Mastitis first symptoms. What is mastitis and how is it treated. Indications for the complete cessation of lactation are

Mastitis (breast) is an infectious and inflammatory disease that occurs in the mammary glands. Lesions spread rapidly, capturing healthy tissue. The disease, left to chance, leads to dangerous complications. Against its background, sepsis, abscess, phlegmon and gangrene develop. If mastitis occurs, home treatment is carried out with medication and folk remedies.

Usually, the mammary glands become inflamed in the postpartum period. This happens due to increased milk production. Breastfeeding women develop lactational mastitis. The disease manifests itself in 2 forms:

• unilateral (more common);
• bilateral.

There is non-lactational mastitis - a pathology not associated with milk production and breastfeeding. The symptoms of this form of the disease are blurred. Inflammation is localized, it does not capture neighboring tissues. Such breasts often take a chronic form. Sometimes it occurs in newborn girls. Hormones received from the mother in excess lead to the disease.

By the nature of the flow, mastitis is distinguished:

• spicy;
• chronic;
• serous;
• purulent.

The reasons

There are many factors that cause mastitis. Staphylococcus aureus most often leads to the lactational form of the disease.. After contact with harmful bacteria on the skin, the appearance of pathology is provoked by such reasons as:

• mastopathy;
• postoperative scarring;
• features of the anatomical structure of the organ;
• severe pregnancy;
• complicated childbirth;
• chronic diseases;
• disturbed sleep;
• postpartum depression.

Most often, inflammation of the mammary glands occurs in women who have given birth to their first child. They lack the skills to breastfeed and express milk. Stagnation in the breasts leads to the development of the inflammatory process.

Non-lactational breast appears with a weakened immune system. Her reasons are:

• hypothermia;
• aggravated infections;
• associated pathologies;
• neuropsychic and physical overload;
• silicone implants;
• breast trauma.

The provoking factor in this case is bacterial infection. The causative agent is the same as in lactation breasts - staphylococcus aureus.

Symptoms

The initial stage of the postpartum and non-lactation form is serous mastitis, which is often confused with milk stasis. Both pathological conditions are accompanied by:

• heaviness in the mammary glands;
• uncomfortable sensations;
• minor tissue thickening.

But with lactostasis, the duration of which is only 1-2 days, the temperature does not rise, milk oozes easily from the nipple. With mastitis, the seals grow, the temperature is elevated. Serous exudate accumulates in the lesions.

In the future, the disease passes into the infiltrative stage. In the inflamed area, a seal is formed without clear boundaries. The breasts swell, hurt, the temperature rises. The skin does not change.

In neglected states, a destructive breast develops - a dangerous pathology. If purulent mastitis occurs, the woman suffers from the following symptoms:

• intoxication;
• high temperature jumping up to 40 degrees;
• loss of appetite;
• disturbed sleep;
• headache.

With purulent mastitis, the skin turns red, the lymph nodes in the armpit increase. The disease can turn into an abscess, phlegmon, gangrene.

Drug therapy

For the treatment of simple forms of breast use methods of conservative therapy. Carry out the treatment of serous mastitis as follows:

Non-lactational mastitis is able to spontaneously disappear. If the disease does not go away, drug therapy is carried out.

Treatment at home

Treatment for breast cancer is started after consulting a doctor. When breastfeeding, most medicines are forbidden to use. Therefore, mastitis is treated with folk remedies, for the preparation of which honey, plants, camphor are used.

cabbage leaves

Cabbage effectively fights breasts. The leaves of the plant are used for applications. Make compresses like this:

Cabbage fights edema, inflammation, resolves seals.

Oils

For the treatment of mastitis at home, camphor and castor oil are used. They make applications.

Camphor oil with mastitis helps relieve pain, eliminate the inflammatory process. Thanks to it, seals are reduced.

Castor oil quickly relieves exacerbation. Rubbing it into the chest, apply a film and a warm bandage.

Peppermint oil helps older patients get rid of mastitis. The tool stimulates blood circulation, fights puffiness. 3-5 drops of mint ether are added to 1 tablespoon of vegetable oil. The mixture is rubbed into the chest at night.

With mastitis, applications with honey are made:

Salt applications

Women should know how mastitis is treated with saline compresses. This is an affordable remedy for getting rid of the disease at home. Salt applications are effective for mild and neglected forms of breasts. Salt draws out exudate, relieves swelling, inflammation, improves blood circulation.

The method of preparing a salt compress is simple: water is heated to 50 degrees, 1 tablespoon of salt is dissolved in it. Cuts are made in a cotton napkin for the nipples (they will avoid irritation of the epithelium in this area), the fabric is impregnated with a solution, applied to the chest, covered with polyethylene, and fixed with a warming bandage. Remove the application after cooling.

Applications for purulent breasts

The following methods help to cure purulent mastitis:

herbal extracts

Carrying out the treatment of mastitis at home, compresses alternate with lotions from plant extracts. At the same time, they drink herbal teas and decoctions of herbs. Prepare them using the following recipes:

Compresses are warming procedures. Doctors note that thermal applications can aggravate the disease, so they are forbidden to use during exacerbation and temperature. To avoid undesirable consequences, use the means recommended by the doctor. In severe forms of the breast, alternative methods are ineffective, and the disease is treated surgically.

Mastitis is one of the most common breast diseases, which is characterized by infectious and inflammatory processes in the breast tissue. This inflammation has a high spread rate. The effect of inflammation is expressed in the purulent destruction of the glands and breast tissues, which can lead to blood poisoning. First of all, it is worth getting acquainted with the symptoms and types of mastitis for girls who are just preparing to become a mother.

An infection leads to inflammation, which in the vast majority of cases is caused by Staphylococcus aureus. This bacterium causes non-critical skin lesions in the form of acne, etc. But it can also lead to dangerous phenomena (meningitis, pneumonia, mastitis, etc.). It is the penetration of staphylococcus into the breast tissue that causes breasts (the old name for mastitis).

Nowadays, doctors are increasingly faced with cases of mastitis, which are caused by a whole complex of bacteria that have entered the mammary gland and caused an infectious inflammation with suppuration. Most often, these are gram-positive staphylococci and gram-negative E. coli.

Mastitis in women is lactational and non-lactational. Lactational mastitis occurs during lactation (especially in girls giving birth for the first time). Non-lactating mastitis appears even in non-lactating women, between the ages of 15 and 60. It is logical to assume that the causes of mastitis of each of the forms are different, but there are common factors among them:

• Decreased immune capacity of the body, which cannot suppress inflammation.
• Stagnation of milk in the breast (lactostasis) is a common cause of mastitis.
• The presence of direct routes for the penetration of bacteria into the mammary gland (wounds, nipple cracks).
• Mastopathy and other diseases of the breast. Their complications lead to infectious inflammation (mastitis).

Risk Factors for Mastitis

The ingestion of Staphylococcus aureus and other pathogens into human breast tissues will not necessarily lead to inflammation and suppuration. Inflammation of the breast in women is caused by anatomical and systemic factors that reduce the body's ability to suppress infection in the mammary glands, or make it easier for bacteria to work:

• Hormonal imbalance leading to mastopathy.
• Microcracks and other damage to the nipple and areola (especially when feeding).
• Surgical interventions, cicatricial formations in the mammary glands.
• Anomalies in the shape of the nipples - flat, lobular and others.
• Severe pregnancy, late toxicosis.
• Small patency of the ducts of the mammary gland, too much milk secreted.
• Diseases that lower the immune system.
• Stress conditions, insomnia and other psychological complications.

The disease "mastitis" is manifested due to the imperfection of the milk channels, insufficient development of the nipple, violation of the technique of feeding and expressing milk.

Symptoms of mastitis

Symptoms of mastitis vary depending on the form of inflammation, as well as the current stage of mastitis. In general, there are common signs of mastitis that are observed in patients:

• The appearance of discomfort in the chest. With the development of mastitis and the growth of inflammation, discomfort develops into pain.
• The breast increases in size, swelling of the mammary gland is observed. With bilateral infection, both mammary glands are susceptible to these changes.
• Reddening of the skin over the site of inflammatory processes is observed, it is accompanied by local swelling of the chest tissues. When touched and palpated, pain is felt.
• Increase and occurrence of pain in the lymph nodes. Particularly in the armpits.
• Weakness of the body as a whole. The patient develops malaise and constant lethargy, loss of appetite.
• The body temperature rises. In the initial stages of the disease up to 37-38°C. At the final, up to 39-40°C.
• The stage of abscess development (late forms of mastitis) is accompanied by nausea and vomiting, headache. All this develops into convulsions and loss of consciousness, the patient is often in an infectious-toxic shock. With timely treatment, this group of symptoms can be avoided.

Clinical forms of mastitis

The clinical picture of mastitis refers to the development of inflammation in a woman, 1-4 weeks after the birth of a child (the most common cases of mastitis). Classification of mastitis reveals two main forms of inflammation: chronic and acute. Chronic mastitis does not cause significant harm to human health, the disease proceeds locally and does not spread through the tissues.

Two ambiguous forms of mastitis can be distinguished:

• Plasma cell mastitis, it is also called periductal mastitis. It is not inflammation in the truest sense of the word. There is an expansion of the ducts of the mammary gland, in which there is a creamy content (plasma, lymphocytes, histiocytes). At times, purulent discharge from the mammary gland through the nipple occurs. Often confused with mastopathy or cancer. It predominantly occurs in older women.
• Fibrocystic mastitis, its development is associated with a violation of the level of hormones and pathologies of the thyroid gland. Represents painful lumps inside the mammary glands. Most often manifested in girls during puberty and in women during menopause.

Types of mastitis are associated with the stage of development of the disease.

Serous

The initial stage of development of mastitis. It is very easy to confuse it with banal lactostasis. Mastitis begins to develop on days 2-5 of breast milk stagnation. In the department of the mammary gland, where stable lactostasis is observed, the tissues are impregnated with serum (serum). There is a local inflammation of the breast tissue, even without exposure to harmful microorganisms. A timely trip to the doctor (mammologist, gynecologist, therapist) will prevent the development of inflammation and quickly recover from mastitis.

There is a thickening of the chest area at the site of stagnation, the temperature of the affected area rises locally, swelling and pain are observed (typical companions of inflammation). Expressing milk causes pain and does not provide relief. If the disease is ignored, mastitis develops into a more severe purulent inflammation.

infiltrative

Infiltrative mastitis is characterized by the accumulation of a mixture of lymph, blood and cell particles in the breast tissues (which is called infiltrate), which can occur in a chronic form. The reason for the development of the infiltrative form of the disease is the defeat of pathogenic bacteria. The duration of the stage is influenced by the body's immune reserves and the aggressiveness (quantity) of staphylococcus, or its union with other bacteria. This type of mastitis is able to quickly move to the next stage of the development of the disease. In the acute form, or recurrence of the chronic form of mastitis, patients experience leukocytosis.

Abscessing

This type is associated with the formation of abscesses. Purulent mastitis begins 4-6 days after the appearance of an infiltrate in the chest tissues. Painful sensations intensify, the chest tissue looks like a spongy material saturated with pus. On palpation, there is a sensation of fluid movement. There is persistent intoxication (weakness, headaches, etc.). If there is no surgical intervention at this stage, mastitis passes into the terminal (destructive) stages.

Phlegmonous

Further development of purulent inflammation. An abscess causes complete swelling of the affected part of the body, redness of the chest is adjacent to the bluish color of the surface tissues. Touching the chest causes sharp pain. The nipple is retracted inward. Body temperature fluctuates between 38-39°C (febrile). Purulent mastitis in some cases is accompanied by convulsions and loss of consciousness. Hospitalization for phlegmonous mastitis is strictly required.

Gangrenous

The last type of mastitis is gangrenous mastitis. The affected breast is much larger than the healthy one. Areas affected by necrosis are visible. The necrosis of breast tissues causes infectious-toxic shock. The destructive stage of mastitis leads to death. But there are chances for a cure for gangrenous mastitis.

Forms, depending on localization

Mastitis is also classified according to the place of occurrence:

• Intramammary localization of mastitis - inflammation occurs in the depths of the mammary glands and affects the glandular tissue. Occurs most often.
• Subcutaneous and subareolar mastitis - the area of ​​suppuration of the breast tissue is superficial. With subcutaneous localization, inflammation is located in any area under the skin of the chest. With subareolar localization, the breast tissue under the areola of the nipple is affected. The cause is small abscesses, infected wounds and other damage to the breasts and nipples.
• Retromammary mastitis is a breakthrough of purulent inflammation that occurs inside the breast tissues (retromammary region).

The manifestation of the disease in children and men

Mastitis in newborns in the vast majority of cases is confused with physiological mastopathy, which is also characterized by inflammation. Mastopathy refers to the signs of normal adaptation of an infant to life outside the womb. It is associated with an excess of estrogens that came from the mother during pregnancy. Ridding the baby's body of excess hormones causes breast engorgement in children. Inflammation is observed in children of both sexes, but in girls it is more common.

Purulent mastitis in newborns is very rare. It is associated with improper hygiene of the baby, ignoring prickly heat and microdamage to the nipples. It is not uncommon for parents' attempts to cure "mastitis" in a newborn (which is actually mastopathy) and lead to infection with a real disease.

Mastitis in men is also extremely rare. The reasons include diabetes, gynecomastia, tumors in the genital area, the use of anabolics and low-quality beer (estrogens). It is hormonal causes in most cases that are the causative agents of male mastitis. Treatment is similar to women's.

Diagnostics

If pain and inflammation occur in the chest area, a person should immediately consult a doctor: a mammologist, pediatrician or gynecologist. The surgeon also treats mastitis.

The process of diagnosing mastitis does not cause difficulties. The patient's complaints, the results of palpation and laboratory tests are taken as the basis.

The following analyzes are carried out:

• Urine and blood analysis (general).
• The study of breast milk for bacteriological composition. The parameters of both mammary glands are compared. Enough for 1 ml of liquid.
• The study of the number of red blood cells in milk. They play the role of markers of inflammation.
• Acid-base balance and reductase are calculated.

In severe forms of mastitis (abscess, phlegmonous mastitis), the patient undergoes a breast examination using ultrasound. Also examine the infiltrate of the affected mammary gland (puncture).

If the diagnosis is difficult (usually in the chronic form of mastitis), mammography is prescribed. Chronic mastitis involves a biopsy to diagnose cancer.

Conservative treatment

Treatment of mastitis with drugs is allowed in the initial stages. In this case, the patient should feel satisfactory: the temperature does not exceed 38 ° C, there is no purulent inflammation. Blood tests should show the absence of any changes.

If drug therapy does not show effectiveness, preparation for surgery begins.

Antibiotics

Antibiotics and antibacterial drugs for mastitis are taken for 10-14 days. The infectious cause of mastitis is eliminated with drugs that contain amoxicillin. It suppresses Staphylococcus aureus, streptococcus and other infections that cause purulent inflammation.

At the initial stages of inflammation of the mammary glands, treatment with penicillin antibiotics is allowed.

Analgesics

Analgesics are designed to reduce the level of inflammation and swelling, as well as relieve the pain syndrome of mastitis. Medicines can be supplemented with antispasmodics. Ibuprofen, Paracetamol, No-shpu, etc. are prescribed. The type of drugs depends largely on whether the woman is breastfeeding.

Antihistamines

Blockade of histamine receptors is important for large swelling of the mammary glands. This is especially true for people with low blood pressure, as well as patients predisposed to septic shock. In the presence of purulent secretions in milk, lactation is suppressed by drugs.

Immunomodulators

One of the reasons for the penetration of infections is a decrease in immunity. Drugs such as Polyglobulin, Methyluracil, Antistaphylococcal gamma globulin and other immunity modulators are prescribed based on tests and anamnesis.

Vitamin complexes

Vitamins have a beneficial effect on the entire body, and also increase a person's ability to resist pathogens. In addition to fruits and vegetables, useful elements are obtained from vitamin complexes such as Complivit, Undevit, etc.

Creams and ointments

Preparations with a local decongestant and anti-inflammatory effect for the mammary glands are prescribed in conjunction with the above medicines against mastitis. The ointment heals damage to breast tissues and eliminates the feeling of discomfort of the affected mammary gland. Assign Traumgel, Heliomycin, Progestogel and others.

Under no circumstances should you prescribe drugs to yourself. This can cause allergic reactions and complications of mastitis.

Surgical treatment

Starting with abscessed mastitis, effective treatment is surgical intervention. A small focus of purulent inflammation is treated by inserting a needle into the mammary glands and pumping out the pus. Antibiotics are then pumped into the devastated area to eliminate the inflammation.

A large abscess and multiple foci of inflammation imply an opening of mastitis. During the operation, the focus of inflammation is opened, and the pus is removed along with the affected tissue. Drainage is installed in the resulting cavity to pump out pus. After 3-4 days, the drainage is removed and a suture is made (if mastitis does not recur).

After surgical measures to eliminate mastitis, the patient undergoes therapy with infusion solutions. This is followed by antibiotics, nonsteroidal anti-inflammatory drugs and immunomodulators.

Alternative treatment at home

Treatment at home is allowed only with serous mastitis or lactostasis. The doctor must agree to home therapy.

Compresses

Use of cold compresses on the chest is allowed:

• Pumpkin pulp boiled in milk.
• Honey cakes (flower honey and wheat flour).
• Tea mushroom.
• Shredded carrots.

cabbage wraps

Cabbage leaf is used for redness of the mammary glands. The cabbage is cooled and applied to the chest for an hour or two. You need to repeat the procedure at least 6 times a day.

Water massage

Rubbing with alcohol

Treatment of mastitis with folk remedies should not include exposure to high temperatures. Alcohol compress and rubbing have a warming effect. Bacteria multiply rapidly in heat. This will speed up the transition of mastitis to the abscess stage.

Ice

When mastitis starts, applying ice will slow the spread of the infection and reduce discomfort. The ice pack should be wrapped in a towel to prevent frostbite. The duration of the sessions is no more than 3 minutes.

Honey

Honey has a disinfectant and antibacterial effect. Promotes healing of wounds. You can make cold honey compresses on the chest no more than 2 times a day.

Essential oils

Essential oils are added to compresses on the chest. Mint helps to lower the temperature, fir kills bacteria and reduces inflammation. Camphor oil acts as a pain reliever. Essential oils are prohibited when breastfeeding (with lactostasis).

Medicinal herbs

Decoctions are made from herbs, which are used in compresses against mastitis. Oral intake is allowed with the consent of the doctor.

• Sage - suppresses the function of lactation, a weak antibiotic.
• Alder reduces inflammation.
• Chamomile is a native antiseptic, the effect is noticeable in infectious mastitis.
• Sweet clover works as an antispasmodic.

Complications of mastitis

Any infection accompanied by inflammation, especially with the participation of Staphylococcus aureus, can give complications in the form of septic syndromes:

• Pericarditis.
• Meningitis.
• Infectious-toxic shock state.
• The appearance of several purulent inflammations - pneumonia, osteomyelitis, etc.
• DIC syndrome.

With the timely intake of drugs, complications of mastitis are not observed.

Prevention of mastitis

Prevention of mastitis is a set of measures that minimizes the risk of the occurrence and development of purulent inflammation:

• The speedy elimination of stagnation of milk in the mammary glands.
• Breast hygiene, especially when feeding.
• Timely healing of chest injuries.
• Normalization of hormone levels.
• Restoration of immune functions.
• Regular examination of the mammary glands by a mammologist.

Since the absence of damage to the breast tissue helps to avoid mastitis, special attention should be paid to the choice of a bra. It should be the right size, comfortable shape and made from natural fabrics.

You should not start even a slight inflammation of the breast and hope that it will pass by itself. Seek medical attention if mastitis is suspected as soon as possible.

Update: December 2018

Mastitis is an inflammatory process in the area of ​​the parenchyma and in the zone of lactating breast tissue. The disease develops only in 2 - 5% of lactating women. Despite the fact that acute mastitis can occur in women at any time, it often occurs 2 to 3 weeks after birth (82-87% of cases), but may be later.

This is explained by the anatomical and physiological changes that occur in the breast at the beginning of the secretion of colostrum and milk. In 90-92% of patients, only one mammary gland is affected, and the left side is more often than right-sided mastitis (it is easier to express with the right hand with the right hand, so the left breast is better emptied than the right one).

The main condition for the development of mastitis is congestion in the chest (see), which can either be accompanied by an infection (often hospital), or not - non-infectious mastitis.

Primiparous women are at risk for mastitis because they:

• there is a physiological imperfection of the ducts of the mammary glands
• underdeveloped glandular tissue that produces milk
• underdeveloped nipple
• besides, there is no experience
• No ().

About the lactation period

The shape, size and position of the breasts are very individual, vary widely within the normal range and depend on:

• age
• phases of the menstrual cycle
• general physique
• lifestyle
• the state of the female reproductive system.

Anatomy of the mammary glands

The breast of a woman has a lobed structure, large lobes are separated by intervals of connective tissue into 20-40 segments, each of which consists of alveoli. The alveolus itself is lined with a single-layer epithelium of the glandular type with an excretory duct, which are interconnected into large ducts in which breast milk accumulates. The lobar ducts, merging with each other, the excretory ducts open at the tip of the nipple of the breast.

In the region of the border of the halos, the ducts have extensions called the lactiferous sinuses. Around the glandular structures, the space of the breast is filled with adipose tissue, which determines its size and also the shape, along with the development of the glandular lobules themselves. A woman's breast is surrounded by a whole complex of lymph nodes, so when the breast becomes inflamed, they increase in size and are painful. Lymph nodes into which lymph flows from the breast:

• axillary (97% outflow)
• supraclavicular
• subclavian
• peristernal
• mediastinal and bronchopulmonary

What happens to the breast during pregnancy and immediately after the birth of the baby

Synthesis and release of breast milk for feeding the baby starting from the second trimester of pregnancy, when the production of colostrum is gradually activated.

• Colostrum - more like whey than regular milk, with a high protein and fat content, is secreted until the first 2-3 days after the baby is born, and then is replaced by transitional and mature milk.
• Maximum amount of milk matures by 6 - 12 days of the postpartum period.
• Stabilization period- when the formation of the optimal amount of milk allocated for the nutrition of the child occurs, this period lasts for the first 3-6 months of breastfeeding.
• Average duration of lactation ranges from 5 to 24 months.

Why does mastitis occur?

causative agents of mastitis

There are 3 main causative agents of lactational mastitis, first of all:

• 70% of lactating women with mastitis have Staphylococcus aureus
• staphylococcus albus
• streptococcus

As a rule, these infectious agents are resistant to penicillins. Less often, β-hemolytic streptococcus, fecal enterococcus, Escherichia coli, Klebsiella pneumonia, up to 1% of Mycobacterium tuberculosis are sown. Most often, anaerobes are detected, which are mainly represented by staphylococci. Also, epidermal staphylococcus aureus can be sown in the crops, but it is not pathogenic, it enters the milk from the nipples that were not processed before the sowing, and does not cause any purulent process in the chest.

infection

Infection can be both community-acquired and nosocomial - it occurs by contact with infected linen, care items, etc. The prognosis for nosocomial infection will be worse than for community-acquired infection.

Adult carriers- with classic mastitis after childbirth, the source of infection can be latent bacteria carriers (more often from medical personnel, roommates, their relatives), who become ill with mild, erased manifestations of purulent or infectious inflammatory pathologies. It is believed that 20-30% of people are carriers of Staphylococcus aureus.

A newborn - a baby can also become a source of infection, which can be a carrier of bacilli, and a patient with inflammatory diseases of the nasopharynx, oral cavity, pharynx or pyoderma (pustular skin disease).

One hit of Staphylococcus aureus on the skin of the chest is not enough for the occurrence of mastitis, for its development, the presence of provoking factors is necessary:

Local anatomical factors provoking mastitis:

• nipple defects - lobed nipple, inverted flat nipple, etc.
• mastopathy
• rough scars after surgical interventions (severe forms of mastitis in the past, removal of benign neoplasms, etc.).

Systemic functional factors:

• abnormal course of pregnancy- late toxicosis, threats of abortion, premature birth
• pathology of childbirth - blood loss during childbirth, trauma to the birth canal, manual removal of the placenta, first birth with a large fetus
• postpartum complications- bleeding, postpartum fever, exacerbation of concomitant diseases.

A decrease in tissue resistance to the pathogenic influence of microorganisms against the background of a decrease in the work of local and general immunity after childbirth, hypovitaminosis, concomitant pathologies, pathology of childbirth and pregnancy create favorable conditions for the development of mastitis.

The mechanism of occurrence of mastitis

milk stasis

When milk stagnates, it contains a small amount of bacteria that accumulate in the ducts of the gland. Over time, milk coagulates and undergoes fermentation processes, which provokes the destruction of epithelial cells lining the milk ducts and alveoli.

Curdled milk, together with particles of desquamated epithelium, blocks the milk passages, causing lactostasis. With stagnation, bacteria multiply intensively and cause infectious inflammation. An increase in pressure in the chest disrupts the processes of blood circulation - venous congestion. Edema contributes to a decrease in the overall reactivity of the tissue, which creates excellent conditions for the reproduction of bacteria.

Inflammation leads to significant soreness of the breast, which naturally complicates the expression of milk, creating a vicious circle: lactostasis increases inflammation, inflammation exacerbates lactostasis.

Cracked nipples

The infection, as a rule, penetrates through cracks in the nipples, infection is possible during the expression of milk or breastfeeding, less often the infection spreads through the blood and lymph. In 25 - 31% of cases of all mastitis, nipple cracks are also recorded at the same time, which makes it possible to trace the relationship. And although cracks in the nipples are found in 23 - 65% of all lactating women, when mastitis develops only in 3 - 6%, nevertheless, the prevention of the occurrence of cracks serves as a simultaneous prevention of the development of mastitis.

The main reason for the development of nipple cracks is improper attachment of the child - incomplete grasping of the breast by the child. Improper breast care can also contribute to the aggravation of cracks (see).

Often, it is the occurrence of cracks in the nipples, forced pumping (and not thorough emptying of the breast at the same time) that causes lactostasis and, as a result, mastitis.

Diagnostics

If symptoms of mastitis occur, a nursing woman should contact a gynecologist, mammologist or surgeon. After examining the breast and evaluating the patient's complaints, the doctor may refer to the following tests:

• urinalysis and complete blood count
• bacteriological (number of bacteria in 1 ml) and cytological (number of leukocytes) examination of milk from both glands
• in addition to clinical symptoms, in the diagnosis of the initial forms of mastitis, laboratory studies of the secret of the female breast will be significant. Normally, it has a slightly acidic reaction (pH - 6.8). Inflammation provokes a change in the acidity of milk towards an increase in pH, which can be explained by an increase in the activity of alkaline phosphatase.

To diagnose erased forms of lactational mastitis, use:

• Ultrasound (with destructive forms of mastitis) to determine the exact localization of the purulent area
• thermal imaging, thermography
• in rare cases, mammography is used for serious indications
• puncture of the infiltrate (with phlegmonous and abscessing forms) followed by bacteriological examination of pus.

Mastitis classification

Depending on the clinical signs, the number of leukocytes and bacteria in the analysis of breast milk, there are:

• lactostasis
• non-infectious mastitis
• infectious mastitis

Using only the clinical signs and symptoms of mastitis, it is impossible to determine the absence or presence of infection. In the absence of effective evacuation of breast milk, non-infectious mastitis will develop into infectious mastitis, and this, in turn, can lead to the formation of an abscess. In clinical practice, the following classification of mastitis is used:

In addition, some breast diseases have similar signs as the symptoms of mastitis in lactating women, so it must be distinguished from:

• boils, carbuncles
• abscesses, phlegmon
• erysipelas, which are combined into one concept - paramastitis
• in chronic mastitis, differential diagnosis with (biopsy of suspicious material and its histological examination) is mandatory.

Symptoms

What is the difference between breast engorgement and full breasts? When the breast swells, both lymphatic and venous drainage is difficult, pressure in the milk ducts increases, both breasts swell and swell. A similar picture is with a breast filled with milk, but there are differences:

• breast full of milk- hard to the touch, heavy, warm, but no swelling or redness, and no visible shiny surface, milk spontaneously leaks from the nipple, the baby is easy to suck and milk flows easily.
• engorged chest Painful, enlarged, swollen, looks swollen and may be shiny, with blurry areas of reddened skin, the nipple sometimes stretches to a flat state, the child has difficulty attaching to the breast and also sucking, since milk does not flow easily from the breast.

Serous form of mastitis, unlike milk stagnation

Acute inflammation must be distinguished from simple stagnation of milk, the causes of which may be: abnormal structure of the nipple, a short frenulum in a child, improper attachment, underdevelopment of the milk ducts in primiparas, untimely pumping, intensive milk production.

With non-infectious mastitis at an early stage, spontaneous recovery is possible - the seal resolves, the pain subsides, the temperature returns to normal. With an infectious, as a rule, without treatment, the process passes into an infiltrative phase. Doctors advise any severe engorgement of the mammary glands with an increase in body temperature to be considered the initial stage of mastitis in order to start diagnosis and adequate treatment in a timely manner.

There are cases when banal lactostasis occurs with severe soreness of the breast and a violation of the general condition of the woman, then after careful decantation of milk after 3-4 hours, the infiltrate is re-palpated and examined:

• With lactostasis, the temperature decreases, the pain subsides and the condition returns to normal.
• With a combination of mastitis and lactostasis after 3-4 hours, the painful infiltrate is palpable, the condition does not improve, the temperature remains high.

Infiltrative stage

In the absence of adequate treatment, after 2-6 days, the process can move into an infiltrative phase, which is characterized by a greater severity of clinical symptoms, and a worsening of the woman's condition.

• An infiltrate without clear contours forms in the affected breast.
• The affected breast increases, the skin over the infiltrate does not turn red yet and there is no edema yet, an extremely painful affected gland.
• In 80% of patients, body temperature rises to 38.0 - 41.0, with treatment it can be reduced to 37-37.5C.
• Signs of intoxication: weakness, headache, lack of appetite.

In the absence of therapy, the infiltrative form of the disease after 4-5 days passes into a destructive stage, serous inflammation becomes purulent and breast tissue resembles a honeycomb with pus or a sponge soaked in pus.

Destructive - purulent and gangrenous mastitis

An increase in general and local symptoms of inflammation will indicate the transition of the initial forms of mastitis to a purulent stage, while signs of purulent intoxication are well expressed, since toxins come from the focus of inflammation into the blood:

• Body temperature is constantly kept at high numbers, temperature drops of several degrees during the day are characteristic. The temperature of the mammary gland itself also rises.
• Intoxication: appetite decreases, headache, weakness appear, sleep worsens.
• The chest is tense, enlarged, the infiltrate itself increases in size, has clear contours, the skin of the chest turns red, and every day this is more and more pronounced.
• In one of the areas of the gland, symptoms of fluctuation appear (movement of fluid / pus).
• In some cases, there is an attachment of regional lymphadenitis (an increase in the nearest lymph nodes).
• Abscesses can form on the surface or in the deep sections of the gland with subsequent spread.

There are the following forms of destructive mastitis:

• Abscessing - with the formation of cavities of abscesses (cavities filled with pus), while softening and a symptom of fluctuations are felt in the infiltrate zone (overflowing fluid when palpated).
• Phlegmonous - significant swelling of the breast and its massive increase, sharply painful, the skin is bright red, perhaps even bluish-red, there is often a retraction of the nipple. The woman's hemoglobin is reduced and the urinalysis worsens.
• Infiltrative-abscessing- the presence of a dense infiltrate, which includes small abscesses of various sizes. It flows harder than abscessing. The symptom of fluctuation is rare due to the fact that the abscesses are not large and the compaction may seem uniform.
• Gangrenous - an extremely serious condition of a woman, characterized by a fever of 40 - 41º, an increase in heart rate to 120 - 130 beats / min, the breast increases sharply in volume, skin edema is noted, blisters with hemorrhagic contents are determined on its surface, areas of necrosis are determined. Gradually, the edema spreads to the surrounding tissues.

Should you continue or stop breastfeeding if you have mastitis?

As for the preservation of breastfeeding with mastitis, a few decades ago, the recommendations of pediatricians and gynecologists were categorical: interrupt breastfeeding for the period of treatment of mastitis.

Today, the situation has turned 180 degrees and without exception, all breastfeeding specialists demand to breastfeed babies, no matter what. It seems that the truth, as usual, is still closer to the middle, or at least should be based on a set of arguments for and against. It is worth making a distinction between feeding the baby with this milk and maintaining lactation as such:

Preservation of lactation

Lactation should be maintained whenever possible, since a regular outflow of milk is very important, according to some reports, only in 4% of cases, acute mastitis progresses to an abscess or purulent mastitis while maintaining lactation and feeding the child.

Breastfeeding a baby with mastitis

As for breastfeeding the baby, it is worth weighing the risks and benefits for the baby of not breastfeeding against the impact of the mother's treatment. In each clinical case, the issue is resolved individually:

• For non-infectious mastitis, which is not so different from lactostasis, breastfeeding cannot be stopped. Of course, in conjunction with rational pumping (not to the last drop, but if necessary to avoid hyperlactation), soft therapeutic massage and anti-inflammatory therapy (Ibuprofen, Traumeel, ultrasound).
• If we are talking about an infectious process. Here it is necessary to proceed from how pronounced the general condition of the mother suffers (it is difficult to feed with a temperature of 40, wild pains and axillary lymphadenitis).

The second moment becomes purulent discharge from the nipples. Breastfeeding instructors stubbornly prove that pus is just dead bacteria and white blood cells and it is not contraindicated to feed a child with it. But excuse me, we will object, why is purulent discharge still sown in bacteriological laboratories, getting a good bacterial growth and determining the sensitivity of pathogens to antibiotics? Purulent discharge from the nipples should:

• or pump very thoroughly before feeding
• or become an obstacle to the continuation of breastfeeding for the period of treatment of purulent mastitis.

It is also possible to maintain lactation during the treatment period with the help of regular pumping until the problem is resolved, but during this period to feed the child and then treat for intestinal disorders against the background of staphylococci obtained during feeding, as well as from the effect of antibiotic therapy, is an extremely unfavorable matter for the baby, for a long time. and costly.

Almost all antibacterial drugs administered to a nursing woman enter breast milk and into the child's body, having an adverse effect - toxic and allergic reactions, the normal microflora of the gastrointestinal tract suffers.

Depending on different pharmaceutical groups, some antibiotics easily penetrate into milk and create high concentrations of active substances, while others pass in small quantities, which does not pose a real threat to the baby and is therefore approved for use during breastfeeding.

Conservative treatment

Depending on the condition of the patient, treatment can be carried out both in a hospital and on an outpatient basis. At the initial stages, complex conservative therapy is carried out, when:

• the disease lasts no more than 3 days
• the general condition of the woman is relatively satisfactory
• no obvious symptoms of purulent inflammation
• temperature less than 37.5 C
• moderate breast tenderness
• general blood test is normal.

Since the main cause and aggravating factor is lactostasis, it is important to effectively empty the mammary glands, so milk should be expressed every 3 hours, first from a healthy breast, then from an affected one. Mastitis treatment:

• Regular feeding or pumping to resolve lactostasis in combination with massage.
• Broad-spectrum antibiotics for infectious mastitis
• Symptomatic therapy - non-steroidal anti-inflammatory drugs (), antispasmodics ()
• Traumeel gel for non-infectious mastitis.

A day later, with positive dynamics, physiotherapy is prescribed - UHF therapy, ultrasound, they promote the resorption of the inflammatory infiltrate and normalize the functions of the mammary gland. Home treatment involves examining a woman every 24 to 48 hours, in the absence of positive dynamics and response to antibiotic therapy, the woman should be hospitalized.

Antibiotics to treat mastitis

Once lactational mastitis is diagnosed:

• the woman has a high temperature, severe general condition
• there are cracked nipples and signs of mastitis
• the condition does not improve a day after the normalization of the outflow of milk.

antibiotic treatment should be started to ensure optimal results. Even the slightest delay in prescribing therapy will increase the likelihood of abscess formation. The duration of the course of treatment is determined on an individual basis, the average course is 7 days. Groups of antibiotics:

• Penicillins

Penetrate into the milk of a woman in limited quantities. The concentration of benzylpenicillins in milk, compared with the concentration in serum, is ten times less. The same rule is typical for semi-synthetic penicillins. In inflammatory processes, the transition of these components into milk is reduced. A relatively low degree of diffusion into milk is characteristic of broad-spectrum penicillins. The index for penicillins is significantly less than 1.

• Cephalosporins

Data suggest limited passage into milk. The maximum concentration in healthy women, an hour after administration, is 2.6% of the maximum concentration in the blood serum. With inflammation, there is an increase in the passage of the antibiotic into breast milk. There is evidence of poor excretion of second and third generation cephalosporins in breast milk. Despite the fact that the index is also less than one, but its value exceeds that of penicillins.

• Macrolides

Penetrate in relatively high concentrations, reaching an average of 50% of the level in the blood serum. But at the same time, there is no negative effect on the penetration of macrolides into the child's body.

• Aminoglycosides

Most of the representatives do not penetrate well into breast milk, and in low concentrations. But still, no official studies have been conducted, since the drugs are prohibited during pregnancy and lactation due to nephrotoxicity. The concentration in breast milk is 30% of the concentration in the blood, but there may be an effect on the intestinal microflora of newborns.

• Fluoroquinolones

All representatives of this pharmaceutical group pass into breast milk, but strictly controlled studies have not been conducted. The use of drugs in this group during pregnancy and breastfeeding is not recommended, due to the high risk of toxicity.

Drugs of choice without stopping breastfeeding: amoxicillin, augmentin (amoxiclav with caution when the benefit to the mother predominates over the harm to the baby), from cephalosporins - cephalexin. Inadmissible when feeding a child: sulfonamides, lincosamines, tetracyclines, fluoroquinolones.

Is it possible to make compresses for mastitis, use ointments?

When the first signs of lactostasis or mastitis appear, you should consult a doctor, establish a diagnosis, determine the stage of the disease and discuss treatment options.

Noninfectious mastitis- warming compresses can only be used for lactostasis and non-infectious mastitis in complex treatment. It is possible to use half-alcohol dressings on the affected area at night, cabbage leaves with honey, burdock leaves, etc. After the compress, the chest is rinsed with warm water. You can also use homeopathic Traumeel gel.

With purulent mastitis warm compresses and the use of ointments may exacerbate the course of the disease and are therefore not recommended.

Surgery

Often, despite the active implementation of conservative treatment with antimicrobial drugs, there may be a transition to purulent or destructive stages of about 4-10% of developing mastitis. Such complications require immediate and active surgical treatment, which will be carried out only during hospitalization.

The abscess zone is opened to remove pus from the tissues and the wound is actively washed with antiseptics, followed by drainage. The procedure is performed under general anesthesia. Also, as an additional study, in order to conduct a differential diagnosis, a small fragment of the walls in the abscess area is sent for histological examination, because. process can be combined with a malignant neoplasm.

Prevention

Seeing a doctor earlier at the slightest suspicion minimizes the risk of developing purulent mastitis. In the postpartum period, a nursing woman should be carefully monitored for the purpose of early diagnosis of lactostasis and mastitis. Basic prevention:

• Use only comfortable nursing underwear
• Better to breastfeed on demand
• If hyperlactation occurs, express a little milk before feeding
• Attach the baby correctly, monitor the correct grip of the breast by the baby
• Don't shorten your feeding time
• Better to sleep on your side or back
• Feed at night, avoid big night breaks
• Do not overcool the chest and protect it from injury
• Prevent the occurrence of cracked nipples and treat them in a timely manner.

It is mandatory to observe the sanitary and hygienic regime. Timely identify and sanitize foci of infection in the mother's body (carious teeth, tonsils, sinuses).

Breast mastitis is a process of inflammation in the tissues of the mammary glands in women. Not so long ago, this disease was called differently - the chest.

In most cases, the process of inflammation develops unilaterally. It spreads quite rapidly throughout the body, which is why, with the development of at least one symptom of this disease, it is imperative to undergo a course of treatment.

Most often, mastitis in women develops during breastfeeding or as a consequence after pregnancy. Sometimes the development of the disease occurs in newborn babies and in some non-nursing young girls. Mastitis of the mammary gland, the symptoms of which are found in this category of patients, is called non-lactational.

To reduce the risk of developing this disease, and to understand how to avoid the process of developing the disease, you need to carefully examine the causes of the formation of the disease, by which the disease manifests itself.

Reasons for the development of lactational mastitis

The active development of the disease occurs after infection in tissues that are located in the chest area. This may occur due to such damage to the breast as cracks. The infection can be spread on the skin of a woman or in the mouth of a newborn baby who is breastfed. After that, harmful microorganisms begin to actively divide and spread, signs of the disease are noticeably manifested. Inflammation of the mammary gland in a woman who is breastfeeding a child may appear due to the following reasons:

1. The development of cracks and other microdamages on the nipples.
2. The only position for feeding a child. Breastfeeding must always take place in various positions, otherwise a large amount of milk may remain inside the breast.
3. A bra that doesn't fit your bust. Lingerie for a woman who is breastfeeding should be used free and not constraining the chest. The bra must support the breast, keeping it natural and not deforming.
4. The development of a repeated process of inflammation. If problems with the health of the child appeared during the first pregnancy, then there is a high probability of relapse. Also, the possibility of infection increases several times during untimely or incorrect treatment therapy. It is necessary to carry out treatment at the first sign of the disease.

In addition to the above reasons, the main factor for the development of the inflammatory process can be be lactose. Stagnation in the mammary gland is considered a peculiar cause of the development of mastitis inside the breast. Prolonged lack of milk is considered the main reason for the formation of an unfavorable environment inside the breast, in which pathogenic microorganisms are actively able to multiply. The infection that developed after this can cause not only the development of the inflammatory process, but also fever with suppuration.

Non-lactational irritation within the mammary gland

In addition to the resulting inflammation processes that occur in conjunction with lactation, other problems and difficulties can occur. To understand the disease, you need to understand what it is non-lactose mastitis, you should carefully study the information about the causes of its development and occurrence in the body. Among these symptoms it is worth highlighting:

Non-lactational type of disease occurs extremely rarely. In addition to it, mastitis of newborn children can be distinguished. The reasons for its development are the mother's hormones, which enter the body of the newborn during feeding and general pregnancy, as well as due to poor care of the child, non-compliance with elementary hygiene standards.

General symptoms of the disease and how to recognize mastitis?

As mentioned above, most often a woman develops unilateral mastitis. In extreme cases, a bilateral process of inflammation is formed.

To understand how to recognize inflammation in the mammary glands of women and eliminate the spread of the disease in time, you need to carefully study the information about its signs and manifestations:

These signs are considered the first manifestations of inflammation of the mammary glands in a woman. In the presence of at least one such manifestation need to contact a specialist immediately and start treatment. Only a professional medical worker can prescribe the correct order of follow-up actions and tell you how to completely get rid of mastitis, as well as what to do when infected. With timely seeking help from a treating specialist, this disease can be overcome within a few days.

It must be remembered that the use of self-medication in this case is strictly prohibited. Otherwise, the risk of developing a more severe form of complications and deterioration of the patient's condition increases.

What are the complications of inflammation of the mammary glands?

Late and improper treatment of a problem in a nursing woman can cause many complications:

Special stages in the inflammatory process

To correctly distinguish one or another stage of the disease, it is worth more carefully studying the characteristics and symptoms of each stage separately:

1. Serous. This stage of the development of the disease is considered the very first. Most often, the symptoms of the presence of mastitis in this case are almost impossible to distinguish from simple lactostasis. Learning to distinguish one symptom from another is not so difficult. Due to the stagnation of milk, lactating women may feel heaviness in the chest, as well as general discomfort. With lactose, the process of expressing milk becomes especially painful, but in this case there is no shortage of milk. Stagnation is temporary, it is for this reason that with a long development of the disease for more than two days, it is worth starting to think about the formation of a more serious form of mastitis. An increase in body temperature and a general process of deterioration in the patient's condition are another indicators of the presence of the first stage of the lesion. In some cases, there are times when the serous period is eliminated on its own. Otherwise, the next stage of the disease develops.
2. infiltrative stage. The second stage of the disease can be characterized by the presence in the patient's body of a dense homogeneous compaction in the area of ​​the affected area of ​​the body. It noticeably increases in size, but there are no other changes in the visual appearance - there is no redness or swelling. If you do not use treatment therapy on time at this stage of the disease, then purulent formations develop, and the next stage of the disease develops.
3. Destructive. At this time, toxins that are inside purulent formations actively penetrate into the body, into the very blood of a sick person. There is a strong increase in the patient's body temperature - up to 39-40 degrees Celsius. At a fast pace, the process of development of other diseases that are associated with the health of the patient is taking place - frequent headaches, lack of appetite, disruption of normal sleep.

Consultation on the treatment of the disease, how to recognize one or another stage of the disease, and how the general treatment of mastitis in a nursing mother should take place, can be obtained from the attending specialist. The destructive form of the disease can be easily recognized by its appearance - the affected area of ​​\u200b\u200bthe chest turns very red, increases in size. Veins in this place become very bright. In any situation, the process of treating mastitis should take place immediately.

Forms of the disease

divided by time two types of inflammation of the mammary glands in women:

1. Chronic.
2. Acute.

In the second variant of the disease, the disease develops suddenly, its symptoms are clearly identified. Most often this happens after the birth of a woman.

Chronic form of breast disease is formed in the process of erroneous treatment of the serous stage. The main feature of the disease is the development of irritation in a certain period of time.

An effective method of treatment in this case is possible only with the intervention of a surgeon and a serious operation. To do this, it is worth carrying out a thorough sanitation of milk flows and subsequent competent antibiotic therapy for the treatment of the disease.

If there is a manifestation of the primary symptoms of the disease, it is necessary to immediately go for an examination to a doctor who treats such a problem - mammologist. Only a qualified specialist and a professional in his field will be able to tell you what to do with mastitis, how to accurately find out the presence of inflammation inside the mammary glands and choose the right procedure for treating the disease.

Before starting therapy for the treatment of breast inflammation, it is necessary to understand the nature of the stage of development of the disease, the reasons for its development, as well as to understand the volume of the affected area of ​​​​the body and the duration of the lesion.

The most common treatment for the disease is antibiotic use. In order to achieve the desired effect in the shortest possible time, the selection of treating drugs occurs individually for each sick patient. Properly prescribed medicines will help in a short period of time to remove the entire infection from the woman's body.

When an inflammatory process occurs in the body similar to lactostasis, special antiseptics should be used and the dynamics of the disease should be monitored. In more complex situations, when the precursors of the disease report its last stage, it is necessary to perform surgical intervention. An operation takes place, during which pus is sucked out of the affected area.

Mastitis: home treatment

There is a large number of traditional medicine recipes for high-quality treatment of mastitis that will help eliminate the cause of the disease of the mammary glands.

Mastitis is an inflammatory disease of the breast tissue. As a rule, it develops in the postpartum period (approximately in the third or fourth week after discharge from the hospital) in breastfeeding mothers, especially primiparas. However, there are cases of the disease in women outside the lactation period, as well as in men and in children, including newborns.

Symptoms and signs of mastitis.
This inflammatory disease occurs and proceeds very quickly. The first symptoms appear from several hours to two days and are expressed in the appearance of quite noticeable pain in the mammary gland of a aching nature, while its contours are preserved, and the skin does not undergo any changes. This disease also manifests itself in the form of an increase in body temperature (above 38 degrees), the occurrence of headaches, weakness, discomfort and increasing pain when breastfeeding the baby, chills, enlargement and redness of the chest, loss of appetite, sleep disturbance. In addition, in the axillary region, due to an increase in size, the lymph nodes begin to be felt in the form of small dense painful formations. It should be noted that mastitis, untreated at an early stage, is fraught with the development of a more serious form of the disease - purulent.

In this option, it is not recommended to self-medicate, because all the means and methods used in this case do not eliminate the source of the inflammatory process, but only relieve its manifestation (symptoms), as a result of which the process progresses. Against the background of the development of the disease, softening appears at the site of compaction in the mammary gland, indicating the appearance of an abscess. The only solution in this situation will be an urgent operation, delay can cause serious complications. To prevent such consequences, early diagnosis and treatment of the disease is important.

Causes of mastitis.
The main cause of the occurrence and development of mastitis are bacteria (mainly staphylococci) that penetrate the breast tissue. And a bacterial infection can get into the tissues through nipple cracks or through the blood if there are foci of infection in the body (pyelonephritis, chronic tonsillitis, etc.).

The appearance of cracks or small defects in the nipples are a kind of gateway for infection. Usually, if bacteria enters the mammary gland, our defense system can cope with them. But since the female body is greatly weakened in the postpartum period, in most cases it is not able to cope with infections on its own. As a rule, immediately after the appearance of cracks in the nipples (which happens in about most women after being discharged from the hospital, especially in primiparas), arching pains appear in the mammary gland, which at the same time swells strongly, thickens, becomes tight, and the skin turns red. All this condition is accompanied by an increase in temperature. There are a lot of reasons for the appearance of cracks in the nipples, but the most common is the non-compliance of the nursing mother with elementary hygiene rules before and after feeding the baby.

Another reason for the development of mastitis may be the so-called lactostasis, which is the stagnation of milk in the ducts of the mammary glands against the background of incomplete or insufficient expression of milk or insufficiently frequent feedings. The presence of milk in the ducts of the mammary gland is considered a favorable environment for the reproduction of bacteria, since it contains a large amount of nutrients. Lactostasis is expressed in painful sensations in the area of ​​​​the mammary gland, the appearance of focal seals (nodules) in it. Usually, with this phenomenon, body temperature does not rise. However, lactostasis that has not been eliminated, within a couple of days, inevitably flows into mastitis, accompanied, first of all, by an increase in temperature. Flat or inverted nipples are one of the causes of lactostasis, because it is very difficult for the baby to suck on the breast, as a result of which it is not emptied enough.

To avoid the development of lactostasis at the first signs of milk stagnation or breast engorgement, it is recommended to express milk more often and apply cold to the mammary gland, it will facilitate its discharge. It is also recommended to carry out daily self-massage of the breast. It is necessary to do it according to this scheme: lower the right hand with the palm down on the head, and at this moment massage the left hand in the direction from the outskirts to the nipple, while the nipple area itself does not need to be massaged.

Two types of mastitis can be observed: lactational (in lactating mothers) or postpartum and non-lactational, which occurs outside the lactation period. The latter type is quite rare, as a rule, it occurs and develops against the background of trauma to the mammary gland, its compression and due to hormonal disorders in the female body. Against the background of a transitional age or hormonal imbalance, mastitis often occurs in women of reproductive age from 14 to 18, from 19 to 24 and from 30 to 45 years. Cystic and fibrous mastitis are nothing more than cystic fibrous mastopathy.

Stages of development of mastitis.
Mastitis develops in three stages: serous, infiltrative and purulent. The serous stage characterizes the earliest stage in the development of the disease, which occurs two to four days after infection and is manifested by fever, enlargement and slight compaction of the mammary gland, its soreness, which increases with breastfeeding or pumping, and relief after that does not come. A general blood test shows the presence of signs of an inflammatory process. Improper treatment or its absence inevitably leads to the fact that the early stage of the disease flows in two to three days into an infiltrative one.

Signs of infiltrative and purulent mastitis.
The infiltrative stage of mastitis is characterized by a pronounced inflammatory process and a more severe general condition of the woman. In the process of palpation of the mammary gland, a clear inflammatory thickening (infiltrate) is observed with reddening of the skin above it, which becomes more and more reddening. The high temperature does not subside, there are sharp temperature drops. Fluctuation occurs (in medical terms, fluctuation), indicating the presence of fluid (pus) in the cavity.

With the phlegmanous form of mastitis (when the abscess is not separated by a capsule from healthy tissues), the body temperature is kept at 40˚, accompanied by chills, weakness. The mammary gland significantly increases in volume, the skin above it becomes edematous, shiny, reddened with a bluish tinge. There is inflammation of nearby lymph nodes.

With the gangrenous form of mastitis (tissue necrosis against the background of circulatory disorders), the general condition of a woman is characterized as extremely difficult: body temperature is 40 - 41˚C, pulse is rapid 120 - 130 per minute, the mammary gland is greatly enlarged, the skin above it is swollen, covered with blisters with bloody contents with areas of tissue necrosis. The swelling affects the surrounding tissues. A blood test shows the presence of severe inflammation.

Chronic purulent mastitis.
The chronic form of breast mastitis is a rather rare phenomenon. It develops against the background of a rather long local treatment with injections of penicillin, mainly purulent mastitis. With this form of the disease, the condition of the patients is characterized as satisfactory: the body temperature is normal, or does not rise above 37.5-37.8 C. On palpation, some slightly painful induration is felt, not soldered to the skin. In the chronic form of the disease, the symptoms are mild. The mammary gland is painful and slightly enlarged, and in rare cases there is inflammation in the nearby lymph nodes with a small or less often high temperature.

Once again, I note that the treatment of mastitis in the early stages of development is conservative, that is, antibiotics, anti-inflammatory drugs, etc. are prescribed. Purulent forms of the disease are treated only with the help of surgical intervention.

mastitis diagnosis.
At the first sign of mastitis, you should immediately consult a doctor. The diagnosis of mastitis consists in the detection of the existing characteristic signs identified during visual examination and probing of the mammary gland. To clarify the diagnosis, a general blood test is performed, showing the presence of inflammation in the body. In order to determine the type of bacteria and their sensitivity to certain antibiotics, a bacteriological study of milk from an inflamed breast is carried out. Often, an ultrasound of the breast is prescribed to diagnose mastitis.

Mastitis and breastfeeding.
Regardless of the stage and form of mastitis, it is impossible to feed a child, because in milk even from a healthy breast (not to mention a sick one) there can be a huge amount of bacteria that are dangerous for the baby. In addition, in the treatment of this disease, antibiotics are prescribed, which, entering the mother's milk, can harm the baby. With a temporary cessation of breastfeeding, you should not refuse to express milk, it is simply necessary, while it must be carried out regularly and with great care. Firstly, the complete emptying of the chest during illness significantly speeds up recovery. Secondly, pumping will help maintain lactation so that after recovery, mommy can return to breastfeeding.

Complications of mastitis.
This disease is often complicated by inflammation of the lymphatic vessels (lymphangitis) and lymph nodes (lymphadenitis). In rare cases, especially in phlegmonous and gangrenous forms, the disease is complicated by sepsis (blood poisoning). When an abscess is opened (often spontaneous), lactiferous fistulas (which are channels that connect abscesses to the surface of the body) sometimes form, which close on their own, but this requires a fairly long period of time.

Prevention of mastitis.
The main thing in the prevention of mastitis is the prevention of cracks in the nipples (the main thing is the observance of the rules of personal hygiene, complete pumping after feedings). If cracks appear on the nipples, immediately consult a doctor and do not self-medicate. In preventing the development of the disease, it is important to treat caries and chronic inflammatory diseases (tonsillitis) in a timely manner, since through the blood, microbes can penetrate into the breast tissue from foci of inflammation in other areas.