Untitled - Memorial University's Digital Archives Initiative - Memorial ...

source of information on t he true extent of puerpera1 breast
infection in these countries. More broadly based studies are
therefore needed.
The generally accepted pathoqenesls af puerperal breast
infection is that it starts with cracked ar sore nipples . This
commonly occurs after the first few days of suckling and is
associated with breaches in t he protective epidermal covering,
which facilitates the entry of pathogenic organisms into
deeper breast tissue, with development of mastitis and its
abscess sequelae (106 ) . The most frequently identified
causative organisms are the Staphylococci, which may arise
f rom the mother' 5 own skin flora or the Lnr e nt ' s naso-
pharyngeal flora (94-97,107] .
42
Sore n ipples are known to occur frequently in breast­
feedj ng mothers especially in the first weeks of breast­
feeding and with the first child (107] . No data on t he actual
i ncidence of sore or cracked nipples nor on the extent to
which this contributes to mastitis have been found by this
author. sporadic mastitis is often a late puerperal disorder
seen frequently after t he second postpartum week : most western
studies indicate t hat most cases occur between t he second and
fifth postpartum week [45,97, 106,107]) . Mastitis is frequently
bilateral and can be recurrent in about 12% of women in
SUbsequent births (107 ] .