Laktostasis or mastitis in nursing - treatment, prevention. Favorites. What are the similarities and differences between mastitis and lactostasis

Increasingly, new mothers are tempted to breastfeed their babies, and just as often they refuse to breastfeed because of the pain of breastfeeding. The most common disease states breastfeeding- lactostasis and mastitis.

Health professionals strongly advise breastfeeding only until 6-9 months of age. But lactostasis and mastitis following it occur, just in the first months of breastfeeding. Mothers refuse to breastfeed, and doctors consider the resulting breast pathology a pretext for stopping breastfeeding.

With timely elimination, lactostasis and mastitis do not cause serious harm, while in other cases there are serious complications. Such problems are found not only in primiparous women, but also in mothers who have repeatedly given birth.

Lactostasis is similar to mastitis, with both diseases there are severe pains in the mammary glands, seals and local redness, but they also have serious differences. To determine which of these two diseases has arisen, it is worth learning a little more about each of them.

Symptoms and causes of blocked ducts

The disease begins due to stagnation breast milk and the occurrence of obstruction of the excretory lactational duct of the gland. It can occur during breastfeeding, regardless of the age of the baby. How to recognize lactostasis?

In the place where the blockage of the breast lobe occurred, soreness and redness appear. There are about twenty lobes in the mammary gland ending in ducts that open into the nipple.

When expressing, it is clear that milk does not flow from all lobes or flows weakly from one of them, while in others the pressure is very strong.

Note: body temperature with lactostasis is not elevated and the state of health is normal.

It should be remembered that the occurrence of these problems is regardless of the feeding experience or the age of the child - lactostasis begins at the most inopportune moment. The main reason is insufficient emptying of the mammary gland, which occurs as a result of:

improperly selected, squeezing breasts, bra;
violations in the technique of attaching to the breast of the baby, as a result of which he does not grasp the nipple well and cannot empty the breast;
breast support with fingers;
endocrine disorders in the mother;
dehydration of the body and, as a result, thickening of milk;
mechanical damage to the breast and nipple;
position during sleep (when the chest is pressed against something);
non-compliance with the feeding regimen;
attachment to only one of the breasts;
the occurrence of cracks on the nipples;
the presence of an inverted nipple;
large size of the mammary glands;
stress, big physical activity, severe fatigue.

Having found out the cause of lactostasis, you can begin to solve the problem, as well as prevent its occurrence in the future. During Taken measures by opening the duct, they prevent complications, for example, mastitis.

Symptoms and causes of damage to the breast lobule

Lactational mastitis is the result of a complication of lactostasis resulting from penetration pathogenic microorganisms into the mammary gland through the duct. Accompanied by more severe symptoms:

fever or chills;
a significant increase in temperature;
redness of the skin over the area of stagnation;
severe pain in the chest when changing the position of the body.

In order to determine what has arisen fever- a symptom of mastitis, it is necessary to measure it in both armpits, elbows and groin.

Mammologist's note: if the temperature is higher in one of the armpits, then it is considered that it is caused by incipient mastitis.

In the development of the disease, there are three interrelated stages that occur one after the other:

injuries and swelling of the nipples of the mammary gland;
lactostasis;
lactational mastitis.

Because of the crack that has arisen on the nipple, pain occurs, which leads to an involuntary reduction in the mother's meal time for the child. This, in turn, leads to blockage of the milk ducts in the breast.

Severe pain with lactostasis makes it difficult to express the breast properly - the clogging of the ducts becomes larger. Stagnation of milk well contributes to the development pathogenic microbes(streptococci and staphylococci) that have penetrated through a crack in the areola or nipple - mastitis occurs.

The mother's immunity is weakened after childbirth and the body can not cope with the resulting foci of inflammation. It is urgent to start treatment in order to prevent further complications.

Comparison of signs of diseases

The symptoms of these two diseases are almost the same, blood tests are similar in both cases, how can they be recognized?

Mastitis is lactational and non-lactational, that is, the likelihood of getting sick with it is higher in a nursing mother. Lactostasis occurs only in the lactation period, that is, when the baby is breastfeeding, and disappears during treatment after a couple of days.

Mastitis is a consequence of untreated lactostasis and begins with significantly pronounced symptoms of inflammation. There are three stages in the development of mastitis:

Serous - there are signs of intoxication of the body.
Infiltrative - prolonged fever and increased inflammation.
Purulent - a purulent lesion joins.

Lactostasis differs from mastitis in the absence of inflammation, normal temperature body and the normal general condition of a nursing woman. With mastitis - a sharp rise in temperature, weakness, headache chills or fever general state heavy enough.

Since lactostasis imperceptibly flows into mastitis, it is very difficult to understand exactly when one ended and the second disease began. However, in the first case, a conservative one is used, and in the second, most patients undergo more complex surgical treatment.

What to do if chest pain is caused by mastitis, see the following video:

Breast problems can occur at any age. However, most often they are affected by women who are breastfeeding. When milk stasis occurs, disease state chest, which can be frightening. Many do not know how to distinguish lactostasis from, and confuse them.

Doubts are not surprising: these two conditions are closely related by characteristic features. But they have some differences. It is important to find out if the condition is dangerous so as not to make premature diagnoses.

Signs of lactostasis

With lactostasis, there is a blockage of the ducts in the mammary gland. The glands themselves are divided into several lobes, the ducts from which exit directly into the nipple. If one of the ducts is pinched, then the process of milk release may be difficult or even stop. In this case, stagnation in the form of a cork can be detected, which prevents the discharge of milk.

The mammary gland can become very swollen. There is also a strong pain syndrome. When pressing on a sore breast, milk can flow easily from some ducts. Affected ducts do not secrete fluid.

Lactostasis appears in lactating women in different periods. But most often it affects mothers who are just establishing breastfeeding. This condition may appear depending on several factors:

The main difference between lactostasis and other breast diseases is that, in addition to pain and a slight increase in temperature, the mother may not be bothered by anything. The woman's condition is regarded as satisfactory.

However, lactostasis carries a certain danger. In the absence of action to eliminate the stagnant condition, a woman may develop non-infectious type mastitis. Further development disease leads to infection of the breast. In this case, surgical intervention is indispensable.

Features of mastitis

Mastitis is serious illness that occurs when there is inflammation in the mammary gland. At the same time, its symptoms are similar to lactostasis, so only a doctor can diagnose the disease.

Mastitis is formed under the influence of the same factors as lactostasis:

The main difference between mastitis and lactostasis is the presence of infection. Most often staphylococcal or streptococcal bacilli. Bacteria, getting into the mammary gland, lead to inflammation. They penetrate through the injured nipple due to:

a child whose mouth may contain bacteria;
dirty linen;
unwashed hands;
in some cases, the occurrence of a focus of inflammation is influenced by chronic diseases from which the woman suffers.

Depending on the form of mastitis, a woman may experience various symptoms:

The main differences between lactostasis and mastitis

The main difference between the two diseases is that lactostasis can be observed already at initial stage defeat. Mastitis can be called a consequence of untreated lactostasis.

The two conditions are characterized by different symptoms:

You can understand what kind of disease a woman has by common features. The woman's condition with lactostasis is satisfactory. She does not feel the rise in body temperature. If the condition worsens sharply, lethargy and hyperthermia appear (up to 38-39 ° C), then mastitis can be diagnosed first.
Local symptoms also differ. With lactostasis, the main warning signs are swelling of the breast, a painful condition at the site of stagnation and redness of this area. Mastitis is characterized by an increase in the size of the mammary gland. In this case, the chest becomes bright red, shiny. It hurts both with pressure and at rest. There is an increase in body temperature in the affected area.
Milk yield also has characteristic features in these two states. With lactostasis, it is present: milk flows from the free ducts, but its exit at the site of blockage is difficult. With mastitis, it takes a lot of effort to get milk out. If you express your breasts with lactostasis, then the woman feels relief. When not observed: the pain remains, and the general condition does not normalize.
With lactostasis, the condition lymph nodes normal. In the case of mastitis, they increase.
Lactostasis, with the right measures to eliminate it, disappears in 1-2 days. With mastitis, if treatment is not started, after 2 days the temperature rises even more. In this case, it occurs.

If you do not see a doctor in time, then mastitis can be transformed into infectious form. In this case, the doctor prescribes not only drug therapy, but also surgical intervention. After all, a purulent inflammatory process can only be eliminated from the inside.

It is important to note that both lactostasis and mastitis do not require cessation of breastfeeding. After all, a child can perfectly help eliminate a stagnant condition in the mammary gland. Therefore, the baby can be applied more often to empty the chest and remove pain. Contraindication to feeding is only infected mastitis. In this case purulent discharge may adversely affect the child.

If a nursing woman has problems, then a mandatory consultation with a mammologist or gynecologist is necessary. They will help put correct diagnosis and recommend measures to eliminate the stagnant condition. Otherwise, there is a risk of developing a severe form of mastitis, which will cause swipe on a woman's body.

This condition is more of a norm than a pathology. Main danger is that lactostasis, the symptoms of which are rather harmless, can turn into a more insidious disease - serous mastitis, which is the precursor purulent abscess mammary gland.

It also happens that some mothers take the symptoms of lactostasis for mastitis, because. in both cases, the symptoms are similar. This also leads to negative consequences, because with mastitis necessary condition treatment is interruption of lactation by artificial means. With lactostasis, breastfeeding is the main guarantee of recovery. Knowing the symptoms of lactostasis, mothers can easily recognize the disease at an early stage, preventing it from becoming severe.

The main signs of milk stagnation

Here are the most characteristics lactostasis:

heaviness in the mammary glands, a feeling of fullness in the chest;
pain in the chest when probing;
compaction of the mammary glands;
dilated veins are pronounced on the sore chest;
slight increase in body temperature and local temperature the affected gland;
when decanting from the affected breast, milk drains gradually, while from healthy gland it flows like a stream. It occurs due to blockage of the milk ducts.

It happens that some parts of the mammary glands in a nursing mother become impossible to empty due to severe pain. Unlike mastitis, lactostasis disappears after emptying the breast. However, in more advanced cases pumping does not bring any relief.

How to distinguish lactostasis from mastitis?

Despite the fact that in the first and second cases the signs are similar, the beginning mastitis has more severe symptoms. The temperature usually rises sharply, chest pains become pulling and jerking, weakness, chills, migraine may occur. Another factor indicating that lactostasis in a nursing mother has taken the form of mastitis is that similar symptoms do not go away for more than three days. In such cases, it is necessary to take immediate measures, otherwise the disease will go into a purulent stage.

How to prevent the onset of symptoms of lactostasis?

To understand what are preventive measures against lactostasis, you need to know what is the cause of its occurrence. Most often, this is the mistake of the nursing mother herself, which consists in expressing milk too actively.

The fact is that the complete emptying of the breast is a signal to the brain that there was not enough milk. In response, the hormone responsible for milk production is released and, consequently, the amount of milk increases. The baby does not have time to cope with such a volume and the remnants of milk turn into painful seals.

But it is also undesirable not to express milk, because. this leads to the appearance of a milk plug, which prevents normal outflow. It is enough only after each pumping to give a breast to the baby - he will suck out the rest of the milk.

Lactostasis in a nursing mother may also occur in response to wrong position body when feeding and a rare change in posture. Often, mothers themselves pinch the ducts of the mammary glands with their finger during feeding, supposedly in order to make it convenient for the baby to grab the nipple. In fact, this leads to insufficient emptying of the gland, from which both the baby and the mother suffer. Therefore, the ideal position for feeding with lactostasis is as follows: the baby lies on his back, and the mother, bending over him, feeds him so that Bottom part chest rested on his chin. In this position, nothing interferes with the normal outflow of milk and feeding is most productive.

Fitted underwear (too tight underwired bra) can also provoke circulatory disorders and lactostasis. Therefore, hide away the linen "from past life» - dense bras from synthetic fabric on foam rubber - and give preference to a sports bra made of natural fabric. In addition, synthetic underwear can react with milk and provoke infectious mastitis.

Stress can also trigger symptoms of milk stasis in a breastfeeding mother. Internal stress causes spasm of the milk ducts and blood vessels mammary glands. The solution is simple - do not overload yourself unnecessarily, entrust some of the usual things to your husband or relatives, because they are happy to help the new mother.

No one canceled immunotherapy during lactation. After all, strong immunity will help the mother’s body cope with the infection that has penetrated, and lactostasis will not turn into purulent form mastitis. Buy at the pharmacy vitamin complex or a doctor may prescribe it.

Based on the foregoing, we can conclude that lactostasis is dangerous only possible complications. If you pay attention to the symptoms in time and take action, you will be able to avoid one of the insidious diseases nursing mother - mastitis.

Breastfeeding issues remain relevant throughout the world. WHO recommends continuous breastfeeding up to 7-9 months of an infant's life and combining it with the rest of the child's diet up to 2-3 years.

However, 18-25% of women in the first 3-6 months of feeding face problems with lactostasis or mastitis. This painful condition often negatively affects psychological state women and leads to mother's refusal to breastfeed. Medical professionals often interpret inflammatory diseases breast as an excuse to stop breastfeeding.

Reducing the percentage of occurrence of lactostasis and mastitis and maintaining the natural feeding of a child up to 1-2 years is an important problem, and requires appropriate attention among doctors and young mothers.

Read in this article

Causes of the disease

Data different authors indicate the occurrence of problems with the breast during feeding in 5-35% of women. Such a discrepancy in indicators indicates the uncertainty of the symptomatology of the process in different clinics. Specialists include everything from the appearance of scuffs on the nipples and pain syndrome before the emergence purulent mastitis and sepsis. Some obstetrician-gynecologists consider mastitis all pathological processes of the mammary gland from the moment of pregnancy until the end of the feeding period.

According to our experts, there are no clear boundaries between lactostasis and mastitis, since one disease cannot exist without the other. At the same time, in the diagnosis it is customary to single out lactostasis directly, as pathological process, which can turn into lactational mastitis. Dominance contributes to this inflammatory process in pathogenesis.

Also, many doctors suggest dividing mastitis into infectious and aseptic, which allows you to choose the appropriate treatment strategy.

The main stages of the development of the disease

Injuries and swelling of the nipples;
Lactostasis;
Postpartum mastitis;
breast abscess;
Direct development of lactostasis and mastitis.

The disease in the mammary gland of a woman develops rapidly, while all stages are interconnected and occur one after another. A small crack in the nipple that occurs during feeding causes swelling and pain. Pain causes a woman to be frightened before the feeding process, she does not voluntarily reduce the time the child eats, which leads to stagnation in the mammary gland.

Quite varied. These include improper feeding technique, regular external influences on the chest (car belt, sleeping on the stomach, tight bra), excessive secretion of breast milk, weak pumping, etc. All this leads to stagnation in the alveoli mammary gland leading to an increase in pain. At the same time, the ducts are closed with a “creamy clot”, the milk output is sharply reduced, and its components seep into the interstitial space.

The next stage of the pathological process is the occurrence of primary aseptic inflammation with swelling and sharp pain, which blocks the exit of milk from the sore breast even more. The inflammation itself is called mastitis.

The vicious circle of the emergence of the pathological process is closed. If it is not possible to resolve lactostasis in time, it necessarily turns into mastitis. This is also facilitated by an increase in the viscosity of the milk produced by the mother, since its liquid part passes into the breast tissue. In addition, there is high probability accession of infection and the development of postpartum abscess of the breast, which requires a longer and more expensive treatment, up to surgery.

Diagnosis of lactostasis, mastitis and its methods

The main difference between lactostasis and mastitis is the absence of inflammation. In view of this, modern medicine pays more attention to mastitis, as more dangerous complication lactostasis.

Most often, lactostasis from mastitis is quite difficult to differentiate. Against the background of an edematous, painful, altered mammary gland, it is difficult to determine the direct source of inflammation in it. General symptoms intoxication of the body, accompanied by fever and dehydration of the body, is inherent in both diseases.

Laboratory diagnostics are often unable to help: general analysis blood in both cases is almost the same and begins to differ only with the development of the process and its transition to the purulent stage.

In view of all this, modern medicine suggests not to single out lactostasis and mastitis separately, but based on the tactics of treatment, to talk about complicated and uncomplicated mastitis. If in the first case you can most often stop at conservative treatment, then the second group in 75-85% of cases require surgical treatment.

To solve this problem, it is necessary to widely use modern methods differential diagnosis. This includes ultrasound examinations of the breast, the main of which is ultrasonography. With its help, it is possible to separate lactostasis, which occurs without temperature, from mastopathy and breast tumors. This diagnostic method helps to recognize initial stages abscessing of the focus if the patient has mastitis, which occurs without an increase in body temperature.

Of course, different for obtaining samples of pus and serous fluid impossible without ultrasound guidance.

An important method of diagnosis is currently bacterial culture female milk. This study allows not only to determine the presence of pus in the expressed milk, which implies a temporary refusal to feed the child, but also to identify sensitivity to different groups antibiotics. Determining the response to antibiotics allows you to prescribe the correct and timely drug therapy and avoid surgery.

We advise you to read about the antibiotic, which is often prescribed for infection during breastfeeding, including in the treatment of non-purulent mastitis. How should the medicine be taken and what effect does it have? Is it possible to continue breastfeeding while taking amoxiclav, you will learn from this article.

Basic Treatments

The whole pathological process begins with lactostasis, so the main and first stage of treatment is the thorough decantation of the milk produced. The main thing in this case is the presence of an experienced midwife during the feeding process, who will be able to determine the causes of lactostasis and will be able to point out to the woman the main mistakes in pumping. The process of emptying the mammary gland, the woman in labor should be repeated every two hours.

The main way to empty the breast remains breastfeeding, correct technique Attaching the baby to the breast is also very important.

Feeding or pumping should take place without pain, as pain signals a violation of the process of emptying the mammary gland. Any damage to the nipple and areola should cause alertness and referral to a specialist.

By the way, only specialists should help a woman with lactostasis, any home-grown craftsmen, grandmas and 'experienced acquaintances' will only aggravate the situation.

And, of course, hygiene!

Treatment of normal lactostasis usually takes 4-6 days, and the symptoms disappear by 3 days. If during this time the condition does not improve, it is necessary to send the woman to additional research. Ultrasound and other diagnostic methods will give on early stages prevent the transition of lactostasis to purulent mastitis and breast abscess

In case of complication of the disease, after consultation with the surgeon, the woman is prescribed antibiotics, anti-inflammatory drugs, drugs that reduce lactation. Antibiotics are connected to treatment on the 4th-5th day of treatment, and among anti-inflammatory drugs, diclofenac and dicloberl are preferred, as they do not have bad influence on the child's body. 1.5-2.5 mg of bromocriptine will provide a sufficient reduction in lactation per day.

Modern methods of treating lactostasis and mastitis categorically deny the use of various alcohol and ointment compresses, dimexide, Vishnevsky ointment and the like.

The use of methods that are not agreed with the doctor, in most cases lead to complications and prolongation of treatment.

Notes for memory

During pregnancy, a mother's school must necessarily tell a woman about the rules of breastfeeding, pumping techniques, and hygiene of the mammary glands during pregnancy and after childbirth. A woman and her relatives should understand that no one is immune from the occurrence of lactostasis and mastitis, know its first signs and first aid methods. A woman armed with knowledge will be able to recognize the approach of the disease in time and competently provide herself with first aid in resolving lactostasis, which will significantly reduce the threat of purulent mastitis and shorten the treatment time.

The experience of most obstetrician-gynecologists proves that with certain knowledge, trust in medical workers and delivered on time specialized care conversion of lactoctase to mastitis a rare event, which allows you to fully adhere to the WHO recommendations on breastfeeding children in the first 1-2 years of life.