Does mastitis go away without treatment. Mastitis: causes, symptoms, treatment of a nursing mother. Symptoms of inflammation of the mammary glands

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 is also a special type of disease - 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 a woman's hormonal status. In addition, a more experienced mother is better able to apply the baby correctly and observe personal hygiene standards.

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 a secondary cause of the pathology, and autoimmune damage to the gland comes to the fore. 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, the general reaction of the 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 this point 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 of 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 tissue of the chest. All symptoms are pronounced, the patient experiences severe weakness, no appetite, headaches, aching bones and muscles. Temperature above 39°C is a 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 the general analysis of 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 the most rapid suppression of the process while maintaining the function and appearance of the 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 injected intramuscularly for a more complete opening of the milk ducts. It is also possible to prescribe oxytocin 5 minutes before pumping (increases milk flow).
• Broad-spectrum antibiotics, antihistamines, vitamins C, B are prescribed.
• Novocaine blockades are also recommended 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.
• With a good effect from the treatment started, it is possible to prescribe UHF to the site of inflammation one day after the start of taking the drugs.

With purulent mastitis, treatment is impossible without surgery. Opening an abscess is the fundamental principle of 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.

For the operation, all patients are hospitalized in the surgical 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 of the surgical treatment of purulent forms of mastitis:

• choosing the best incision site, 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. In severe forms of the disease, accompanied by systemic manifestations of 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 - a 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 other medical prescriptions. It most likely will not improve the course of treatment, but it will not worsen it either.

Symptoms and treatment of non-lactational mastitis

The cause of non-lactational mastitis is the penetration of infection into the mammary gland 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 of 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 an acute process that was treated incorrectly or insufficiently effectively. The symptoms resemble those in the acute form of the disease, but the clinical picture is “pale”: there are no acute intoxication phenomena, the general condition rarely suffers, there is no reddening of the skin at the site of inflammation, and it is not painful to feel. 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 in 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 of chronic mastitis is 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 that are incomprehensible to mere mortals, but look for alternative ways to deal with 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 too much time is often spent to understand that, for example, cabbage does not help with mastitis at all, and the use of camphor oil only delays the inevitable transition of a non-purulent form of pathology into an abscess or even phlegmon.

However, for those who didn't heed the warning, here are a few traditional medicine recipes that are believed to help manage the disease:

• A bun is made from melted butter, rye flour and fresh milk in the evening, left to “cure” overnight, and then applied to the sore breast.
• The leaves of burdock and coltsfoot are poured with boiling water and applied to the sore spot.
• A piece of kombucha is 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.

The use of Vishnevsky's ointment for mastitis can also be equated with traditional medicine. Xeroform, which is part of it, is several times inferior to modern drugs (for example, chlorhexidine) in its antiseptic properties. The tar, also contained in the preparation, has a predominantly irritating effect, “due 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.

After feeding, the breast should be washed with water without soap, dried with a clean towel and left open for 10-15 minutes. Such air baths allow the skin to completely dry out. After that, a bra is put on (only cotton or cotton!), In which a sterile napkin or gauze is placed.

The nutrition of a nursing mother should be complete, it must contain a sufficient amount of protein necessary for the adequate functioning of the immune system, as well as vitamins A, C and group B. Lifestyle is also extremely important: sleep, walks in the fresh air, a positive emotional mood - everything it improves the body's resistance to infections and doesn't cost a dime. It is necessary to completely eliminate smoking and drinking even minimal amounts of alcohol.

Mastitis or mastopathy: what is the difference

Most often, women do not understand the difference between mastitis and mastopathy. It would seem that the same pains in the mammary gland, the same seal that is palpable in it, even fluid leakage can be. However, there is still a difference.

The first symptom that is with mastitis is an increase in temperature. Even with mild forms of the disease, the temperature may rise, which is uncharacteristic for mastopathy. The second sign is the connection with the monthly cycle. Pain in mastopathy increases before menstruation and weakens or even disappears after the end of bleeding. The third sign is the lack of connection with lactation. Mastopathy is manifested both in women who have given birth and in those who have not given birth. The fourth sign is the absence of an aggressive course of the disease, that is, suppuration with mastopathy rarely occurs. Actually, if pus appeared, then we are already talking about mastitis.

Mastopathy is the growth of glandular, connective or epithelial tissue, while mastitis is an infectious and inflammatory process caused by a specific pathogen. Accordingly, the treatment in case of mastopathy differs radically from the treatment of mastitis.

Inflammation of the mammary gland is a rather simple pathology in diagnosis, but a very insidious pathology in treatment. Procrastination, ignoring medical prescriptions, self-medication can lead to loss of lactation, breast deformity, and in some cases, sepsis and death. Only a timely visit to a doctor will help prevent life-threatening and health consequences.

Hello. I got a lump in my chest. The doctor said it was mastitis and prescribed antibiotics. And they are dangerous! Can there be any treatment for mastitis with folk remedies? Well, recipes that helped someone exactly? Zhanna, 36 years old

Zhanna, unfortunately the methods of traditional medicine help extremely rarely. There is an opinion that their effectiveness is zero, but in fact, those whom they allegedly helped, in fact, had lactostasis, which they got rid of with the help of pumping. Do not ignore the appointment of the surgeon, otherwise the risk of developing an abscess is high and an operation may be necessary.

Gennady Bozbey, Emergency Medical Doctor

Ask a doctor a free question

Mastitis is a purulent inflammatory process of the mammary gland, in which the patency of the ducts is disturbed. Most often, the disorder occurs in women during the period of feeding the baby.

The vital activity of pyogenic microbes (mainly streptococci and staphylococci) leads to the onset of the disease. The infection enters the injured nipples through clothing, household items and from the baby. The disease can also develop as a secondary infection through lesions of the genital organs in the postpartum period.

Varieties of mastitis in adults

lactation. Occurs in women during breastfeeding. The main factors in the appearance of the disease are wearing uncomfortable underwear, improper breastfeeding and pumping. This leads to the occurrence of lesions of the nipple and congestion, the most favorable for infection and the development of pathogenic microflora.

Fibrocystic (non-lactation). Mastitis of this type affects not only women, but also men of different age categories. It causes trauma to the mammary glands, climatic changes (a sharp change of belts) and a failure of the hormonal level. Metabolic disorders (diabetes mellitus) are an additional factor in the onset of the disease.

Symptoms of the disease

The primary signs of mastitis are pronounced and their appearance is characteristic of all varieties of the disease. Main symptoms:

if the pathology is postpartum in nature, it manifests itself within the first month after childbirth;

the temperature rises sharply (up to 39 - 40 degrees), accompanied by characteristic signs - pain in the head, fever, followed by chills, and severe weakness;

in the mammary glands there are severe pain and fever.

If a visit to a specialist is postponed and proper medical therapy is not carried out, the disease passes into the acute phase of inflammation. After two days, the skin turns red, the chest swells and there is a seal, accompanied by pain.

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Methods of treatment

With the primary symptoms of mastitis, treatment should be started immediately under the supervision of a physician. As an urgent measure (before visiting a specialist), cold applied to the inflamed area may be applied.

Treatment is prescribed on an individual basis, based on the form of the disease and the characteristics of its course.

At the first stage of the pathology (not burdened by acute purulent lesions), it is eliminated by conservative methods. With lactational mastitis, medication therapy is carried out if the patient feels satisfactory, with a temperature below 37.5 degrees and with only one seal in the mammary glands.

To eliminate an abscess in lactating women, antibiotic drugs are prescribed that are acceptable during feeding. In some cases, in the interests of the mother and baby, lactation may be temporarily or completely stopped.

With mastitis, cephalosporins and the penicillin group of antibiotics are usually prescribed. They are used intramuscularly, intravenously or in drinking mode. Anesthetics are used to relieve pain.

Antibiotics are taken simultaneously with the elimination of the causes that led to the development of purulent pathology. As an addition, desensitizing therapy, physiotherapy (laser therapy and UHF), taking vitamin preparations and eliminating anemia can be applied in the treatment.

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If after two days of treatment there is no effect, in order to avoid complications of inflammation, the specialist prescribes a more radical measure - a surgical intervention, in which the abscess is opened and the affected tissue is removed.

In women who are not in the period of feeding, the general symptoms may be similar to those of a cancerous growth in the breast area. In this case, in order to identify an accurate diagnosis, a small affected part is pinched off to conduct an analysis confirming the non-malignant nature of the disease.

The main measure to prevent the occurrence of mastitis will be its timely prevention. Women during lactation should prevent injury to the nipples and congestion by expressing milk in time. In addition, it is important to strictly observe the rules of personal hygiene and wear comfortable underwear (special bras recommended for use have been developed for nursing mothers).

At the slightest suspicion of the occurrence of mastitis, you should contact a mammologist and the attending gynecologist.

Inflammation of the mammary gland, provoked by pathogens, is classified in medicine as mastitis. This disease is considered quite common - on average, mastitis is diagnosed in 16% of women. Most often, the inflammatory process in the mammary gland begins in a nursing mother, and for those who are first engaged in this business, the woman simply does not know how to properly attach the baby to the breast, which leads to stagnation of milk, and this is a provoking factor.

Unfortunately, preventive measures do not give the expected result, mastitis is diagnosed by doctors more and more often. That is why women should have information about the symptoms of this disease and methods of its treatment, especially since in most cases the patient can be helped by folk remedies.

Reasons for the development of mastitis

As mentioned above, the development of the disease in question is associated with the penetration of pathogens into the mammary gland and in most cases they are. However, if a woman in the body has any pathological process of a chronic course caused by another type of pathogens, then they will cause the development of mastitis. Often, doctors diagnose the disease in question, which was caused! And this is explained simply: the infection enters the mammary gland along with the bloodstream.

The main reason for the development of mastitis is recognized as stagnation of milk in the gland (lactostasis) - this environment is ideal for the reproduction of pathogenic bacteria, the infection develops rapidly and provokes inflammation / suppuration.

Important! The main way to prevent lactostasis is to properly attach the baby to the breast. It will help you learn how to properly attach your baby to a video workshop from a breastfeeding consultant - Nina Zaichenko.

Types of mastitis

Doctors differentiate several types of the disease in question, each of which has its own course of action:

The classification of mastitis is not difficult - as a rule, a specialist, already at the first appointment of a patient, can diagnose and differentiate the type of disease with great accuracy.

Diagnostic measures

The symptoms of mastitis are so pronounced that a woman herself can diagnose this disease in herself. But still, it is necessary to visit a specialist - he will prescribe, evaluate the infiltrate and the amount of purulent contents, take milk from the diseased mammary gland for bacteriological examination - you need to find out which pathogenic microorganism provoked the development of the inflammatory process. Such a diagnosis will help prescribe effective treatment and prevent the development of possible complications.

Note:no matter how much mastitis progresses and what type of inflammation is diagnosed, this disease is a categorical contraindication to feeding a child. The fact is that with mastitis, the mother’s milk is infected and must be expressed. It is usually allowed to feed the baby 5 days after the end of treatment, so that the milk no longer contains traces of antibiotics.

Mastitis is an inflammatory process that usually occurs without complications. But a woman should seek qualified medical help in a timely manner in order to receive competent and effective treatment.

Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category

Mastitis is an infectious inflammation of the mammary glands, which most often develops in women after childbirth and is associated with breastfeeding.

Lactational (associated with breastfeeding) mastitis accounts for 95% of all inflammatory breast diseases in women. Mastitis not associated with breastfeeding is much less common and can occur even in men and newborns.

Most often, lactational mastitis develops 2–3 weeks after childbirth against the background of stagnation of milk in the mammary gland - lactostasis. Pathological lactostasis is often considered as the initial stage of mastitis. Stagnation of milk contributes to the development of an infection that enters the gland through microdamages, as well as through the milk ducts of the nipple from the newborn during feeding. If milk stagnates in the breast for a long time, bacteria begin to actively multiply in it, which leads to the development of inflammation.

Mastitis usually develops on the 3rd-4th day of lactostasis. With the timely elimination of milk stagnation, as a rule, it is possible to prevent mastitis.

The development of symptoms of mastitis occurs quickly, within a few hours. Without treatment, the condition gradually worsens, the symptoms worsen, the temperature becomes higher.

The initial stages of lactational mastitis can usually be managed with simple measures: massage, changes in feeding and pumping techniques, and physiotherapy. The later stages of the disease are very difficult, requiring antibiotics, weaning the baby from the breast and surgery. After a surgical operation, rough scars often remain, which spoil the appearance of the breast and force a woman to turn to plastic surgeons.

The insidiousness of lactational mastitis lies in the fact that its initial stages are very quickly and imperceptibly replaced by purulent ones. Therefore, at the first signs of breast disease, you should immediately consult a doctor to avoid complications and long-term crippling treatment.

Symptoms of mastitis

Mastitis usually occurs on one side, more often on the right. Manifestations of mastitis depend on the stage of the disease. Since the breast tissue is rich in blood vessels, milk ducts and adipose tissue, the infection spreads very quickly through the mammary gland without encountering natural barriers on its way, the stages follow each other.

Symptoms of the initial stage of mastitis - serous, differ little from lactostasis:

• a feeling of heaviness, fullness and pain in the mammary gland, aggravated during feeding;
• an increase in the size of the mammary gland, redness of the skin;
• pain when probing the lobules of the mammary gland;
• milk becomes difficult to express;
• body temperature rises to 38-39 o C.

The serous stage of mastitis is replaced by an infiltrative stage - against the background of the persistence of symptoms in the gland, an area of ​​compaction is determined, which is sharply painful when palpated. At this stage, mastitis can be stopped without surgery, the infiltrate can be forced to resolve.

Without treatment, within 3-4 days, the serous and infiltrative stages of mastitis turn into purulent. With suppuration of the tissues of the gland, the state of health deteriorates sharply: the temperature rises, pain intensifies, swelling of the mammary gland. Depending on the individual characteristics, an abscess can form in the tissues - an abscess or phlegmon limited to a capsule - a diffuse purulent inflammation of the gland without clear boundaries. In the latter case, mastitis is especially dangerous.

Causes of mastitis

The immediate cause of mastitis is usually bacteria - Staphylococcus aureus or other microbes that are found on the surface of a person's skin. The infection enters the mammary gland through microdamages on the nipple or excretory ducts of the milk ducts. It is believed that the source of infection may be the newborn itself, which transmits microbes to the mother during feeding.

If the mammary glands are regularly emptied (during feeding and / or pumping), then the bacteria do not have time to multiply. When milk stagnates, microbes, multiplying, increase its viscosity, which aggravates lactostasis. Further development of the infection leads to purulent inflammation in the mammary gland.

lactostasis

Primary (physiological) lactostasis (milk stasis) is most common in women after the first birth, which is associated with a violation of the preparation of the mammary glands for feeding.

On the 3-4th day after childbirth, milk suddenly arrives, but the mammary glands are not yet ready to accommodate it. Excessive stretching of the milk ducts leads to their inflammation and swelling. Milk is excreted with great difficulty, so it is difficult for a newborn to suckle on his own, and he may refuse to breastfeed, which further aggravates the process.

If the necessary measures are not taken at this time, pathological lactostasis develops within a few hours. Its symptoms:

• the chest becomes dense, bumpy, hot to the touch;
• there is a feeling of heaviness and soreness in the mammary glands;
• the general state of health worsens, the temperature can rise.

If milk is properly expressed, there is a rapid improvement in well-being, which never happens with already developed mastitis. In addition, you can note a significant difference in body temperature when measuring it in the right and left armpits: on the side where the chest is more tense and painful, the thermometer will rise higher. With the development of mastitis, this difference will no longer be. However, only a specialist can reliably distinguish the stage of pathological lactostasis from mastitis.

If you experience the symptoms described above after giving birth, seek help as soon as possible. At the maternity hospital, at any time of the day, you can go to the midwife on duty, who will help you “drain” your breasts and tell you how to do it yourself in the future. In addition, the midwife will teach you a massage technique that promotes the expansion of the milk ducts and the discharge of milk from the gland.

During your doctor's round, be sure to tell him about your breast problems. The doctor will examine the mammary glands, give you his recommendations and, possibly, prescribe additional treatment, for example, physiotherapy.

If you have milk stasis after you were discharged from the maternity hospital, seek medical help from a gynecologist or a breastfeeding specialist at a antenatal clinic.

It is necessary to fight lactostasis under the supervision of a doctor. Otherwise, you can miss the time and not notice the moment when lactostasis develops into mastitis.

Chronic mastitis

Chronic mastitis is a rare disease that can develop in a woman at any age, usually after acute mastitis. The reason for the transition of the process into a chronic form is incorrect or incomplete treatment. With this disease, one or more purulent cavities are formed in the mammary gland. Sometimes cavities are opened through the skin with the formation of fistulas - passages through which pus periodically drains. Chronic mastitis requires surgical treatment.

Risk Factors for Mastitis

Some women have a predisposition to stagnation of milk and the development of mastitis. Factors that increase the likelihood of these conditions include:

• pathology of pregnancy (toxicosis, preeclampsia, threatened miscarriage, etc.);
• cracked nipples, flat or inverted nipples;
• mastopathy or a large volume of mammary glands;
• cicatricial changes in the mammary glands after injuries, operations (including after the installation of breast implants);
• irregular feeding or pumping;
• a significant decrease in immunity (for example, with diabetes mellitus, HIV infection, etc.).

In these cases, it is necessary to carefully monitor the condition of the mammary glands after childbirth, especially in the first 2–3 weeks, until lactation is finally established.

Causes of non-lactational mastitis

Non-lactating mastitis is more likely to develop in women aged 15–45 years:

• against the background of puberty in girls;
• during menopause in women;
• as well as in some endocrinological diseases.

The immediate cause of non-lactational mastitis is usually an infection. Bacteria can enter the mammary glands with blood flow from foci of chronic inflammation in the body, for example, with chronic tonsillitis, cystitis. In addition, non-lactational mastitis can be a consequence of trauma, including nipple piercing.

Mastitis in newborns

This disease can develop in children of both sexes and is associated with hormonal changes. After childbirth, a high level of maternal hormones is maintained in the baby's body for some time. When their level decreases (usually 4-10 days after birth), the baby may experience breast engorgement and even milk discharge from them. By itself, the physiological engorgement of the glands in newborns does not require treatment and resolves on its own.

But during this period, the baby's mammary glands are very vulnerable. If they become infected, mastitis may develop. The entry of bacteria is facilitated by non-observance of hygiene rules, rubbing of the mammary glands, attempts to squeeze milk out of them, diaper rash and skin diseases. The development of mastitis in newborns is accompanied by fever, anxiety and crying of the child, redness and enlargement of the mammary glands. These symptoms require urgent medical attention.

Diagnosis of mastitis

If you experience symptoms of milk stasis or mastitis, you should consult a doctor as soon as possible. This may be an obstetrician-gynecologist in a antenatal clinic, a polyclinic or a paid clinic. In addition, assistance with the development of lactostasis and mastitis can be provided in the maternity hospital where you gave birth. If it is not possible to get to a gynecologist, contact a surgeon. Diagnosis and treatment of mastitis is also within his competence.

The basis for the diagnosis of mastitis is an examination of the mammary gland. Probing it can be painful, but it is necessary for the doctor to determine the stage of the process and further treatment tactics. With lactostasis, during the examination, the doctor can “dissolve” the chest, which will immediately bring relief.

Additional examination

As an additional examination is assigned:

• a general blood test from a finger - shows the presence and severity of the inflammatory reaction;
• bacteriological examination of milk and analysis of the sensitivity of pathogens to antibiotics - shows whether there are microbes in milk in an amount capable of causing mastitis (over 5 * 102 CFU / ml), and also provides information on those antibiotics that act on the inoculated microbes;
• ultrasound examination of the mammary gland (ultrasound) - allows you to accurately determine the stage of mastitis and its prevalence, the location of inflamed foci, their size, the presence of abscesses, etc.

Mastitis treatment

The sooner you seek medical help, the easier, shorter and more effective treatment will be. The onset of symptoms of mastitis should always be a reason to see a doctor as soon as possible. Remember that mastitis does not go away on its own, but on the contrary, it progresses rapidly and can deprive you of your breast within a few days. After all, nutritious breast milk is an ideal incubator for pyogenic microbes.

In no case do not delay time, relying on folk methods and advice from "experienced" friends. Cabbage leaf, honey cakes or urine therapy remained in the people's memory only because in the old days, when there were no antibiotics and other effective medicines, they were the only means of help.

A lot of experience has now been accumulated in the treatment of postpartum mastitis. For these purposes, both non-drug methods and drugs are used. Purulent stages of mastitis necessarily require surgical treatment. Moreover, the earlier the operation is performed, the better its therapeutic and aesthetic result.

Can I breastfeed with mastitis?

According to the position of official Russian medicine, with the development of mastitis, it is necessary to stop breastfeeding. At the time of treatment, the child is weaned and transferred to artificial feeding. In exceptional cases, at the stage of serous mastitis, the doctor may allow healthy breastfeeding. However, the infiltrative and, moreover, purulent stages are clearly an indication for stopping feeding.

Weaning a baby from the breast is a very unpleasant measure for every mother, because there is nothing more useful for a baby than breast milk. However, with the development of mastitis, such a measure is a must. Continuing to breastfeed can harm your baby because:

• The main cause of mastitis - Staphylococcus aureus is excreted in milk in large quantities. Staphylococcus is the causative agent of many infections, especially dangerous for young children. When it enters the mucous membranes, staphylococcus aureus causes sore throat and otitis media, when it enters the gastrointestinal tract - toxic infection (staphylococcus toxins are one of the main causes of food poisoning with milk and dairy products in children and adults). The antibodies that a baby receives with breast milk cannot always protect him from this bacterium, and even more so from its toxins.
• For the treatment of mastitis, various drugs are used: antibiotics, antispasmodics, antipyretics, etc. With continued feeding, the baby drinks a cocktail of these drugs with the mother.

Continuing breastfeeding for a woman with mastitis is also fraught with complications, since:

• Feeding a baby, even from a healthy breast, reflexively increases milk production, which is extremely dangerous for mastitis and can aggravate the course of the disease. For a speedy recovery, on the contrary, inhibition is shown, and sometimes a complete temporary cessation of lactation.
• Continuation of feeding imposes a number of serious restrictions on the choice of drugs, which reduces the effectiveness of treatment and can lead to the development of complications.

In addition, feeding with mastitis is an extremely painful process that will not bring joy to either the mother or the child.

Now on the Internet, and, sometimes, on breastfeeding courses, you can read or hear recommendations to breastfeed at all costs. Such advice is reassuring to women, and they continue to breastfeed through pain and suffering, to the detriment of themselves and the child.

In fact, the authors of such advice confuse the stage of lactostasis, when it is necessary to continue feeding, with mastitis. With lactostasis, full feeding and pumping milk is the best medicine. During and after the emptying of the mammary gland, there really is relief. While with mastitis, the mere thought of feeding reflexively starts the process of milk production, which worsens the condition. Therefore, the issue of breastfeeding should be decided only by a doctor after a full diagnosis and determination of the stage of the disease.

Treatment of non-purulent mastitis

Serous and infiltrative stages of mastitis are treated conservatively - without surgery. For treatment, drugs are used, as well as physiotherapy.

Milk is expressed every 3 hours. First, the diseased breast is decanted, and then the healthy one. Your doctor may give you antispasmodics (drugs that widen the milk ducts) in pill form or by injection before pumping.

Sometimes novocaine blockade of the mammary gland is done before pumping. To do this, using a long thin needle, an anesthetic solution (novocaine) is injected into the soft tissues behind the mammary gland - a substance that interrupts nerve impulses from the gland to the brain. After the blockade, the pain disappears for a while, the milk passages open, which greatly facilitates pumping. As a rule, antibiotics are added to the anesthetic solution to create their therapeutic concentration in breast milk.

Physiotherapy treatment is extremely effective for lactostasis and mastitis. At non-purulent stages of mastitis, ultrasound, microwaves, and UV radiation are used. Physiotherapy helps to reduce inflammation and pain in the gland, expand the milk ducts, improve the process of milk secretion, and prevent its stagnation in the gland.

Antibiotics are an essential component of mastitis treatment. For the best effect, antibacterial drugs are prescribed in the form of intramuscular or intravenous injections. During treatment, the doctor may change the antibiotic based on the results of a bacteriological analysis of milk and an antibiotic susceptibility test.

To speed up recovery and reduce the risk of purulent complications, it is necessary to temporarily reduce milk production. For this, with mastitis, special medications are prescribed.

At the stage of serous and infiltrative mastitis, milk production is somewhat reduced - inhibited. If no improvement is observed within 2-3 days from the start of complex treatment, and a high risk of complications is created, the doctor may advise you to completely stop - to suppress lactation. To do this, you will need to give written consent.

The decision to resume lactation will be made by the doctor after the end of treatment, depending on your well-being and the results of the tests. With purulent mastitis, it is always recommended to suppress lactation.

In addition to the main ones, additional drugs are used in the treatment of mastitis, which have a tonic, anti-inflammatory and immunomodulatory effect.

Treatment of purulent mastitis

With the development of purulent forms of mastitis, surgical treatment is always necessary. The operation is performed under general anesthesia. Depending on the location and size of the abscess, the surgeon makes one or more incisions in the mammary gland. Pus and dead tissue are removed through these incisions. Then the wound is washed with an antiseptic solution and drains are installed - tubes through which the wound is washed, drugs are administered and the wound discharge is removed after the operation.

The operation is usually completed with sutures. If the postoperative period proceeds safely, the sutures are removed on the 8th–9th day. After the operation, antibiotics and physiotherapy are prescribed to improve wound healing.

Prevention of mastitis

The basis for the prevention of mastitis is the timely fight against milk stagnation, the correct technique of feeding, pumping and caring for the mammary glands.

The physiological mechanisms of milk production, its accumulation in the breast and return during feeding are very complex. For their proper formation, a close relationship between mother and child is very important. Therefore, the initial measures for the prevention of mastitis are:

• early attachment to the breast (in the first 30 minutes after childbirth);
• joint stay of mother and baby in the maternity hospital.

Every woman after childbirth should learn how to breastfeed properly. Improper feeding increases the risk of nipple cracks, milk stagnation (lactostasis) and, in the future, mastitis.

A woman should be taught the technique of proper feeding by the attending obstetrician-gynecologist or midwife. For all breastfeeding questions, you can contact the staff of the maternity hospital.

Basic rules for breastfeeding:

1. Before feeding, you need to take a shower or wash yourself to the waist with warm water and baby soap, you can wash your breasts only with water so as not to dry the skin of the nipples.

2. You should take a comfortable position: sitting or lying down, so that there is no feeling of fatigue in the muscles and there is no need to change body position, interrupting feeding.

3. The child must be securely held by your hand near you, after making sure that even if you fall asleep during feeding, the baby will not fall. To do this, you can put a pillow under your arm or fence off the edge of the bed with a roller from a blanket.

4. During feeding, the entire body of the child should be turned towards the mother, the head and back should be in the same line, the baby's mouth should be opposite the nipple. The child should be able to move his head freely to get comfortable.

5. The most important point is the correct grasp of the breast during feeding. The child should take the breast with a wide open mouth, not only the nipple, but also most of the areola. The lower lip of the baby during sucking should be turned outward.

6. If the baby sucks rhythmically and deeply, does not worry, does not puff out his cheeks and does not choke, and you do not feel pain during sucking, then everything is correct.

7. If it is necessary to interrupt feeding, do not pull the breast out of the baby's mouth, this can injure the nipple. To painlessly remove the breast, gently press your finger on the chest near the baby's lips, then the nipple can be easily released.

8. After feeding, the remaining milk must be expressed. If there are phenomena of lactostasis, then the baby is first of all applied to the diseased breast.

How to Express Milk Properly

With the phenomena of lactostasis, manual pumping is more effective, although this is a very laborious and sometimes painful process.

• To facilitate the passage of milk before pumping, you can do a gentle massage of the breast.
• During pumping, place your fingers on the periphery of the areola (on the border of the skin and areola), do not pull the breast directly on the nipple.
• Pumping alternate with stroking movements from the periphery of the mammary gland to the areola of the nipple.

Breast Care

The skin of the mammary glands, especially the oklososkovy circle, is very vulnerable, through damage to the skin, an infection can penetrate into the mammary gland. Therefore, you must adhere to the following rules:

• during pregnancy and after childbirth, wear cotton underwear that does not tighten the chest, but reliably supports the mammary glands in order to avoid their compression;
• linen should be changed daily, washed in hot water and ironed;
• during lactation, it is advisable to use special nipple pads that absorb the secreted milk; without special liners, linen quickly coarsens from drying milk and injures the skin;
• with the formation of cracks in the nipples, consult a gynecologist in a antenatal clinic.

You can get additional advice on breastfeeding and mastitis prevention at the antenatal clinic or at the pediatric clinic for children.

Mastitis is a pathological condition in the body, in which an inflammatory process develops in the tissues of the mammary glands. This is a common ailment that has varying degrees of severity and occurs not only in adult women, but also in children during infancy. Pathology is accompanied by a strong bursting of the mammary gland, the occurrence of painful sensations in it, an increase in temperature and chills. There are multiple complications of the process, including abscess, necrosis, phlegmon. For this reason, when the first signs appear, treatment should be started immediately.

The most common cause of the disease is an infection that enters the mammary glands through microtraumas on the chest. In most cases, the disease is the result of penetration through the skin of the bacteria Staphylococcus aureus, which is present in 9 out of 10 people. This pathogenic organism accounts for 70% of all infectious forms of mastitis. There are other pathogens of the lactation type of the disease:

• streptococcus;
• coli;
• tuberculosis bacteria;
• fecal enterococcus.

Infection occurs through underwear, bedding, personal hygiene items, or from other people who carry the bacteria. New mothers often contract mastitis within the maternity ward from healthcare workers, roommates, or visitors. In some cases, the disease is transmitted during breastfeeding from the infant to the mother, if the inflammatory process is present in the child in the oral cavity (stomatitis), pharynx, pharynx, or there are dermatological pustular diseases.

In addition to direct infection through microtrauma and cracks in the nipples and areola, a woman's body should be affected by pathological factors that reduce the barrier properties of the skin and suppress the immune system. Conditions that increase the risk of contracting lactational mastitis:

• mastopathy;
• pathological structure of the nipple (retracted or flat shape);
• transfer of surgical interventions on the chest;
• experiencing postpartum depression, traumatic situations that caused severe stress;
• pathological pregnancy with toxicosis, gestosis or premature birth;
• significant injuries received during childbirth, which caused a recurrence of chronic somatic diseases.

Non-lactational mastitis is much less common. It is associated with disturbances in the functioning of the body and in some cases has an infectious etiology. This condition occurs not only in nursing mothers, but also in children, provoking the formation of characteristic symptoms. The main condition for the development of the disease is a reduced level of immunity due to the transfer of a viral or bacterial disease. Consider a number of reasons that cause this type of mastitis:

• physical exhaustion;
• stress;
• hypothermia (hypothermia);
• mammary gland injuries.

Symptoms and signs of the disease

Mastitis has a specific picture of the disease, which determines the staging of inflammation and its form. The syndrome develops gradually, manifested by discomfort in the chest, a slight increase in temperature, mild malaise in the early stages, and serious necrotic processes at the stages of suppuration of the gland. The general course of the course of the disease in lactating women and in newborns has different features.

At a nursing mother

Symptoms of mastitis in women during lactation are determined by the stage of development of the problem. The main signs of the disease, taking into account its degree of progression:

1. Serous stage:

• there is tension and a feeling of fullness in the chest;
• on palpation, small seals can be detected that have clear boundaries and are not soldered to other tissues;
• when touched, painful sensations appear;
• there is painful pumping, but the milk leaves easily;
• body temperature in the first days remains normal.

If the described symptomatic complex does not go away within a few days, the seals do not disappear after feeding, pain remains, and the temperature rises, the onset of mastitis can be assumed. In the acute course of the disease, a woman feels severe weakness, fever, the temperature reaches 39 degrees, there is pain when decanting. The mammary glands are saturated with serous fluid, the influx of leukocytes to the focus of inflammation increases. At this stage, the disease may go away on its own or move on to the next stage.

2. Infiltrative stage:

• an infiltrate is formed in the chest, which has a fuzzy shape;
• glands swell, increase in size;
• in places of inflammation, the skin turns red due to hyperthermia;
• increased local and general body temperature.

If no action is taken, the condition worsens, and the disease passes to the next stage within 5 days. The dynamics of the symptomatic complex is reflected in the presence of blood in the milk from the damaged ducts of the mammary glands.

3. Purulent stage:

• general asthenia (weakness, depression, increased fatigue);
• sleep disturbance;
• the rapid deterioration of the general condition due to intoxication of the woman's body due to the release of bacterial waste products into the blood;
• body temperature rises to 40 degrees;
• loss of appetite;
• severe headaches, fever;
• discoloration of the skin of the chest;
• the spread of swelling and edema of inflamed tissues;
• veins in the skin and regional lymph nodes increase.

This stage is accompanied by complications leading to the formation and release of blood infiltrate, suppuration of the glands, abscesses are formed, in some cases multiple gangrenous phenomena are appropriate.

In newborns

In children aged from one day to six months of either sex, physiological mastitis may be noted. This is a normal condition caused by overproduction of maternal hormones in milk. With this form, the child has an increase in the breast in the form of a slight swelling, it is possible to separate the exudate from the inflamed area. Usually this phenomenon does not require any intervention and the swelling of the glands subsides by six months. If the baby experiences discomfort, soreness, pus or blood discharge comes out of the chest, it is necessary to resort to medical assistance, which consists in sanitizing the purulent focus.

Diagnostics

The diagnosis of mastitis is carried out as a result of an external examination of the mammary glands and their palpation. The following laboratory tests may be required for clarification:

• general analysis of blood and urine;
• bacterial culture of milk;
• cytological examination;
• ultrasound of the glands;
• determination of milk acidity.
• mammography.

Therapeutic measures

Mastitis is one of the diseases that cannot be ignored due to the severity of symptoms. Seeking medical help should be prompt, in the early stages of the disease, which helps not only to get rid of the problem faster, but also to avoid dangerous complications. Given the fact that milk stasis in the breast triggers inflammation and can aggravate the situation, in order to successfully treat the disease, you need to follow these recommendations:

• regular emptying of the breast through feeding or pumping;
• massage after feeding, study of seals;
• milk is taken at least once every 3 hours: first from a healthy breast and only then from an inflamed one.

As part of the therapy, both traditional and folk methods are used.

Pharmacy preparations

Treatment of mastitis in women is based on the specifics of its occurrence. The source of the disease is an infection, therefore the basis of drug therapy is antibiotics (usually in medium doses and with intramuscular injection). The type of drug and the duration of treatment are determined individually, the doctor may prescribe the following groups of drugs:

• penicillin agents ("Amoxicillin", "Augmentin") penetrate into milk in minimal concentrations, therefore, they are acceptable for use without stopping breastfeeding;
• cephalosporins ("Cefalexin") have limited permeability into milk and are allowed during breastfeeding;
• aminoglycosides pass into breast milk in minimal concentrations, but a negative effect on the microflora of the infant's digestive tract is possible.

When feeding for the treatment of mastitis, it is forbidden to use drugs from the groups of tetracyclines, fluoroquinolones and sulfonamides. In addition, symptomatic therapy is prescribed: non-steroidal anti-inflammatory drugs (Ibuprofen), anti-spasmodic drugs (No-shpa), homeopathic products (Traumeel S gel for non-infectious form).

It is important to understand that the conservative method is appropriate only if a number of conditions are met:

• the duration of the course of the disease is no more than three days;
• there are no symptoms of a purulent process;
• pain in the chest is moderate;
• the general condition is satisfactory, and the body temperature does not exceed 37.5 degrees.

home remedies

Treatment of mastitis with folk remedies is usually performed in combination with traditional methods, acting as an element of a symptomatic effect on the problem. Among the effective recipes that have helped many women cope with the disease include:

• Cumin: dried mint leaves are crushed in equal proportions, a little rye flour and water are added to the powder. The creamy mass is used as an ointment: it is used to treat the sore chest, and after complete drying, the remnants are removed with warm water. The frequency of application is 3 times a day.
• Pumpkin pulp is boiled in milk until cooked, kneaded to a homogeneous gruel and applied to the affected gland when cooled. The mass is covered with gauze and left overnight.
• Baked onions are kneaded to a mushy consistency and combined with milk and honey in equal amounts. The composition is applied to the place of compaction, covered with gauze on top and left for 3 hours.

Compresses

An effective home remedy for breast inflammation is compresses. They should not be warming, otherwise the pathological process will only intensify. The easiest way is to use cabbage: fresh vegetable leaves are scratched a little with a fork on the inside and, after smearing with honey, are applied to the chest. The compress is changed as soon as the previous one has become sluggish.

Another proven recipe is starch lotion. Potato powder is mixed with vegetable oil until a mushy consistency is obtained and applied to the chest (keep up to 5 hours).

Prevention of mastitis

There are the following measures to prevent the development of inflammation of the mammary glands:

• correctly apply the baby to the breast during feeding, so that he swallows the nipple with his upper lip, and the lower clasps part of the areola;
• to carry out feeding the baby on demand, preventing the breasts from overflowing with milk;
• observe hygiene standards for the care of the mammary glands;
• Wear comfortable bras that support your breasts.