Acute mastitis during pregnancy: causes and treatment. Treatment of mastitis during pregnancy

Mastitis is inflammatory disease breast cancer, which is most common in women of reproductive age (16 to 45 years), and is most often associated with pregnancy and breastfeeding. However, mastitis can occur at any age. In a simplified form, we can say that mastitis is an infectious lesion of a lobule (or lobules) of the mammary gland through a damaged surface (cracks, scratches).

Causes of mastitis

As mentioned above, the most common cause of mastitis is infection, usually gram-negative flora. The main causative agent is staphylococci and streptococci, which usually enter the mother through the child's mouth, if hygiene, feeding techniques are not observed (insufficient preparation of the nipples before childbirth), with reduced immunity - gram-negative flora is often part of the normal flora and is not normally pathogenic, but various diseases that reduce immunity can cause mastitis. It is necessary to add to the main causes of mastitis also lactostasis, leading to "stagnation" of milk, creating favorable conditions for infection and progression of the process.

There are postpartum or lactational mastitis (during feeding), fibrocystic mastitis (in no way related to feeding and can occur in women of any age), mastitis ("breast") of newborns - engorgement of the mammary glands in newborns (regardless of gender) associated with the ingestion of lactogenic hormones with mother's milk to the child.

Postpartum lactational mastitis occurs as a result of infection in the breast tissue during breastfeeding. Three stages can be distinguished in it: serous (beginning), infiltrative (diffuse and nodular) and purulent (infiltrative, abscessing, phlegmanous and gangrenous). It is more common in nulliparous women over 30 years of age, with somatic diseases. The most common causative agent is Staphylococcus aureus. It is characterized by the severity of the process and often requires surgical intervention.

Infant breast is a consequence of the ingestion of maternal lactogens to the child during feeding. As a rule, the first symptoms appear from the moment of the first feeding. The peak is reached by 10-12 days of life, evidence of which is often breast swelling during these days. Passes in 2-3 weeks - a month by itself, in rare cases - when infected, the child may develop neonatal mastitis, requiring immediate surgical intervention.

Fibrocystic mastitis is dishormonal benign disease mammary glands and is associated with an imbalance of sex hormones, or thyroid hormones (two main reasons).

Symptoms of mastitis

Along the course, mastitis can be acute, less often chronic.

Acute mastitis, as a rule, is more often lactational and occurs in nursing mothers. The forms of acute mastitis include:

Serous - characterized by milk retention in the mammary gland, a violation of its outflow, engorgement of the gland.
infiltrative - an infiltrate (seal) appears in the mammary gland, in the absence of treatment - the transition to the next stage
abscessing - limited purulent focus
phlegmonous - the spread of purulent inflammation in the breast tissue
gangrenous - massive foci of necrosis appear in the mammary gland

Chronic mastitis is of two fundamental forms - purulent and squamous.

Purulent mastitis is most often the result of poorly or untreated acute mastitis. Most often it occurs in women who have given birth.
Chronic squamous mastitis is characterized by the absence of delimited abscesses (abscesses), more often among menopausal women. It presents a serious problem in terms of diagnostic errors and requires attention, as it is often mistaken for malignant tumor with all the ensuing consequences.

Symptoms of acute lactational mastitis include:

1. Acute onset - usually at 2-4 weeks postpartum. Body temperature rises rapidly to 38-39°C, often accompanied by chills. There is pain in the mammary gland. In the absence of treatment, mastitis becomes infiltrative within 2-3 days - a rather dense painful infiltrate appears. The skin over the infiltrate is reddened.
2. If there is no treatment or it is inadequate, mastitis turns into purulent form that happens within 2-4 days. The temperature rises to 39 ° C and above, signs of intoxication are growing: lethargy, weakness, poor appetite, headache. Swelling of the mammary gland increases, soreness increases, softening areas may appear against the background of a generally compacted mammary gland.
3. If purulent mastitis acquires an abscess form, the purulent infection is delimited. However, the process can go further, the infection can spread and mastitis will flow like phlegmonous. The general condition of the puerperal in such cases is severe. The temperature reaches 40 ° C, strong, amazing chills, intoxication is pronounced. The mammary gland sharply increases in volume, its skin is edematous, hyperemic with a bluish tint, any touch to the gland is sharply painful.
4. The most severe form of mastitis is gangrenous, which has an extremely severe course, with pronounced intoxication and death of breast tissue. Exodus given state unfavorable.

Symptoms of fibrocystic mastitis include:

1. Pain in the mammary glands - usually constant, not infrequently associated with menstrual cycle, often appear in the second half of the cycle.
2. The appearance of nodules in the mammary gland - multiple (diffuse form) or single and well-defined (nodular form)
3. Redness of the mammary gland, the appearance of rashes and engorgement on the surface of the skin of the mammary gland are possible

Symptoms of breast cancer in newborns include:

1. Enlargement or swelling of the breast (nipples) on both sides, coarsening of the skin.
2. Discharge of a white liquid from the breast - milk.
3. In girls (most often during the peak of the process) may begin to stand out white slime with an admixture of blood from the vagina, which lasts no more than 2-3 days.
4. In boys, the scrotum may swell slightly (no more than 4-5 days).

Diagnosis of mastitis:

1. As a rule, acute lactational mastitis is not difficult to diagnose, because the symptoms are quite well expressed. Often a simple examination, examination and palpation of the breast is enough to confirm mastitis.
2. Clinical Tests- leukocytosis in the blood predominates, a shift in the leukocyte formula is a characteristic sign of the inflammatory process.
3. Bacteriological examination of milk and, if necessary, bacteriological examination of blood.
4. Ultrasound - has importance in the diagnosis of not so much acute as fibrocystic mastitis. This is especially important due to the fact that this type of mastitis is often confused with a malignant disease, which is most common in the nodular form of fibrocystic mastitis (or fibrocystic mastopathy, as it is often called). Thanks to ultrasound, it is almost always possible to accurately distinguish malignant process from this pathology.
5. Breast biopsy - most often with nodal shape fibrocystic mastitis, to finally differentiate it from malignant pathology. The study is painful, it is not uncommon to conduct under ultrasound control.

Mastitis treatment

Treatment only in hospital last resort at home, but under the supervision of a doctor. There can be no question of any self-treatment!

The most important thing in treatment lactational mastitis- this is the establishment of a good outflow of milk from the breast, which is achieved by competent pumping. Most often, the breast is emptied by manual pumping, however, a breast pump can be used for this purpose. The main treatment measures include:

1. When starting mastitis:

Complex use of antibiotics, with preliminary sowing of milk to determine the sensitivity. Currently, the most commonly used are: semi-synthetic penicillins (methicillin, oxacillin, dicloxacillin), lincomycins and aminoglycosides (gentamicin, kanamycin). The course of treatment is 7-10 days.
It is important to reduce lactostasis in the affected gland. The most effective in this regard is parlodel (2.5 mg 2 times a day for 3 days).
The use of physical factors of influence - it is possible to use UV radiation (3-4 biodoses) - preferably, ultrasound 0.2-.6 W / cm3, microwaves (deci- and centimeter range). The effectiveness of these methods has not been proven. It is prescribed only by a doctor.

2. With purulent mastitis

Unfortunately, in this case the main type of treatment is surgical, while maintaining all the principles of treatment festering wound(opening and removal of an abscess, often removal of necrotic tissue, antibiotic and infusion therapy)

Breastfeeding in all of the above cases is recommended to stop. After the normalization of the process, breastfeeding can be continued (on average, 7 to 14 days after therapy, depending on the severity of the disease).

Principles of treatment fibrocystic mastitis can be described briefly - when a pathology is detected, treatment, as a rule, is aimed at finding out the causes of a hormonal shift and eliminating the causes. Surgical intervention is justified only if it was not possible to accurately establish the diagnosis and suspicions remain about the malignancy of the process.

Infant breast treatment is required only in rare cases of infection. Treatment in this case is surgical. The rest of the problem goes away on its own.

The disease can in no way interfere with the course of pregnancy, but it can seriously complicate the postpartum period. Among the complications of mastitis, one can single out the chronization of the process, the spread of infection to adjacent tissues, etc. Most severe complication mastitis - sepsis, in which the patient is treated under conditions intensive care unit. The prognosis is often unfavorable.

Obstetrician-gynecologist Kupatadze D.D.,

It seems that everything is behind us: the long way of bearing the fetus is over, the child was born, but, unfortunately, there are complications in the near future after childbirth. In particular, mastitis during pregnancy and in postpartum period may be the reason for serious problems in mother and unpleasant diseases in the baby. Inflammation inside the mammary gland leads to the formation of purulent foci. And the saddest thing is that you can not feed the baby breast milk.

Mastitis: what are the causes

Considering that there is no inflammation without the presence of an infection, it should be understood that it is the microbes that cause a purulent process in the breast tissue. Most often causal factor- a widespread microorganism staphylococcus, which is found on the human skin.

2. Lactostasis

The mammary gland is made up of many lobules, each of which produces milk. The nutrient fluid from the lobules through the excretory ducts enters the nipple area, and from there it is already out to the child. If the exit from the milk lobules closes, then lactostasis develops (milk retention in certain areas of the mammary gland). It is this condition that creates the conditions for the occurrence of inflammation.

3. Nipple crack

If a woman violates the technique of feeding a child, then she may experience injuries in the nipple area. Cracks are not only painful, but also become the entrance gate for infection.

4. Reduced immunity

Quite often, a woman after childbirth has a very pronounced decrease in defensive forces organism. This may occur due to postpartum trauma, bleeding, anemia, and malnutrition. In this case, the inflammatory process occurs much easier and faster.

5. Violation of hygiene

A woman should be very strict about hygiene rules, constantly treating the mammary glands and nipples before feeding in order to prevent possible infection and reduce the risk of inflammation in the breast.

Mastitis during pregnancy and in the postpartum period develops in stages. And this creates conditions for a woman to notice the complication in time and consult a doctor in a timely manner. Most often, the disease begins with stagnation of milk in the breast or against the background of a crack in the nipple. When microbes get inside, an inflammatory seal occurs. Then suppuration begins in this place, which requires immediate medical attention.

Mastitis: what will be the symptoms

2. Temperature rise

Against the background of purulent inflammation, there will be a pronounced and persistent increase in body temperature. Usually the temperature reaction is up to 38-39 degrees, and this increase persists for a long time, and attempts to reduce it do not give a good result.

3. Changes in the mammary gland

Outside, you can see that the breast has increased in size - on the side where the inflammation is, the mammary gland will be larger. In the place of suppuration there will be not only a seal, but also a patch of redness. There will definitely be swelling of the tissues. At the very worst case there will be a purplish or purple patch on the skin.

4. General complaints

The woman will have a pronounced weakness, drowsiness, apathy, her appetite decreases and she does not want to do anything.

In the tests that the doctor will prescribe, there will be characteristic changes in the blood. AT bacterial culture milk, it is possible to identify the microbe-causative agent, with the determination of sensitivity to drugs.

Mastitis: how to treat

1. Antibiotics

Unfortunately, without using antibacterial drugs not enough. For the entire time of taking the medicine, you must stop feeding the baby, because the antibiotic will pass into breast milk. Doses of the drug should be sufficient to ensure that inflammation is eliminated.

2. Breast emptying

If the problem in the gland is still at the level of lactostasis, then you should try to completely express the milk. A woman who can cope with the stagnation of milk will be able to avoid mastitis.

3. Stop feeding

In cases where it is necessary to stop lactation and it will not be possible to feed the baby, the doctor will prescribe special tablets. Having clearly followed these recommendations, a woman will stop lactating within 1-2 days.

4. Operation

In the worst case, when a purulent focus has formed, it is necessary to perform an operation (an incision of the gland and removal of pus from the chest). This manipulation will be done by the surgeon in a hospital setting. After this, a long-term anti-inflammatory and antibiotic treatment against the background of which, of course, it is impossible to feed the baby with breast milk. In some situations postpartum woman can preserve the ability of the mammary glands to produce milk, so that after treatment, continue to provide the baby with natural feeding.

The inflammatory process in the mammary gland is more common in women who give birth for the first time and do not have experience in proper feeding of the child. If lactostasis occurs, then it is necessary to drain the breast as soon as possible. If this does not help and microbes have penetrated inside, you should consult a doctor in a timely manner to prevent dangerous complications for mom and baby.

Primiparous women often develop mastitis - purulent inflammation mammary gland, in which pathological processes cause unpleasant and sometimes very painful symptoms. Symptoms of mastitis most often occur during breastfeeding, but can appear even before childbirth, when future mother breasts begin to swell, preparing for the upcoming lactation.

In some cases, mastitis develops without being associated with pregnancy or breastfeeding (so-called non-lactating mastitis), and this occurs in women aged 20-60 years. In isolated cases, mastitis is diagnosed in girls who have just been born, which is associated with excessive intake of mother's hormones into the blood.

Inflammation of the mammary gland in women and its treatment is within the competence of mammologists. Among lactating women, the incidence of mastitis is 5-15%, and medical prevention of the disease is often ineffective. The vast majority of patients (85%) are primiparous, since they always have a higher risk stagnant processes in the chest due to lack of skills proper feeding and pumping. In non-nursing women, the incidence of mastitis is not high (no more than 1% of all mammological pathologies).

Mastitis, or, in the old way, the chest, has a tendency to spread rapidly over vast areas of the mammary gland. lactation mastitis always proceeds more severely than non-lactation mastitis. This is due to the penetration of pus into the ducts with the flow of milk and the coverage of purulent processes throughout the loose structure of the gland. As a rule, the disease affects only one gland, mainly the right one, but in last years doctors identify many cases of bilateral mastitis. Without treatment, this pathology can cause serious complications, the most formidable of which is sepsis, or blood poisoning.

Why does mastitis develop?

The causative agents of the disease in the vast majority of cases - staphylococcus aureus, streptococcus often - are not susceptible to antibiotics of the first generations. Occasionally affects organ tissues even coli, which can happen after poisoning, intoxication. Inflammation of the mammary gland occurs after the introduction of infection into the tissues, which can occur in various ways:

• through cracked nipples;
• through chafing, sores of the nipples, which were formed due to improper attachment of the child;
• with lymph flow from adjacent foci of infection;
• by hematogenous route from any infectious foci (with reduced immunity).

Mastitis during breastfeeding does not occur in every young mother. There are factors that provoke its development:

• complicated childbirth;
• purulent-septic complications after childbirth from other organs;
• mastopathy;
• large size of the mammary glands;
• flat, inverted nipples;
• scars on the mammary gland;
• decrease in general, local immunity;
• lactostasis (stagnation of milk, impaired venous and lymphatic outflow);
• insufficient emptying of the breast during breastfeeding;
• mechanical injuries of the nipples;
• improper attachment of the child to the breast;
• poor hygiene of the mammary glands;
• use of soiled underwear.

Prenatal mastitis is often associated with pathologies during pregnancy. After childbirth, if the mother's immunity is greatly reduced, the infection can easily spread from the tonsils, urinary tract, lungs, boils, carbuncles, get into the chest and cause inflammation of the mammary gland. Since the gland of lactating women has all the conditions for the existence and active reproduction of the infection, symptoms of mastitis appear after a couple of days.

Of all the above factors, the most common cause of mastitis is lactostasis - stagnation of milk due to its abundant production and insufficient or improper pumping. In the lobule of the gland where the most milk has accumulated, the ducts are clogged with milk "plugs". A woman has seals in her chest, which, however, can resolve after a thorough massage. If you do not pay attention to the problem, purulent mastitis occurs with all the characteristic signs.

Non-lactation mastitis develops without a woman having a breastfed baby. The disease is infrequent, and its main causes are associated with hormonal disorders, abortion, trauma, gland compression, complications fibrocystic disease, sharp decline immunity, severe hypothermia. Sometimes such mastitis is a complication of small abscesses or boils in the chest.

Mastitis classification

The division of mastitis, depending on the functioning of the mammary glands, is as follows:

1. Non-lactational mastitis, including fibrocystic mastitis.
2. Lactational (postpartum) mastitis (more than 95% of cases).

The second type of pathology develops only in lactating women. Non-lactating mastitis is associated with other causes and occurs in non-lactating women or in pregnant women.

According to the type of inflammatory process, pathology can exist in several forms. They also represent the stages of mastitis:

1. Serous (acute) mastitis. The initial stage of the pathology, in which inflammation of the breast tissue occurs, the appearance characteristic features(high temperature, pain, etc.). It proceeds similarly to the usual lactostasis.
2. Infiltrative mastitis. In one of the lobules of the gland, a seal is formed, causing significant pain.
3. Purulent mastitis. If the first two stages of the pathology are not treated, purulent mastitis causes suppuration of the inflamed area of ​​the mammary gland.
4. Abscessing mastitis. A large purulent focus is localized in the chest.
5. Phlegmonous mastitis. At this stage, there is a spread of purulent phenomena throughout the gland or their transition to a healthy gland.
6. Gangrenous mastitis. There is necrotization of the tissues of the organ, the formation of blood clots in the vessels of the gland.

Usually, purulent mastitis causes localization of abscesses in the following areas:

• near the nipples, or subalveolar mastitis;
• inside the gland, or intramammary mastitis;
• behind the mammary gland, or retromammary mastitis;
• under the skin of the chest.

In addition, acute mastitis and chronic (recurrent) mastitis are distinguished.

How the disease manifests itself

The symptoms of mastitis vary depending on whether acute type pathology develops or chronic. Symptoms of mastitis of a nursing mother often occur against the background of lactostasis and as its complication, but sometimes they appear suddenly, without prior stagnation of milk. In some cases, mastitis begins only with inflammation of the milk ducts, then it is referred to as galactophoritis. The main symptoms of acute mastitis:

• breast engorgement;
• swelling of the gland;
• appearance painful hardening without clear contours;
• redness, hyperthermia of the skin in the affected area;
• inflammation of the nipple and the circle around it;
• increase in body temperature;
• general intoxication (weakness, sweating, headache);
• severe pain in the gland;
• an increase in the size of the entire organ;
• soreness of feeding, pumping;
• sometimes - the appearance of blood in the milk.

With the development of infiltrative mastitis, which occurs in the absence of therapy after 2-3 days, the clinic of the disease intensifies, the general condition continues to deteriorate. As a result of palpation of the breast, it is possible to accurately identify the focus of inflammation (infiltration). Gradually, the pathology acquires purulent character. Symptoms of mastitis in nursing in this case:

• secretion of milk with pus;
• increased signs of intoxication;
• fever up to 40 degrees;
• growth of infiltrate;
• the appearance of fluctuations (fluctuations of the skin due to the presence of liquid pus);
• the presence of extensive cavities with pus (phlegmonous mastitis);
• shine, hyperemia of the skin;
• the appearance of bluish spots;
• enlarged axillary lymph nodes.

If gangrenous mastitis develops, in addition to purulent fusion and extensive tissue necrosis, inflammation spreads to chest. In this case, the pathology may be complicated by sepsis.

Signs of mastitis chronic form arise as a result of improper treatment of acute mastitis. Gradually, small abscesses form in the mammary gland, the tissues around them thicken and become hard. Slow inflammation causes the formation of fibrous ridges around purulent cavities (encapsulation). The body temperature of a woman is subfebrile or normal, the lymph nodes are often enlarged. The gland itself is moderately painful, the skin is slightly reddened, a serous fluid is released from the nipple, sometimes with blood. With non-lactational mastitis, the symptoms are similar to those with chronic mastitis, proceeding with mild severity.

Mastitis: is the danger great?

The danger of pathology exists already at the stage of purulent processes, when a cavity filled with pus forms in the chest. It is impossible to cure her with the methods of conservative medicine, so the woman has to undergo an operation to remove pus, stopping feeding the baby. Gangrenous mastitis is very difficult, irrevocably spoiling the shape of the breast and often becoming more complicated. common infection blood.

The consequences of mastitis are possible even after a successful operation. Some time after discharge, the woman develops milk fistula, which can resolve or fester again. Also, against the background of reduced immunity, suppuration often occurs. postoperative suture, or a new exacerbation of mastitis. In addition, any operation causes aesthetic damage to the mammary gland, sometimes significant. Long-term complications mastitis can become fibrocystic or nodular mastopathy and even breast cancer.

Examination for mastitis

Usually, acute mastitis does not raise doubts in the diagnosis already when examined by a mammologist and palpation of the affected area of ​​\u200b\u200bthe chest, lymph nodes. To clarify the diagnosis and differentiate it from some forms of cancer, an ultrasound is prescribed, reflecting inflammatory phenomena in iron:

• expansion of the ducts;
• increasing the thickness of the skin, a layer of fiber;
• decreased tissue echogenicity;
• the presence of a zone with greatly reduced echogenicity (inflammatory infiltrate);
• the presence of abscesses, necrotic tissues.

Sometimes, if the ultrasound picture does not give an accurate picture of the nature of the disease, an x-ray examination (mammography) may be required. A biopsy of the abscess or infiltrate is possible using fine needle aspiration. If treatment is ineffective, antibiotics for mastitis are selected after bakposev discharge from the mammary gland and determine the sensitivity of the pathogen to drugs. Additionally, the doctor may prescribe the following examinations:

• clinical analysis of urine, blood;
• cytology of milk from a diseased gland.

If it is not possible to visit a mammologist, you should contact the clinic for a surgeon or gynecologist.

Features of the treatment of mastitis

If the prevention of mastitis was ineffective, treatment of the pathology should be started as early as possible. This will help prevent purulent processes, cancel the need for surgery. An important non-drug measure of therapy is the correct expression of milk every 3 hours. Since this manipulation is very painful, it is often performed after a novocaine blockade. If within a day the desired effect does not occur, appoint antibiotic therapy. Antibiotics for mastitis are administered intramuscularly, and sometimes additionally - in the area of ​​inflammation. Use penicillins, more often - cephalosporins. If the purulent focus continues to grow, do surgical operation.
Other treatments that are used for mastitis (duration 7-15 days):

1. Desensitizing and antihistamine therapy.
2. Drug suppression of lactation (drugs are used to inhibit the production of prolactin). Such treatment will be required for phlegmonous mastitis and necrosis phenomena, as well as for severe course diseases in combination with various complications.
3. Taking vitamins (especially with mastitis, ascorbic acid, a group of vitamins B, is indicated).
4. Reception of antispasmodics, painkillers.
5. Treatment of intoxication (infusion of glucose, electrolytes).
6. Physiotherapeutic methods.
7. Application of Vishnevsky ointment (bandages, compresses).

Feeding for the period of therapy will have to be stopped due to the presence of infection in the milk, as well as decay products of bacteria and leukocytes. The intake of such milk can provoke digestive disorders in the baby and the development of intestinal dysbiosis.

Operation for mastitis

Within two days, the doctor decides on surgical intervention. Indications for surgery:

• lack of positive dynamics;
• symptom progression.

Breast surgery for mastitis is performed under general anesthesia. An important task of the doctor is not only the complete extraction of the purulent focus, but also the maximum preservation of the aesthetic appeal of the gland. The abscess is opened, bridges, pockets, all necrotic areas are removed, the cavity is drained. If there is an infiltrate, it is also removed completely. With abscessing mastitis, it is important to excise each purulent focus, so several incisions in the mammary gland are performed.

After the operation, the woman expresses her milk to prevent stagnation. Wounds are drained, washed with antiseptics, which will help them faster and with less cosmetic consequences drag on. The sutures are removed 7-10 days after the operation. In the early rehabilitation period treatment with antibiotics, taking general tonic drugs, vitamins, immunomodulators, UV, UHF, microcurrents, magnetotherapy is indicated.

Treatment of mastitis at home is allowed only at the stage of the serous type of pathology, before the formation of abscesses. Since it is quite difficult to determine the type of disease on your own, mastitis is treated with folk methods after consulting a doctor. Such popular recipes are popular:

1. Compresses with mint leaves. For resorption of edema and seals with mastitis, they take fresh leaves mint, crushed a little and crushed until juice is released, applied to the chest. From above, the mammary gland is wrapped with gauze, a cloth. The compress is kept for 2 hours, after which it is removed, at least 2 procedures are performed per day. If there were no fresh leaves available, you can steam the dried ones and repeat the procedure in the same way. In addition to mint, leaves of cabbage, alder, coltsfoot have an excellent resolving effect.
2. Compresses with chaga. A piece of chaga mushroom should be well steamed in boiling water, cool. Wrap it with a bandage, attach it to the mammary gland, cover it with parchment on top (without cellophane). Leave the compress on all night, thus being treated for 7 days.
3. Honey onion compresses. Bake an onion in the oven. Grind the onion into gruel, add a spoonful of honey. Run a compress on the chest from this mass, secure with a rag, leave overnight. The course of treatment is 5 days.

Prevention of mastitis

Every woman after childbirth, especially a primipara, should remember that only properly organized prevention will protect her from such unpleasant disease like mastitis. Of course, not everyone can learn how to correctly attach the baby to the breast and optimally set the feeding regimen. But in our time, in any maternity hospital and antenatal clinic there are breastfeeding specialists who will gladly initiate a woman into all the mysteries of lactation. Prevention measures for mastitis are as follows:

• feeding on demand;
• pumping milk if the child for some reason "delays" the feeding process;
• no restrictions on the duration of feeding;
• timely treatment of cracks, wounds on the chest and nipples;
• observance of hygiene of a breast, all body;
• wiping the mammary glands only with a soft towel;
• do not wash your breasts with cold water;
• treatment of nipples between feedings with Bepanten ointments, sea buckthorn oil;
• preventing the baby from seizing the nipple without the areola;
• conducting light massage with the formation of seals in the chest;
• performing special physical exercises for the postpartum period.

Usually, even in the maternity hospital, a woman is told how to deal with lactostasis and take care of the mammary glands during lactation. Compliance with all these rules will help prevent inflammation of the glands and, possibly, severe surgery.

Mastitis - breast or inflammation of the nipples is a fairly common pathology that usually develops with improper breastfeeding technique in nursing mothers.

In addition, cracks in the nipples can be the cause of mastitis, and breasts also occur with a rough impact on them. Therefore, mastitis during pregnancy can also be.

Symptoms
Symptoms of mastitis during pregnancy, as well as during breastfeeding, are a feeling of fullness in the chest, pulling pain and fever. When palpated, the chest becomes tight, hot and hard. Even gentle touches can deliver a woman severe pain. Along with these symptoms, the general condition of the woman may also worsen. The disease is a threat to the woman and the baby, especially in advanced stage. Therefore, it is necessary to consult a doctor even if there are at least a couple of signs of mastitis during pregnancy.

Purulent stage of mastitis
Timely detection and treatment of mastitis is not able to harm the woman and the fetus during pregnancy, and in the future does not exclude the possibility of breastfeeding. However, the most dangerous state for the expectant mother is the stage of purulent mastitis. Here, not only hospitalization is necessary, but also an operation, i.e. complete surgical intervention.

How to warn?
The disease is always easier to prevent than to identify and cure in the future. That's why Special attention to the chest should be given to those women whose nipples are flat or inverted. Here you need to prepare them for feeding with the help of a specialist. One more important point, which will help to avoid the occurrence of mastitis during pregnancy will be the absence of hidden inflammatory processes in the body. Any diseases must be cured before pregnancy or immediately after detection during the bearing of the baby. Otherwise, the infection can penetrate not only into the mammary glands, but also into the circulatory system.

How to treat mastitis during pregnancy?
Treatment of mastitis during pregnancy can be traditional - using medications and special means or folk. If a pregnant woman has found signs of mastitis at home, then the affected breast must first be tied up. During the day, it must be periodically lubricated. ichthyol ointment excluding rubbing movements.
Good for mastitis alcohol compress and castor oil. But the use of these two drugs during pregnancy should be done with caution and ideally after the recommendation of a doctor.

If mastitis needs to be cured during breastfeeding, milk from the affected breast must be expressed and poured into the sink. Never give a sick breast to a child. If an abscess has appeared on the chest, then a warming compress of 2% H2O2 can be applied to the affected area of ​​the skin. AT maternity hospitals may prescribe special procedures to help quickly get rid of mastitis.

Folk remedies
Folk remedies for treating mastitis during pregnancy are quite simple and safe. Very effective application to a sore breast cabbage leaf, which must be replaced with a new sheet when dry; applying gruels from grated carrots or from a mixture of bean flour and soapy water.

Get rid of purulent abscesses onions will help, which, before being applied to the site of the lesion, is first baked in the oven and cooled, and then mixed with honey or linseed oil.
Often, our grandmothers used plantain in the treatment of mastitis during pregnancy, famous for its unique properties. You can make an ointment from it. For this leaves greater plantain plucked, washed and crushed. The resulting slurry is poured warm, boiled water and wipe problem areas of the chest. Starch (rice and potato) has a striking effect, which is also applied to the chest mixed with water. Sometimes the water is changed to sunflower oil.

If the use folk methods treatment of mastitis during pregnancy did not bring the expected results, then consult a doctor.

Laparoscopy for ectopic pregnancy necessary, first of all, to confirm the diagnosis, as well as for the operation.