's important to keep hands clean before touching the breasts, and to sterilize any pumping equipment.

It's also important to breastfeed regularly and thoroughly, in order to keep the milk from pooling in the breast tissue.

Symptoms

Once mastitis develops, it can cause breast pain, breast swelling, lumps, yellow discharge of the nipples, redness, warmth, or flu-like symptoms.

Left untreated, mastitis can progress into a full infection where or even sepsis.

Treatment

For treatment, the goal is to clear any inflammation and allow milk to flow freely.

If caught early, conservative treatment such as rest, ice, and continued breastfeeding can help significantly in clearing of blocked ducts.

Ice is generally better than heat, as the goal is to reduce swelling to allow the milk to flow freely.

Once blockage ducts are cleared, the body should be able to handle any bacteria present.

If symptoms don't improve within 24 hours, antibiotics may be necessary to fully clear any infection present that may be causing additional inflammation.