Mastitis is an inflammatory disease. Mastitis. Symptoms, causes, diagnosis and treatment of the disease. Acute lactational mastitis

Mastitis, which is popularly called breastfeeding, is quite serious illness, which manifests itself in the form of inflammatory processes in the area of ​​\u200b\u200bthe mammary gland. Inflammation spreads very quickly, so every woman needs to know what mastitis is, how it manifests itself and how to deal with it. Absence timely treatment can lead to the destruction of the gland and adjacent tissues. Mastitis is especially dangerous for people with weak immune system- there is a risk of sepsis and further spread of infection throughout the body.

The inflammatory process is most common in women at childbirth age, that is, in the range from 18 to 35 years. In 95% of cases, the disease worries mothers during lactation, especially in the first month of breastfeeding. Mastitis can also occur in men and children, but such situations are extremely rare.

There are two main types in total:

1. lactation;
2. non-lactation.

Obviously, the first type is directly related to pregnancy, in particular breastfeeding. The appearance of mastitis most often occurs after the first birth. The cause is small cracks that appear during feeding or milk stagnation, which allows pathogenic microorganisms to develop rapidly. Their development is expressed in the occurrence of inflammation of the breast.

Mastitis is mostly unilateral and manifests itself with right side. However, on this moment every tenth woman who comes to the doctor with a similar problem complains of discomfort in the chest area on both sides.

Not lactational mastitis breast appears much less frequently - only 5% of total. This type can occur at absolutely any age in both women and men and even children. Mastitis in non-breastfeeding women is great danger, but is much quieter. In the absence of treatment, a transition to the chronic stage is possible.

Reasons for the appearance

Mastitis of the mammary gland has an infectious-bacterial nature. From this it follows that inflammation is provoked by bacteria that have entered the body. Subsequently, the breast swells and becomes extremely sensitive, painful sensations appear, skin take on an unhealthy red color. There are cases when mastitis is caused by several types of bacteria, which greatly complicates the fight against the disease.

Lactational mastitis in women is usually associated with breastfeeding. A greater percentage of inflammation occurs in those who have first births. Also, mastitis during pregnancy can begin shortly before childbirth - at about 7-9 months. Mastitis in non-lactating women, young girls and children certainly belongs to the non-lactation variety.

The causes of mastitis lie in the infection of staphylococcus, streptococcus or coli. Milk ducts and blood streams can serve as transport for bacteria.

There are several reasons for the spread of infection:

• cracks and various damages;
• lactostasis (stagnation of milk);
• non-observance of hygiene rules;
• piercings, implants and other foreign bodies;
• purulent inflammation on the skin of the chest.

The slightest injury or crack in the nipple can lead to the rapid spread of infection in the mammary gland through the milk ducts and lymphatic vessels. The purulent process affects the chest not only from the inside, but also from the outside, affecting a large number of skin covers.

But the most common cause of occurrence is precisely the stagnation of milk. When the regular outflow of milk stops, fermentation of milk begins and active development bacteria. The result is inflammatory process and accumulation of pus in the breast. Important points are the observance of the rules of hygiene and proper care of the skin of the breast during lactation and breastfeeding.

In the second type of mastitis, the reasons are different. Non-lactational mastitis has a slightly different nature of the lesion. If in the first case there must be an infectious agent, then microbial associations become the cause.

Mastitis can occur not only in a nursing mother, but also in a newborn baby. A sexual crisis is possible, which is characterized by a slight swelling of the mammary glands, as well as the release of a milky-white liquid. If there are no redness and seals on the skin, you should not sound the alarm. This phenomenon is called physiological mastitis, which disappears by 2-3 weeks of a newborn's life. But attempts to “cure” it can lead to the development of a bacterial one.

Symptoms

Depending on how widespread the infection is in the breast and the form of the disease, various symptoms and signs of pathology. Symptoms are very similar to lactostasis, so only a qualified specialist can distinguish them.

Mammologists distinguish several main symptoms:

• decrease or complete absence appetite
• nausea and vomiting;
• loss of consciousness;
• dizziness and severe headaches;
• weakness and malaise;
• swelling and swelling of the mammary glands;
• pain on palpation;
• redness of the skin of the chest;
• obvious discomfort in this area;
• heat up to 40°C.

If treatment is delayed long box, mastitis will progress, as a result of which the chest will increase along with pain. It is possible to excrete blood and pus along with breast milk. Purulent mastitis can also lead to the formation of purulent cavities in the mammary gland.

Stages of development

Thanks to the improvement of modern medicine, doctors are able to determine with incredible accuracy the stage of development of the pathology in the patient, the causes of occurrence and prescribe effective treatment. A well-recognized disease is half the path to recovery.

There are 5 main stages:

• serous;
• infiltrative;
• abscess;
• phlegmonous;
• gangrenous.

Serous

most mild form is the serous stage of mastitis development. It is not possible to recognize it immediately, but it can be cured quite quickly, since there is no tissue damage by pathogenic organisms. The serous stage begins approximately on the third day of lactostasis with the formation of an inflammation focus. Be sure to consult a doctor if the following signs of mastitis occur: fever, pain and discomfort when pumping, breast tightness and swelling, loss of appetite. Lack of treatment will absolutely lead to the progression of the disease and the development of the next infiltrative stage.

infiltrative

characterized by the formation of an infiltrate with subsequent infection by pathogenic microorganisms. The duration of this stage directly depends on the state of the human immune system and the aggressiveness of bacteria. The transition to the stage of purulent mastitis, the so-called abscess, can occur extremely quickly.

Abscess

It begins to develop approximately 3-5 days after the onset and defeat of the infiltrate. All signs of mastitis progress noticeably, the patient's condition worsens. First of all, the temperature increases significantly (38 - 40 ° C), there is a noticeable reddening of the skin around the inflamed area, a painful seal in the chest is felt, which, on palpation, looks like a sponge soaked in purulent secretions. Weakness, headaches, nausea, vomiting, drowsiness and other symptoms of intoxication are also gaining momentum.

Phlegmonous and gangrenous

Mastitis at this stage can be cured only with the help of surgical intervention. The pus is removed, followed by drainage. Otherwise, mastitis develops into complex destructive forms, which are much more difficult to deal with: phlegmonous and gangrenous. The first is characterized by damage to the subcutaneous fat of the mammary gland and other breast tissues, the second - possible education blood clots in blood and lymph vessels.

Inflammation of the mammary glands in men

Mastitis in men is a completely uncommon phenomenon, because this pathology more common in women. The only factors provoking the development of inflammation of the mammary glands in men can be called failures in metabolism and the endocrine system. The consequence is the appearance pathological disorders in the mammary gland.

Also in men with impaired hormonal background gynecomastia may develop - swelling of the mammary glands. Plus, the skin can become inflamed and redden. The result of the manifestation of the above symptoms may be the allocation of defective breast milk.

The thing is that the mammary glands of men and women are similar in structure, but differ in development. Up to puberty there are absolutely no differences. Therefore, the appearance of mastitis in men cannot be called abnormal.

Mastitis manifests itself in the stronger sex in about the same way as in women. It can start from the serous stage and look like swelling of the mammary glands. There are painful sensations on palpation and are detected small seals inside. It is also possible a noticeable increase and soreness of the lymph nodes located in the armpits.

Later, the infiltration phase begins, in which the formation of an infiltrate, an increase in the number of leukocytes in the focus of infection and a noticeable deterioration in the condition due to intoxication are observed. An urgent consultation with a specialist is necessary for the appointment of treatment. If left untreated, the disease will progress. The purulent stage in men is rare, but its appearance threatens with serious consequences.

Diagnosis and treatment

If you have symptoms characteristic of mastitis, contact your doctor immediately for further diagnosis of the condition of the mammary glands. The doctor can put accurate diagnosis based on complaints and breast examination.

In some cases, additional procedures are prescribed for a complete diagnosis: mammography, breast ultrasound, general urine and blood tests, infiltrate puncture, bacteriological culture of milk and cytological examination.

With a serous and infiltrative stage, mastitis can be prevented without surgical intervention. A complex of conservative treatment is prescribed, which includes: establishing the correct regimen for feeding and expressing milk, antibiotics, ultrasound and UHF therapy. Breastfeeding in this case is allowed to continue, but only by expressing milk from a healthy breast, followed by pasteurization and feeding the baby from a bottle. Milk from a diseased breast is also subject to pumping, but in no case should it be given to the baby.

Antibiotics are allowed to be taken for ten days. If no improvement was noticed within 2-3 days, it is urgent to consult a doctor for further diagnosis and to exclude the risk of the pathology moving to the next stage.

Patients with abscessing and complex destructive forms of the disease are sent to the surgeon for further examination. Usually, the cavity is cleaned of pus and drained. After surgery for without fail need to take a course of antibiotic therapy. The main thing is to never self-treatment serious diseases such as mastitis.

Preventive measures

Prevention of mastitis is very similar to preventive measures for lactostasis for the simple reason that the second often precedes the development of the first. The main aspect in the question of how to avoid mastitis is regular breastfeeding, followed by expressing the remaining milk. It becomes mandatory to attach the child to each breast in turn for uniform emptying. Constant emptying of the mammary gland gives an almost 100% guarantee that neither lactostasis, nor even mastitis will bother you.

Some mothers use the breast as a sedative for the baby. Such a procedure is just as dangerous for the health of the mammary glands as the lack of their full emptying. Don't let your baby just suck on the breast without sucking out the milk.

Another important point is the correct attachment of the baby to the breast. The baby should completely capture the nipple along with the areola. Before feeding, it is necessary to wash not only the hands, but also the chest. If the slightest damage appears on the skin, be sure to use special wound healing agents for a quick recovery.

Effective prevention of mastitis also includes the identification and local elimination of foci of infection. General antibiotic therapy during lactation and breastfeeding is prohibited, since the drug can enter the baby's body through breast milk.

Inflammation of the breast in women and men is a serious disease that should not be left to chance. Timely access to a doctor, compliance with all recommendations and prevention will save you from the consequences and the transition of pathology to chronic form.

Breastfeeding is a great opportunity to raise a healthy and developed child, it is a wonderful side of motherhood, but these are some problems that, although not inevitable, are quite possible. During lactation, sometimes there are troubles, one of which is lactational mastitis. However, the disease can also occur in nulliparous women, But more on that later.

Mastitis in women: what is it

The name of the disease traditionally goes back to the Greek language. It is to him, as well as Latin, that doctors owe the opportunity to name each disease with an incomprehensible word. Mastitis comes from the Greek "μαστός" - breast and the Latin ending "-itis", meaning the inflammatory nature of the process. Simply put, mastitis is an inflammation of the mammary gland, and like any similar pathology, it goes through several stages in its course.

What is the classification of mastitis

Doctors have developed several classifications of mastitis depending on the stage of the process, the location of the lesion, prevalence, etc.

The most interesting for non-physicians will be the following types of classification of mastitis:

• Origin:
• Lactational (in women who have given birth).
• Non-lactating (everyone else, including infants).

Along the process:

• spicy,
• chronic.

According to the nature of inflammation:

Non-purulent, in turn dividing into

• serous,
• infiltrative;

• abscessing;
• phlegmonous;
• gangrenous.

There are also special kind diseases - infiltrative-abscessing, combining two forms, which are included in the name.

lactation or postpartum mastitis

As the name implies, breastfeeding women suffer from this disease. According to statistics (ICD-10 code - O.91) occurs in different regions of the country in 2-18% of cases of successful birth. It is noted that the frequency falls depending on the number of births: after the birth of the second child, the risk of mastitis does not exceed 10%, and after the third it is almost eliminated. Repeated births change the ability of the breast to adapt to changes in the hormonal status of women. In addition, more experienced mom better knows how to properly apply the baby, and observe the rules of personal hygiene.

Causes of acute mastitis

Staphylococcus aureus is considered the direct "culprit" of the development of acute mastitis (purulent and non-purulent). This microorganism constantly lives on the skin and mucous membranes in almost half of healthy people, without causing any illness for years. However, when provoking factors appear, it is he who becomes the causative agent of any form of mastitis in 9 cases out of 10. Much less often, the “culprits” of the disease are Escherichia and Pseudomonas aeruginosa, streptococcus, enterococcus, proteus, etc.

Sometimes (for example, with granulomatous mastitis), the microbial flora is only secondary cause pathology, and comes to the fore autoimmune lesion glands. However, this type of disease is still very little studied, and it is assumed that it is only one of the manifestations of systemic granulomatosis.

Here is what increases the risk of developing this pathology:

• lactostasis;
• pathological pregnancy and childbirth;
• the presence of comorbidities.

Signs of mastitis in a nursing mother

Lactostasis is a kind of "pre-painful" stage, which is noted in the majority (approximately 85%) of women with mastitis. There are many reasons for its development, which can be conditionally divided into objective ones:

• injury,
• cicatricial changes after operations,
• stiff nipple and its fissures,
• elongation, refinement and tortuosity of the milk ducts,
• diffuse or focal fibrocystic mastopathy;

and subjective, that is, a violation of the feeding technique and non-compliance with the regimen (feeding "on demand").

Acute mastitis usually develops 3-4 days after the onset of lactostasis, passing through several stages in its development that differ clinically.

Serous mastitis

This is the very first stage of the disease. An inflammatory reaction begins, the body temperature rises, chills appear, the mammary gland may increase slightly in size, and the place where the process began is painful, the skin over it turns red (hyperemia). When feeling the chest, apart from pain, there are no other signs of inflammation; it is impossible to feel the pathological focus. When expressing milk, its amount may be less than usual.

Infiltrative form

During this stage, the sensations of the patient are the same, the high body temperature and pain also persist. However, now in the mammary gland, with careful palpation, you can feel a shapeless seal without clear boundaries and softening areas. With serous and infiltrative mastitis general reaction body is caused precisely by the stagnation of milk. It is absorbed into the blood through the milk ducts damaged by inflammation, and it is this that causes the syndrome of intoxication.

Acute purulent mastitis

In the absence of proper treatment or in the treatment of mastitis with folk remedies, a purulent process develops for 3-4 days. From now on conservative treatment becomes ineffective.

Abscess form

When the process passes into the abscess phase, the patient's condition begins to deteriorate, the phenomena of pronounced intoxication increase, the body temperature in a third of patients rises sharply to numbers exceeding 38 ° C. The skin over the focus is intensely red, the pain is sharp. When feeling, a clearly defined seal is determined, in the center of which there is a softening area.

Infiltrative-abscess form

The course of this form is heavier than the previous one. Almost half of women complain of a temperature rise above 38°C. The main difference between this form of mastitis and abscessing is that a large seal is palpated (palpated) in the thickness of the gland, which consists of many small abscesses. Because of this, it is almost impossible to feel softening in the focus area.

Phlegmonous form

An even more severe type of inflammation. The general condition of the patients becomes severe, the symptoms of intoxication are pronounced, a third of the patients suffer from fever over 39°C, and almost all of them have a temperature above 38°C. Pain in the mammary gland is strong, weakness, loss of appetite, pallor appear. The volume of the affected mammary gland is sharply increased, the breast is edematous, the skin is sharply hyperemic, sometimes its color becomes bluish, the nipple often becomes retracted. Phlegmon captures 2-3 quadrants of the organ at once, and its total defeat is also possible. Feeling the breast is very painful.

Gangrenous form

This is the most dangerous form mastitis, in which the condition of a woman becomes severe or extremely severe. In this case, purulent fusion is not limited only to some part of the mammary gland, but captures it all. Often the process extends beyond the organ, affecting the fiber chest. All symptoms are pronounced, the patient is tested severe weakness, there is no appetite, there are headaches, aching bones and muscles. Temperature above 39°C - common occurrence in the gangrenous process.

Local manifestations are also bright: bluish-purple skin, exfoliation of the epidermis with the appearance of blisters over the focus, filled with fluid mixed with blood. Areas of complete necrosis (necrosis) of tissues appear. Other organs and systems of the body may also be involved in the process. For example, due to severe intoxication, the kidneys may suffer, which is manifested by changes in general analysis urine.

My chest hurts and is red. The symptoms are similar to mastitis. Which doctor should you go to? Lera, 21 years old

Lera, you should contact the surgeon and strictly follow his instructions. You may need to first go to a therapist for a referral.

Mastitis treatment

As with any inflammatory process, with mastitis, treatment can be conservative and surgical. The main tasks of the doctor in this case are to maximize rapid suppression process while maintaining the function and appearance mammary gland. With non-purulent forms, the treatment of mastitis at home is quite possible, since it consists in taking certain medications, although not in tablets or syrups, but parenterally. It is advisable to stop breastfeeding.

In non-purulent forms, treatment is as follows:

• 8 times a day, milk should be expressed first from a healthy, and then from a diseased gland. Milk can be given to the baby only after pasteurization. If its disinfection is not possible, it should be destroyed.
• 20 minutes before pumping or feeding, an ampoule of no-shpa is administered intramuscularly for more full disclosure milk ducts. It is also possible to prescribe oxytocin 5 minutes before pumping (increases milk flow).
• Antibiotics are prescribed a wide range actions, antihistamines, vitamins C, B.
• Recommended also novocaine blockades with the use of an antibiotic in the absence of an allergy to both novocaine and the corresponding drug.
• Semi-alcohol compresses are also used for mastitis. It is forbidden to use any ointment bandages.
• At good effect from the started treatment, it is possible to prescribe UHF to the site of inflammation a day after the start of taking the drugs.

At purulent mastitis treatment is not possible without surgery. An abscess opening is fundamental principle surgery, and not a single folk remedy or taking drugs orally or by injection can force the body to “deal with” pus. That is why several types of surgery have been developed, which in most cases allow avoiding any cosmetic defects or dysfunctions.

All patients are hospitalized for surgery. surgery department. Intervention is carried out in the operating room, subject to the rules of asepsis and antisepsis. The details of the operations themselves are of interest only to specialists, here we will only indicate the main stages surgical treatment purulent forms of mastitis:

• choice the best place incision, taking into account possible aesthetic consequences;
• opening the abscess and complete removal of pus and dead tissue;
• drainage (installation of a system that allows the remnants of pus, blood, wound discharge to flow freely from the abscess cavity);
• washing the abscess with antiseptic solutions by the drip method (permanent drip irrigation).

Levomekol, which was previously used relatively often for mastitis, is no longer used. The drainage-flushing method of treating the disease, according to research, is much more effective than just ointment applications.

After the operation, it is possible to immediately close the wound with sutures, but in case of extensive lesions, the surgeon may decide to perform a two-stage closure of the wound, followed by plasty of the defect with a skin flap.

Immediately after the operation, the woman is given antibiotics. The gold standard in the treatment of acute purulent mastitis is the use of cephalosporin drugs. Practice shows that penicillin antibiotics(augmentin, amoxiclav, and even more so amoxicillin and the like) are not effective enough to suppress the microbial flora.

Depending on the microorganism that caused suppuration, drugs from 1 to 4 generations (cephalexin, cefazolin, cefuroxime, ceftriaxone, cefotaxime, cefpirome) can be used. At severe forms diseases associated with systemic manifestations inflammation, as well as in sepsis, thiena is prescribed. Of course, we are not talking about ingestion of drugs; they are all administered intramuscularly or into a vein.

In order not to stop lactation, even with purulent inflammation, you should continue to express milk. This is necessary in order to prevent the continuation of lactostasis, which can cause a relapse of the disease. Lactation is interrupted only in a few cases: in severe forms of the disease, sepsis, bilateral process, relapse of the disease. It is possible to stop breastfeeding and with the persistent desire of the mother to do this. In these cases, special drugs are used that suppress milk production - parlodel, dostinex.

It should be noted that there is a tendency to prescribe drugs with unproven or unexplored efficacy. So, sometimes traumel is prescribed for mastitis - homeopathic remedy intended for use only in traumatology and orthopedics. At least that's what the manufacturer's instructions say. However, there is no particular problem if traumeel is taken simultaneously with the rest medical appointments. It most likely will not improve the course of treatment, but it will not worsen it either.

Symptoms and treatment of non-lactational mastitis

Cause non-lactational mastitis- penetration into the mammary gland of infection through cracks or wounds of the nipples, as well as in case of skin damage. This disease occurs in a non-nursing woman aged 15-50 years. There are also special forms This pathology: mastitis during pregnancy, which occurs extremely rarely, and mastitis in newborns, affecting both boys and girls. The provoking factors of the latter are diaper rash, purulent-inflammatory skin diseases.

The symptoms of mastitis in non-lactating women are exactly the same as in lactation. A feature of its course is more frequent and faster, compared with lactation, abscess formation. The disease itself is easier, better treatable, but more often becomes chronic and recurs.

The treatment of this form of the disease is exactly the same as with its lactational form. Newborns also open an abscess, followed by drainage.

Chronic mastitis

This disease is most often the result of acute process treated incorrectly or insufficiently effectively. The symptoms are similar to those of acute form illness, however clinical picture differs in "pallor": there are no acute phenomena of intoxication, general state rarely suffers, there is no reddening of the skin at the site of inflammation, palpation of it is not painful. On careful examination, a very dense infiltrate is palpated.

Sometimes chronic mastitis occurs in the form of a fistula, when an abscess of the mammary gland occurs during acute mastitis breaks out on its own. The channel through which pus flows out becomes a fistula. Due to insufficient outflow of pus, the inflammation does not completely stop, it becomes sluggish, and since the contents of the abscess constantly flow through the canal, it cannot close.

Treatment chronic mastitis- only surgical. The abscess cavity is opened, all non-viable tissues are removed, they are excised in the fistulous canal, after which the wound is sutured according to the same rules as in the acute form. Antibiotic prescription is mandatory.

Treatment of mastitis with folk remedies

The tendency of our people to keep everything under control makes them not turn to doctors using methods incomprehensible to mere mortals, but to seek alternative ways fight the disease. The treatment of mastitis with folk remedies most often consists either in applying some kind of compresses to the chest, or in drinking certain decoctions, infusions or teas from plants considered medicinal. Practice, however, shows the complete failure of such methods. The risk is huge, because it often takes too much time to understand that, for example, cabbage does not help with mastitis at all, and the use camphor oil only delays the inevitable transition purulent form pathology into an abscess or even phlegmon.

However, for those who did not heed the warning, we will indicate a few recipes. traditional medicine, which are believed to help cope with the disease:

• from ghee, rye flour and fresh milk they make a bun in the evening, leave it to “walk” overnight, and then apply it to the sore breast.
• The leaves of burdock and coltsfoot are poured with boiling water and applied to the sore spot.
• A piece kombucha placed on gauze, covered with parchment or any other paper and applied to the affected mammary gland for 5-7 days. The procedure is carried out before going to bed.

equate to folk medicine You can also use Vishnevsky's ointment for mastitis. Xeroform, which is part of it, according to its antiseptic properties many times inferior modern drugs(for example, chlorhexidine). Tar, also contained in the preparation, has a predominantly irritant effect, "thanks" to which almost always the non-purulent form of the disease turns into a purulent one, worsening its course and making the operation absolutely necessary.

Unfortunately, there are no statistics on cases of recovery with such treatment, but any surgeon has a dozen stories in his arsenal about how a woman lost her breasts because she did not go to a regular doctor for too long, preferring the recommendations of newspapers like "Grandmother's Pharmacy" ".

Mastitis is an inflammatory process in the tissues of the mammary gland. It is manifested by strong arching pains in the chest, swelling, induration, redness of the skin of the gland, a sharp rise in body temperature, chills. Mastitis is diagnosed visual inspection mammologist, it is additionally possible to conduct an ultrasound of the breast. The disease can lead to the formation of an abscess, phlegmon, necrosis in the mammary gland, the development of sepsis, and even lethal outcome. In case of microbial contamination of milk, breastfeeding will have to be stopped. AT remote period mammary gland deformity may occur, the risk of developing mastopathy and breast cancer increases.

Symptoms of mastitis

Acute postpartum mastitis is most often an inflammatory complication of lactostasis in nursing mothers. Sometimes it develops without precedence of pronounced signs of milk stagnation. Manifested by the appearance painful hardening in the mammary gland, redness and an increase in skin temperature in the area of ​​compaction, fever and common symptoms intoxication. With progression, the pain intensifies, the chest increases, becomes hot to the touch. Feeding and pumping are sharply painful, blood and pus can be found in milk. Suppurative mastitis often progresses with the development of a breast abscess.

Plasma cell mastitis is rare disease, which develops in older women who have repeatedly given birth after the cessation of lactation. It is characterized by infiltration of tissues under the nipple by plasma cells and hyperplasia of the epithelium of the excretory ducts. Such mastitis does not suppurate and has some common external features with breast cancer.

Mastitis in newborns is a fairly common condition in children of both sexes, manifested by swelling of the mammary glands, discharge when pressed on them (as a rule, is the result of the residual action of the mother's sex hormones). With the development of acute purulent inflammation and the formation of an abscess, surgical debridement of the purulent focus is performed, but most often the symptoms subside after three to four days.

Diagnosis of mastitis

The focus of inflammation in the mammary gland is determined by palpation. There is also an increase (sometimes moderate soreness on palpation) axillary lymph nodes from the affected chest. Suppuration is characterized by the definition of a symptom of fluctuation.

When mastitis is detected at the stage serous inflammation or infiltrate conduct conservative treatment of mastitis. Antibiotic therapy is given with strong operating funds wide spectrum of action. In this case, serous mastitis, as a rule, disappears after 2-3 days, it may take up to 7 days for the infiltrate to resolve. If inflammation is accompanied by severe general intoxication, carry out detoxification measures (infusion of electrolyte solutions, glucose). With severe excessive lactation, drugs are prescribed to suppress it.

Purulent forms of mastitis, as a rule, require surgical intervention. The developed abscess of the mammary gland is an indication for emergency surgical sanitation: opening of mastitis and drainage of the purulent focus.

Progressive mastitis, regardless of its stage, is a contraindication to further feeding (including healthy breasts), since breast milk is usually infected and contains toxic tissue breakdown products. For a child, pathologically altered breast milk can cause the development of dysbacteriosis and disorders functional state digestive system. Since mastitis therapy includes antibiotics, feeding during this period is also not safe for the baby. Antibiotics can significantly damage normal development and dew of organs and tissues. During the treatment of mastitis, milk can be expressed, pasteurized, and only then given to the child.

Indications for the suppression of lactation: the absence of dynamics in serous and infiltrative mastitis for three days of antibiotic therapy, the development of a purulent form, the concentration of the inflammatory focus directly under the nipple, the existing purulent mastitis in the history of the mother, comorbidities organs and systems, significantly worsening general well-being mother.

Prevention of mastitis

Measures for the prevention of mastitis coincide with measures for the prevention of lactostasis, since this condition is a precursor to mastitis in the vast majority of cases.

To prevent milk stagnation, a complete thorough emptying of the mammary glands is necessary: ​​regular feeding and subsequent pumping of milk residues. If a child gorges on milk from one breast, next feeding it is first applied to the gland untouched last time.

Don't let your baby just suck on the breast for comfort, without sucking out the milk. Contribute to the development of inflammation of the mammary gland cracks in the nipples, so it is necessary to prepare the nipples for feeding, carefully observe hygiene rules(clean hands, chest), correctly attach the baby to the breast (the child must capture the entire nipple with his mouth, along with the areola).

One of the preventive measures for the development of mastitis can be called timely detection and sanitation of foci of infection in the body, however, it is worth remembering that general antibiotic therapy during lactation is contraindicated.

The body of a woman is subject to constant changes. Periodicity menstrual cycles, restructuring of the body at conception, wearing and after the birth of a child. Various factors can, which a woman usually does not suffer from. Mastitis is common in women who are breastfeeding their babies, although there are cases of occurrence in those representatives who have not given birth recently.

What is it - mastitis?

If you are experiencing chest pain, then you may we are talking about mast. What it is? This is an inflammation of the mammary gland, which is located in the breast of a woman. It is more common in women during lactation (breastfeeding). However, sometimes it occurs in newborns and even men. Often affects only one mammary gland, although bilateral lesions are not ruled out.

Classification:

1. By forms:
   • Spicy;
   • Chronic.
2. According to the stages of development are divided into types:
   • The initial stage - serous mastitis - the penetration and reproduction of bacteria in the chest;
   • The second stage - infiltrative mastitis - inflammatory foci merge, there is a general swelling of the chest;
   • The third stage - purulent mastitis - purulent contents of the infiltrate. It, in turn, is divided into types:

• Abscessing - limited purulent focus (abscess);
• Phlegmonous - the spread of pus throughout the tissue;
• Gangrenous - massive appearance of necrosis. Often treated by removing the breast.

• They also distinguish pathological lactostasis (or latent, lactational mastitis), which manifests itself in lactating women with stagnation of milk in the breast.

Causes of mastitis of the breast

The main reason for the development of mastitis of the mammary gland is the penetration of infection (bacteria or viruses). This includes:

1. streptococci,
2. mycobacterium tuberculosis,
3. staphylococci,
4. coli.

The infection finds its way through wounds and abrasions on the nipples, as well as through excretory ducts. It can be carried through the lymph or through the blood from other organs that are affected by the infection.

Without contributing factors, the body can fight off the infection. However, their presence worsens the position of women. What are these factors?

• Breast trauma. Through wounds, the infection penetrates;
• Milk stasis, which is favorable environment for the reproduction of bacteria;
• hypothermia;
• Weakness of immunity;
• Hormonal disruptions that expand the excretory ducts of the mammary gland and open the way for infections.

Symptoms and signs

Common symptoms and signs of mastitis are:

• Deterioration: fever, chills, weakness, headache;
• Pain and breast enlargement;
• Redness of the skin of the chest;
• Palpable induration of tissue in the area of ​​the breast.

Signs of latent mastitis:

1. A slight increase in temperature to 37.5ºС;
2. Painful sensations when pressed;
3. Thickening of the mammary glands.

Signs of serous mastitis:

1. Chills;
2. Raising the temperature to 38.5ºС;
3. Drawing pain, aggravated by breastfeeding;
4. Weakness;
5. Headache;
6. redness of the chest;
7. Decreased appetite;
8. Perceived induration of the breast.

Symptoms of infiltrative mastitis:

1. Heat;
2. Sedentary compaction of the breast;
3. severe chest pain;
4. Enlarged lymph nodes in armpit with corresponding symptoms, as in lymphadenitis, from the side of the affected chest.

With purulent mastitis, the symptoms intensify:

1. Fever up to 39.5ºС;
2. The skin of the chest is red and hot;
3. Chills;
4. Change in the shape and shape of the mammary gland, swelling;
5. Severe throbbing pains;
6. Axillary lymphadenitis is pronounced.

A non-nursing woman shows the same symptoms and stages of development of mastitis as a nursing woman, only there is no latent stage.

With the formation of an abscess (abscessing mastitis), symptoms appear:

1. Painful swelling that does not go away;
2. Purulent discharge from the nipple;
3. Not falling temperature, despite all the antipyretic drugs taken and measures to eliminate the disease.

Mastitis in children

Although mastitis mostly affects breastfeeding women, it can also occur in newborns. The reason for this is the penetration of infections through the mother. At the same time, the baby's breasts may temporarily swell, regardless of whether it is a boy or a girl. Usually physiological swelling goes away on its own. However, it is better to consult a pediatrician who, if necessary, will prescribe antibiotics, anti-inflammatory drugs that will quickly eliminate the pathology.

Mastitis in adults

Mastitis in adults is manifested mainly in women: more often during breastfeeding, but there are cases in non-nursing women. In men, the disease manifests itself quite rarely due to infection penetration through the lymph, blood or damaged nipples.

Diagnostics

Diagnosis of inflammation of the mammary gland is carried out first with the appeal of a woman with complaints to a doctor (mammologist, surgeon), which aroused suspicions of the development of the disease. How long ago did they appear, what did the woman have before or during this, how clearly do they manifest themselves? The doctor performs a general examination and feels the chest to confirm suspicions of mastitis. Without instrumental and laboratory research not diagnosed:

• Blood analysis;
• Microbiological analysis of secreted contents from the mammary gland;
• Ultrasound of the mammary glands;
• Check for other inflammatory diseases in other organs.

Treatment

Treatment of mastitis depending on the stage of the disease, since the methods used at each stage differ significantly:

1. At the stage of lactostasis:
   • Expression of milk;
   • More frequent attachment of the baby to the breast;
   • gland massage;
   • Dry heating of the chest (with a heating pad);
   • A bandage or special bra that holds the chest.
2. At the stage of serous and infiltrative manifestation:

• Physiotherapy is prescribed: UHF, microwaves, UVI, ultrasound.
• Medications are prescribed: antibiotics, immunoglobulins, adaptogens, painkillers, vitamins.
• Ibuprofen (pain relief), paracetamol are prescribed.

1. At the stage of purulent manifestation:

• Open up the pus surgically and delete the content;
• The purulent cavity is washed with antiseptic drugs (antiseptics);
• A drain is placed to allow the contents to drain while healing occurs.

Infusion therapy showed itself well - intravenous drip of glucose and saline solutions.

How are they treated suppurative lesion all breast tissue? Only way complete removal breasts - mastectomy. Over time, allowed plastic surgery to restore the shape of the breast.

At home, mastitis is not treated. However, preventive measures are allowed that help to early stages development, as well as after recovery:

• Wearing the right bra that does not press or pinch your breasts;
• Compliance correct technique breastfeeding;
• Compliance with personal hygiene;
• Timely pumping of milk that the baby does not drink;
• No hypothermia;
• Treatment for all infectious diseases arising in other parts of the body;
• Consulting a doctor at the first manifestations of mastitis;
• Relaxation;
• Warm compresses to the chest.

Plasma cell mastitis is treated with x-ray exposure or, if it does not help, excision of the affected area.

Diet during treatment is not prescribed. Since a woman is breastfeeding, her diet is completely dependent on given period. The kid should get everything nutritional vitamins and substances that help him to be strong and healthy.

life forecast

Mastitis, although it is infectious disease, however, it does not worsen the prognosis of a woman's life in any way. If you start treatment in a timely manner, then you can avoid any negative consequences. How long do women live with mastitis? It all depends on the complications, if we are talking about the fact that the patient is not treated:

• Destruction of breast tissue.
• Breast deformity.
• Loss of the ability of the mammary gland to produce milk, resulting in an inability to breastfeed.
• Spread of infection to neighboring tissues, for example, provoking lymphadenitis.
• Sepsis is the penetration of pus and infection into the blood, which will spread pathogens throughout the body.

Happy is the woman who does not know what mastitis is. But unfortunately, this disease is quite common. Up to five percent of nursing mothers suffer from mastitis and, as a rule, this disease most often affects primiparous women. Therefore, it is very important to strictly observe the rules of breastfeeding and elementary sanitary standards. However, mastitis is an insidious disease. It affects not only nursing mothers, but also women after thirty, newborns and even adult men ...

The fact is that breast mastitis is inflammatory disease mammary glands, which is caused by various microorganisms. The trigger for the development of mastitis can be a cold, infection penetration through microcracks in the nipples. There are two types of mastitis - lactational, which appears in lactating women and fibrocystic.

The problem of breastfeeding mothers

As a rule, mastitis in lactating women develops in the first three months after the birth of a child. Mastitis provoked during breastfeeding can be a violation of the waste of milk through the ducts. As a rule, this is due to both banal inexperience and improper feeding baby, and inept actions when decanting. That is why lactational mastitis most often affects women giving birth for the first time.

With improper pumping and feeding, microcracks appear on the nipples, which become the entrance gates of infection. Staphylococcus aureus and other types of microorganisms penetrate through the cracks in the chest and cause inflammation. Sometimes mastitis in lactating women is the result of a postpartum infection. But this happens very rarely.

Signs of mastitis

If mastitis has begun to develop, it is impossible not to recognize its symptoms. The disease manifests itself acutely: the temperature suddenly rises to 38-39 ° C; the breast increases in size and becomes dense and sensitive. In parallel, a woman may have chills, nausea, weakness, weakness, which resembles flu symptoms. Further, the signs of mastitis are growing rapidly. After a while, it is simply impossible to touch the breast, it is so painful to the touch. After 2-3 days, a seal appears in the chest, the skin turns red, burning and pain are felt during feeding.

Most often, mastitis in a nursing mother develops in one breast. It almost never appears after 6 months - most often it affects a young mother in the period of 2-3 weeks -3 months after the birth of a child. Unfortunately, if mastitis appears, then the woman is at risk - the percentage of incidence of recurrent mastitis is quite high. If the treatment is not started on time, trying on yourself the “tested” grandmother's recipes retold by friends, then the disease will quickly develop into purulent mastitis. In this case, medical treatment may no longer be effective and surgery will be required.

Other types of mastitis

Women in their thirties may develop non-lactating mastitis. It affects weakened ladies who have problems with the immune system and sluggish pathological processes in the body. In this case, the signs of mastitis may not be so obvious and overlap with the symptoms of other diseases, which makes diagnosis difficult.

After forty to sixty years of age, symptoms may resemble mastitis-like breast cancer. For diagnosis, tissue is excised in the area of ​​\u200b\u200bdensification to rule out cancer.

Non-lactating mastitis in women can be caused by trauma to the mammary gland, abrupt change climate - a very frequent guest is non-lactation mastitis after holidays in warm countries in winter.

Very rarely, but still occurs mastitis in men. First of all, this is a sign of hormonal imbalance in the body; often mastitis appears in those who suffer diabetes. Occasionally, men who have had sex reassignment surgery and breast implants also develop mastitis, but this is rare. As a rule, the treatment of male mastitis is done without surgical intervention, with medical methods.

There is mastitis in children. Most often, mastitis occurs in newborns, which develops in the first weeks of life due to infection. Microorganisms penetrate with blood from another focus of infection or from the outside, through skin lesions. It must be remembered that children's mastitis develops very quickly and has a rapid course. After a day or two, the disease enters purulent stage. You should not think that if a newborn boy, then he cannot get sick with mastitis - children's mastitis equally often affects both boys and girls.

Mastitis appears as a common inflammatory disease - the temperature rises, the child becomes apathetic or, conversely, excitable, refuses to eat. One breast increases. On the first day of the disease, there is no redness, then swelling, redness, and soreness appear. Breast mastitis in a child requires a quick visit to the doctor at the first suspicion. Children are treated in the hospital with antibiotics and vitamins.

Mastitis affects girls in adolescence- This is usually the culprit. hormonal changes organism, leading to a temporary weakening defensive forces. The treatment of mastitis in adolescents is similar to the treatment of non-lactational mastitis in adult women.

Mastitis treatment

Despite the severity of the symptoms, mastitis in women is treated successfully and fairly quickly. The conservative and surgical methods treatment. If mastitis is diagnosed quickly and not started, then antibiotic therapy is prescribed for two weeks. disappearance pain is not a reason for drug withdrawal. If treatment is interrupted, then mastitis may return again.

In parallel, to alleviate the condition, ice is applied to the chest, plentiful drink, warm shower. No matter how much it hurts, you can't stop breast-feeding or squeezing. If purulent mastitis has developed, it is better to express milk. Otherwise, milk will accumulate in the breast and mastitis will worsen.

If antibiotic therapy does not give results and mastitis has passed into the purulent stage, then surgical intervention: an abscess is opened in a hospital.

Prevention of mastitis

Lactational mastitis is better prevented than treated! From the very beginning of feeding, follow simple rules that will help avoid infection of the breast. Wash before and after every feeding mammary glands wipe with a mild disinfectant solution. Be sure to change the position of the child, apply it alternately to each breast, but only after he has completely emptied the first breast. Express any remaining milk.

No need to allow the baby to play with the breast - if he has already eaten and just indulges, then stop feeding. Due to the constant presence of the nipple in the child's mouth and biting, microcracks may appear on them, through which the infection can easily penetrate into the mammary gland.

Appearing cracks in the chest should be immediately lubricated with a solution of brilliant green.

Especially carefully it is necessary to monitor the health of adolescent girls, not allowing them to supercool the mammary glands, to engage in sports that can lead to chest injury.

The main thing to remember is that at the first signs of the disease, you do not need to self-medicate, look for forgotten recipes in books, follow the advice of neighbors and good relatives. Mastitis is cured quite quickly and without any complications, if you consult a doctor in time.