Recurrent mastitis. Mastitis: forms of the disease, symptoms and treatment

Mastitis is an inflammation (most often unilateral) of the mammary gland caused by pathogenic coccal flora (most often staphylococci). In most cases (96%), mastitis develops in nursing women (usually after the first birth) or in last weeks pregnancy. Non-lactation mastitis develops in non-lactating women, young girls (juvenile mastitis) and newborns.

The female mammary glands are designed to perform the complex functions of producing milk and feeding the baby. With a variety of shapes and sizes (there are no women with the same breasts), the mammary glands of all women have a constant and complex structure. The mammary gland is mainly represented glandular tissue located under the skin surrounded by fatty tissue. Connective tissue passes through the thickness of the gland, dividing it into several (15-20) large lobes, each of which branches into smaller ones glandular structures– lobules. The lobules contain mammary glands, which are winding tubes with extensions at the end (alveoli). Milk is formed in the alveoli, and the tubes perform the function excretory ducts and open on the nipple. The mammary glands are penetrated by blood and lymphatic vessels.

Infection in the mammary glands can penetrate in several ways:

— The most common and “simple” way for microbes to enter the breast tissue is formed in postpartum period. In the mammary glands of lactating women, milk ducts actively function, through which, under certain conditions, pathogenic bacteria penetrate from the environment. The so-called lactation mastitis represents the largest group of mastitis.

— Mechanical injuries to the mammary gland and cracked nipples can serve as “entry gates” for infection.

— Relatively less often, infection enters the mammary glands from distant foci purulent inflammation.

Inflammation can develop in the area of ​​the nipple or areola if microbes penetrate through cracks into the tissue of the gland (interstitial mastitis). If microbes enter the glandular lobules through the milk ducts (parenchymal mastitis), inflammatory process develops in the thickness of the gland and is limited to the glandular lobules. If the pus from the affected thoracic lobe is evacuated on its own, self-healing occurs. Sometimes purulent melting of the gland capsule occurs, inflammation spreads into the surrounding tissue, and parenchymal mastitis becomes interstitial.

Like any inflammatory process, mastitis has several successive stages of development, during which inflammation passes from the phase serous inflammation in heavy purulent process. As the process progresses, the symptoms of mastitis increase and may develop. purulent abscess or . Most often, mastitis is diagnosed and treated in the acute stage, so chronic forms of mastitis are rare.

Serious purulent mastitis with a severe course among patients occurs on this moment rarely, and then as a consequence of delayed or incorrect therapy, or in case of significant deviations in the functioning of the immune system. Purulent forms of mastitis can lead to the most dangerous complication - sepsis, life-threatening sick.

Mastitis must be treated!

Mastitis is one of the diseases that simply cannot be ignored. Most often, women seek help in the early stages of the disease and receive qualified medical care on time. In modern antenatal clinics and maternity hospitals, preventive conversations are held with women about the prevention of mastitis.

The expression “breast mastitis” is not correct. The term “mastitis” comes from the Greek word mastos - breast, therefore, the name of the disease speaks of its localization. Mastitis cannot occur anywhere else other than the mammary glands. Breast mastitis does not exist.

Causes of mastitis

Mastitis is infectious in nature. Infectious purulent mastitis develops with the participation of pyogenic flora: staphylococci, streptococci, coli and others. One pathogen or a combination of pathogens may play a role in the occurrence of mastitis. In the latter case, the disease is more severe and is accompanied by a bright clinical picture.

Through microtraumas and cracks in the nipple, microbes lymphatic vessels or through the milk ducts they enter the tissue of the mammary glands, where they provoke an inflammatory purulent process (abscesses and phlegmons). The toxins produced by mastitis pathogens melt the surrounding tissues, and the inflammation begins to spread quite quickly, involving a large number of surrounding tissue.

Areas of purulent inflammation are classified according to location: in the area of ​​the areola, subcutaneous, located in the stroma (in the thickness) of the glands and retromammary (under the mammary gland).

Purulent lactation mastitis develops against the background of lactostasis (milk stagnation) in combination with infection. Usually, if lactostasis is not eliminated in 3–4 days, it transforms into purulent lactation mastitis. Thus, the causes of lactostasis are also the causes of mastitis. With lactostasis in the ducts, with the participation of infectious agents, milk fermentation processes begin. Ideal conditions are created for the proliferation of pyogenic bacteria, and the process quickly spreads throughout the mammary gland, acquiring the character of purulent inflammation.

Predisposing factors for the occurrence of mastitis after childbirth include structural changes in the mammary glands (scars, etc.) and violations of hygiene rules. The state of the patient's immune system determines the severity of the disease.

Non-lactation mastitis is uncommon. The reasons for its occurrence include:

— traumatic injuries of the mammary glands;

- purulent processes in the skin or subcutaneous tissue mammary gland(,), when inflammation begins to invade the underlying tissue;

- foreign bodies (for example, piercing or implant) in the mammary glands;

- purulent inflammation of any breast formations.

The appearance of non-lactation mastitis involves microbial associations, and not just one pathogen, as in the case of lactation mastitis.

Symptoms and signs of mastitis

Mastitis most often affects one breast. Bilateral damage to the glands is observed in 16-21% of all cases.

Symptoms of mastitis increase gradually as the infection spreads. There are acute and chronic forms of the clinical course of mastitis. The development of subsequent stages, as a rule, is either the result of a woman’s inattention to her condition, or provoked by improper therapy.

Acute mastitis in the initial stage has the character of serous inflammation. Serous mastitis is characterized by an unexpressed clinical picture and a mild course. The mammary gland becomes uniformly dense to the touch and slightly painful to the touch. Temperature at serous form mastitis can reach 38°C. Discovered in time serous mastitis responds well to therapy and is eliminated in a relatively short time.

In case of untimely diagnosis and/or lack of adequate treatment, mastitis takes on an infiltrative form. Pain in the affected area of ​​the mammary gland becomes severe, and the temperature continues to rise. The affected mammary gland appears swollen, increases in size and becomes painful. A painful dense infiltrate with unclear boundaries appears at the site of inflammation, and the skin of the gland turns red. Regional lymph nodes may be enlarged.

The abscess form of acute mastitis usually begins after 3–4 days and is next stage development of inflammation, when formation occurs in the formed infiltrate purulent cavity- abscess. Signs of intoxication appear - chills, fever (body temperature reaches 40°C), enlarged lymph nodes. A delimited, sharply painful area is felt in the mammary gland. Unlike infiltration, an abscess is “softer” to the touch (due to the liquid pus accumulated in it). The structure of the mammary gland predisposes the purulent process to spread throughout its entire thickness; sometimes patients have multiple abscesses that look like a honeycomb. Superficial abscesses can open on their own.

If the wall of the abscess undergoes purulent melting, and the process becomes diffuse in nature, the phlegmonous form of mastitis begins. Cellulitis does not have clear boundaries, therefore, upon palpation of the mammary gland, it is not possible to identify a clearly demarcated area of ​​compaction. The patient's condition is serious, the symptoms of intoxication are worsening, and the fever is increasing (temperature exceeds 40°C). Characteristic feature is pronounced swelling and enlargement of the mammary gland, inverted nipple and bluish discoloration of the skin.

The gangrenous form of mastitis is the most severe; it is an advanced purulent process. The mammary gland greatly increases in size, acquires a purplish-bluish tint, and foci of necrosis become black. Multiple blisters may appear on the surface of the gland, similar to the consequences of a burn.

A terrible complication purulent mastitis is sepsis - a generalized purulent infection that poses a threat to the patient’s life.

Chronic mastitis occurs in an infiltrative form and is often secondary, as a consequence of ineffective treatment of the acute process. Much less often, chronic mastitis is primary. The patient's general condition does not suffer much, the affected mammary gland may be slightly enlarged in size, and a very dense, almost painless infiltrate can be easily palpated in it. It is uncommon to find enlarged lymph nodes or mildly elevated temperature.

Non-lactation mastitis does not have clear clinical signs; most often it occurs with the formation of an abscess.

Mastitis in a nursing mother

Towards total number During childbirth, the incidence of mastitis ranges from 3 to 20%. In most cases, purulent inflammation in the mammary gland in women in the postpartum period is caused by S. aureus (Staphylococcus aureus). The “entry gates” for pathogenic microbes are cracks and microtraumas of the nipples. It is possible that infection can enter through the milk ducts during feeding or pumping. Mastitis in a nursing mother can be a consequence of improper care of the mammary glands or develop due to non-compliance with personal hygiene rules.

Postpartum mastitis, unlike its other forms, is predominantly associated with lactation (hence the name “lactation”) and is diagnosed in 2-11% of lactating women. Lactation mastitis is characterized by unilateral damage to the mammary glands, develops mainly at 5-6 weeks after birth and goes through all the stages inherent in acute purulent mastitis of any origin.

Violation of the regimen and/or rules of breastfeeding provokes stagnation of milk in the mammary gland, which provokes the development of local non-infectious inflammation.

Since the trigger for the development of inflammation is lactostasis, at the beginning of the disease a woman experiences a feeling of tension in the mammary gland. Stagnation of milk leads to the fact that the mammary gland increases in size, and overcrowded milk ducts can be felt in the form of painful compactions without clear boundaries. The amount of expressed milk decreases significantly and body temperature rises.

If lactostasis is not eliminated in the next 3 to 4 days, secondary pathogenic flora attaches, which causes decomposition of milk and damage to the milk ducts, that is, the process takes on the character of acute purulent inflammation. The mammary gland looks swollen and red, the discharge from the nipple becomes purulent, and symptoms of intoxication increase. An attempt to empty the mammary gland is not possible due to severe pain. The further scenario of the disease depends on how quickly the patient seeks qualified help: if a woman does not turn to a specialist, does it too late, or tries to cope with the disease on her own, the likelihood of developing severe infectious process gets very high.

Non-lactation mastitis after childbirth is much less common; it develops without the participation of lactation and is similar to that in non-lactating women.

Mastitis in newborns

Purulent mastitis occurs infrequently in infants. Sometimes women confuse the concepts of mastitis and physiological mastopathy in newborns.

Physiological mastopathy (breast engorgement) appears in approximately 70% of newborns and is an absolutely normal phenomenon. For proper development For the fetus and continuation of pregnancy, a woman requires estrogens. During pregnancy, they are produced so much that they penetrate into the fetus in utero through the placenta and accumulate in its body. After birth (usually during the first month of life), the newborn's body begins to get rid of unnecessary estrogens from the mother. A sharp decline hormone levels lead to the so-called “sexual crisis”, leading to changes in the mammary glands.

Physiological mastopathy is considered one of the indicators of healthy adaptation of newborns to extrauterine life. The sexual crisis is most clearly manifested in those babies whose pregnancy and birth took place without serious complications. All changes in the glands during physiological mastopathy are reversible and disappear on their own within 2–4 weeks.

The gender of the newborn is not related to the hormonal sexual crisis, but physiological mastopathy is more common in female newborns.

Physiological mastopathy in newborns begins to appear within two days after birth; by the end of the first week of life, the symptoms decrease and can completely disappear within a month. The mammary glands increase in size evenly, occasionally the process can be one-sided. There is no need to panic if a small amount of fluid similar to colostrum is released from the milk ducts. The skin of the mammary glands does not show signs of inflammation, and their engorgement does not cause any inconvenience to the baby.

Neonatal mastopathy does not require any intervention. Attempts by parents to “treat” the child can provoke the transformation of a simple physiological state into a pathological infectious process. Excessive hygiene procedures, all kinds of compresses and lubrication, heating, squeezing out the contents of the mammary glands lead to the fact that all kinds of mechanical damage appears on the delicate skin of the breast (especially the nipples) - cracks, scratches, irritations, etc. Through such damage, microbes enter deep and provoke the development severe septic complication – neonatal mastitis.

Neonatal mastitis can develop due to improper care of the baby. It is very important to bathe the child in a timely manner and prevent development.

As in the case of mastopathy, children of both sexes can get mastitis. The disease begins at the moment when the symptoms of physiological mastopathy begin to disappear. Instead of their complete disappearance, there is a rapid development of the clinical picture of an acute infectious process, which in most cases is one-sided.

The mammary gland becomes painful and increases in size. As the disease progresses, the skin of the breast turns red and becomes hot, and you can feel a lump in the area of ​​inflammation. The child's condition worsens as the infection worsens. If treatment is not started in a timely manner, an abscess will form at the base of the breast infiltrate. At this stage of the disease, children require urgent surgical care: the abscess cavity must be opened and the pus evacuated. If there is no intervention, the purulent process can develop further and turn into a generalized form - sepsis.

Purulent mastitis in newborns should be treated exclusively in a surgical hospital. Treatment methods depend on the stage of the process and the condition of the child.

Diagnosis of mastitis

Diagnosis of mastitis begins with studying the patient’s complaints, such as pain in the affected gland and deterioration in health. May be noted purulent discharge from the nipple and fever. Breastfeeding women often indicate symptoms of lactostasis that precede the development of acute mastitis and/or the presence of cracked nipples.

Visual examination and subsequent palpation of the affected mammary gland determines the presence and nature of the seal, swelling, change in color and temperature of the skin. Pay attention to enlarged lymph nodes, the condition of the nipples and areola, the presence of purulent discharge, rashes and cracks. For superficial purulent mastitis During palpation, a breast abscess can be detected.

After a conversation and a thorough examination, a laboratory diagnostics:

— A general blood test indicates an acute inflammatory process: an increase in the number of leukocytes and an increase in ESR.

— Milk examination reveals an increase in the content of leukocytes (more than 106/ml) and bacteria (more than 103 CFU/ml).

— Bacteriological examination of discharge from the nipples makes it possible to reliably identify the pathogen, and also, for the purpose of subsequent therapy, to determine its sensitivity to antibiotics.

If it is necessary to clarify the diagnosis, a ultrasound scanning mammary glands. It allows you to determine the presence, location and size of foci of purulent inflammation. During an ultrasound, the doctor can puncture foci of inflammation and obtain material for bacteriological examination.

When making a diagnosis, it is necessary to differentiate mastitis from lactostasis, which is sometimes difficult, since purulent mastitis often follows lactostasis. Distinctive features of lactostasis are the improvement of the patient’s condition after emptying the gland and the absence of signs of purulent inflammation.

Treatment of mastitis

Treatment of mastitis is a broad and varied complex therapeutic activities. The choice of method and timing of treatment remains with the attending physician.

The best-case scenario is treatment started in the initial phases of mastitis, when external signs there is no illness yet, but there are complaints about discomfort in the area of ​​the mammary gland and congestion (heaviness, swelling, etc.). Essentially, treatment initial stages mastitis (serous stage of the process) is a treatment for lactostasis. Sometimes it is enough to provide complete emptying glands, installing correct mode feeding and expressing milk. If symptoms increase, fever develops (temperature rise above 37.5°C), severe pain appears, and the need for antibacterial therapy arises. In addition to antibiotics, antispasmodics, ultrasound or UHF therapy are used.

Breastfeeding can be continued if inflammation is eliminated and bacteriological examination of milk is negative result. Feeding is carried out exclusively from a bottle; it is not recommended to put the baby on any breast. Expressed milk from a diseased gland is not used, but that obtained from a healthy gland is pasteurized and given to the child using a bottle. Expressed milk cannot be stored. The decision to stop or continue feeding at any stage of inflammation is made by the doctor on an individual basis.

Treatment with antibiotics is carried out for no longer than 10 days. If improvement does not occur after 48–72 hours from the start of therapy, it is necessary to exclude the formation of an abscess. Despite adequate antibacterial therapy initial forms acute mastitis, mammary abscesses develop in 4–10% of cases.

The abscess phase of mastitis in most cases requires surgical intervention. In relatively mild cases, it is possible to puncture the abscess, evacuate the purulent contents and administer antibiotics directly to the source of inflammation.

If the patient's condition is severe, the patient is immediately hospitalized in a surgical hospital, where the abscess is opened and drained, followed by mandatory antibiotic therapy.

Self-medication of mastitis at any stage can have the most unpredictable and often sad consequences!

Compress for mastitis

Despite numerous reminders about the dangers of self-medication of purulent processes, the number of women who are keen on home treatment of acute mastitis is not decreasing. Feasibility of therapy folk remedies must be discussed with your doctor first. Acute mastitis, especially against the background of lactostasis, develops quickly, and if antibacterial therapy is not timely, severe septic complications can occur, so the time spent on home treatment, can only contribute to the worsening and spread of the infection.

To treat mastitis, women use all kinds of compresses. To “warming” compresses with alcohol solutions you should not resort to it - when purulent inflammation begins in the mammary gland, any thermal procedure promotes the rapid spread of microbes throughout the gland, and instead of relief, the patient will only harm herself even more.

Among other things, alcohol aggravates lactostasis.

Compresses with camphor oil will not help cure mastitis. If camphor gets into milk, it will harm the baby.

For the treatment of mastitis initial stages apply compresses (not hot) with medicinal herbs, grated carrots, rice starch, pieces are used kombucha, leaves of fresh cabbage and coltsfoot. From the entire arsenal of methods traditional medicine For each specific patient, the attending physician will help you choose the right one.

Prevention of mastitis

Prevention of purulent mastitis includes measures that eliminate its causes and should begin at antenatal clinic, continue in the maternity hospital and end in the children's clinic.

Prevention of mastitis consists of several simple rules:

— Rules of personal hygiene allow you to keep the skin of the mammary glands clean. It is necessary to take a shower and change your underwear promptly. You should not wear underwear that compresses the mammary glands. Underwear made from synthetic fabrics irritates the breast skin and prevents the mammary glands from “breathing.”

— Timely treatment cracks and irritation of the nipples will prevent the development of inflammation and the development of mastitis. It is not recommended to feed a baby from the breast on which the nipple is damaged.

— Correctly chosen feeding regimen and compliance with the rules of emptying the mammary gland (pumping) will prevent lactostasis and its consequences.

— Correct good nutrition, rich in vitamins and proteins, will help increase the body's resistance to infections.

Every antenatal clinic holds classes where expectant mothers are told about methods and methods for preventing mastitis. In the maternity hospital, such conversations are conducted by a feeding specialist. After discharge from the maternity hospital, a young mother is helped by a patronage nurse: During home visits with mother and baby, she teaches how to hold and properly latch on to the baby during feeding, proper breast care, and expressing milk. It’s hard not to agree that with such a well-organized preventive work Every woman has the opportunity to maintain her health.

The most reliable way to prevent mastitis is to visit a doctor in a timely manner. If there is any problem in the mammary glands, you should consult a specialist.

Mastitis is a disease in which inflammation of the mammary gland occurs. It affects women from 15 to 45 years of age.

With mastitis, severe inflammation of the breast tissue occurs. This disease is considered a common complication after a woman gives birth to a child. Usually, the first signs of the disease begin to bother a woman several weeks after the birth itself. It is during this time period, according to experts, that a nursing woman should monitor her health as best as possible. Particular attention should be paid to the breasts.

Mastitis is caused by Staphylococcus aureus. It easily penetrates a woman’s body through cracks or small wounds, which can be formed on breast nipple. The milk ducts, blood vessels and lymphatic ducts. Defeat causes a lot of discomfort and unpleasant sensations. Although, based on signs such as lactostasis (stagnation of mother's milk), it is not always possible to diagnose mastitis in a nursing mother in a timely manner.

Types of mastitis

It is necessary to highlight the fact that mastitis can be divided into several types according to the signs it manifests itself. In such cases it may be:

1. Chronic
2. Spicy

And what kind of inflammation develops in female gland, the disease can be divided into the following types:

1. Serous
2. Infiltrative
3. Lactational
4. Purulent mastitis

The lactation type of disease is in turn classified into:

You should also know where exactly the inflammation is concentrated. The form of the disease will depend on where the source of infection is located. They may be as follows:

1. Subcutaneous
2. Subareolar
3. Intramammary
4. Retromammary
5. Total form (in this case, the structure of absolutely all tissues located near the mammary gland is disrupted

Typically, symptoms that occur at any stage of mastitis development manifest themselves in the form of severe pain and discomfort. It is very important to seek medical assistance in a timely manner. Otherwise, the consequences may not be the most pleasant for a woman.

Why do mastitis develop in women?

Breast mastitis can be caused by a change in the structure of the shape of the mammary gland, as well as the presence of chronic or purulent infection. The most common causes of this disease in women are the following:

1. Tissue damage by microbes
2. Severe stagnation of mother's milk
3. Frequent hypothermia
4. Improper hygiene of the breasts and the whole body

Symptoms of mastitis can often be similar to the presence of other serious illnesses breasts It is for this reason that experts do not recommend delaying a visit to the doctor at the first appearance of pain in the mammary glands.

Who is at risk

Particular attention should be paid to those women who have previously encountered any breast diseases, as well as those who have given birth, and who after childbirth began to develop skin disorders of a purulent-septic nature.

Mastitis is diagnosed in almost 70% of women who have given birth for the first time. 27% suffer similar illness after the birth of the second child, and only 3% of women are susceptible to the disease, having already experienced several births in their lives.

An interesting fact is that the disease can affect not only the woman who gave birth. Quite often there are cases when mastitis develops in girls and men.

At the same time, it is necessary to note the increased number of diseases in animals. It is known that mastitis in cats and mastitis in cows are more common than in other animals.

A disease that does not occur as a result of breastfeeding is considered to be non-lactation. It can develop only due to severe trauma to the mammary gland. The development of mastitis can also be influenced by hormonal imbalances and other chronic diseases.

Mastitis in infants

Such deviations in the development of newborns occur in 70% of cases. In most cases, mastitis affects only girls, although sometimes boys can also get sick. Premature babies are not at risk. They may be diagnosed with more severe deviations.

While still in the mother's womb, the child receives estrogen (sex hormones in women) throughout all months. As soon as the baby is born, their number sharply decreases, which can result in hormonal imbalance. It is this that in most cases contributes to the occurrence of physiological mastitis in infants.

Treat this type no need for illness. After some time, all unpleasant symptoms disappear on their own.

If the mother experiences complications during pregnancy, the child may become infected with purulent mastitis. This type of disease poses a great threat to his life. Therefore, as soon as the mother notices something strange in the child’s behavior, she should immediately seek the help of specialists.

Signs of the disease in women

Most women who give birth for the first time have no idea how mastitis manifests itself. To protect yourself, you need to be informed that this disease can manifest itself the following signs:

1. Frequent and severe chest pain, which only gets worse over time.
2. When you feel your breast, you may notice a small lump.
3. A sharp increase in body temperature (the mark on the thermometer can rise higher than 38 degrees).
4. In the place where the inflammatory process occurs, the breasts will become reddish.

Very often, similar symptoms are observed in young mothers who gave birth for the first time. Pain begins to bother them already 3-4 days after birth. This reason is explained by the fact that the gland ducts in such women are not yet of sufficient size. And in order for them to acquire the necessary form, a certain amount of time must pass.

The first thing a woman should pay attention to is the appearance of cracks in her nipples. It is through them that the infection enters the body and causes an inflammatory process. After this begins, pain occurs. Most often they can be of an increasing nature. Also with the appearance of pain, female breast It may swell and become a little larger in volume.

As soon as one of the described signs showed, the woman mandatory should see a doctor. Only after prescribed drug treatment and following all the doctor’s advice, the disease can be defeated very quickly and its possible consequences can be avoided!

If you don't pay attention to alarming symptoms, mastitis can become purulent. In such cases, the woman’s well-being deteriorates sharply, and she needs urgent medical care.

What a nursing woman needs to pay attention to

In a woman after childbirth, mastitis makes itself felt after a few days. The reason for this is lactostasis. That is why a young mother needs to pay special attention to the following symptoms of mastitis:

1. A sharp increase in body temperature (the mark on the thermometer can rise above 38 degrees). After this, weakness, headache and nausea may appear.
2. Every time the baby is fed, severe pain will occur in the mammary gland.
3. The shape of the breast may change (the skin will be hot and red, and it will be almost impossible to touch it due to acute pain). In rare cases skin begin to peel or itch.
4. In such situations, the disease affects both mammary glands. Therefore, the healing process will not occur very quickly.

For what reasons can mastitis develop in a nursing woman?

Even if a woman carefully monitors the condition of her breasts while breastfeeding her child, unpleasant symptoms of the disease can appear very often, especially in the first few months. These symptoms can be caused by following reasons:

1. A woman's breasts retain a lot of milk after feeding her baby. Such stagnation is very harmful to the entire body.
2. The appearance of small cracks and wounds on the nipples (this is a consequence of improper attachment of the baby to the mammary gland).
3. Using uncomfortable and tight fitting underwear, which in turn can put very strong pressure on the chest, thereby causing injury.
4. Chest bruise or injury.
5. Weak immune system after illness.
6. Not following body care.
7. A woman does not drink enough water per day.
8. Genital warts.
9. Treatment of cervical erosion.

Most often, mastitis in nursing women develops as a result of the accumulation of milk and the addition of bacteria (staphylococcus) to it. It is they that penetrate the woman’s gland, thereby causing a strong inflammatory process in all tissues.

Infection can also occur through untreated caries, pyelonephritis and tonsillitis.

How to promptly diagnose the presence of mastitis

To make a correct diagnosis, it is necessary to describe in detail to the doctor the state of your health and indicate which symptoms are bothering the woman. It is on the basis of these data, as well as laboratory and clinical studies, that the specialist will determine accurate diagnosis.

If a specialist misses something or for some reason is unable to establish the presence of purulent mastitis, then the treatment period for this form of the disease may be delayed indefinitely.

Blood and urine tests may be used for diagnosis. If necessary, the specialist will offer to undergo an ultrasound examination of the breast and breast echography. Such methods make it possible to provide extensive information about the condition of ongoing mastitis.

Any experienced doctor should immediately pay attention to the woman’s lethargy and the fact that during examination, touching her breasts will be unpleasant to her. Sometimes the pain can be so severe that the patient does not allow it to be examined and felt normally.

If necessary, the patient can be left in the hospital for further treatment.

Treatment of mastitis

As soon as a woman shows the first symptoms of an unpleasant disease, she urgently should go for a consultation with a gynecologist. The doctor will prescribe you to go special studies, on the basis of which it will be assigned therapeutic treatment. Antibiotics become the main components of treatment. In each case, they must be selected strictly according to individual character the course of the disease and the patient’s well-being.

Treatment of mastitis in a nursing woman consists of following these recommendations:

1. It is necessary to regularly carry out procedures that help remove excess milk from the breast.
2. Therapeutic massage to improve milk flow.
3. Expressing milk after feeding your baby. They need to be done every 3 hours. Only then can you achieve positive result.
4. Using medications that help slow down the production of breast milk.
5. To reduce severe pain and reduce fever, you can use medications:
6. Antipyretic drugs will help reduce high body temperatures.
7. The introduction of novocaine will reduce severe pain in the breast area.

In the initial stages of mastitis, you can use warm compresses and do a light massage. After these procedures, the female breast should be kept warm. During this period, it is recommended to wear loose underwear.

Home treatment for purulent mastitis is impossible. Such situations require the intervention of doctors and surgical intervention.

Preventive actions

In order to avoid the occurrence unpleasant symptoms bottom disease, every woman can perform simple rules. Only compliance with a special regime will keep her health in order.

Preventive measures that are easy to perform at home include:

1. You need to feed your baby not after a certain amount of time, but only when he demands it himself (this also applies during the night).
2. Express excess milk only when necessary.
3. Use only comfortable underwear, preferably made of cotton, not synthetics.
4. It is necessary to learn how to properly attach the baby to the breast and each time change the position in which the baby is fed.
5. Try to stay in cold air as little as possible and avoid drafts.
6. If cracks or wounds appear on the nipples, they must be treated urgently to prevent germs and viruses from entering the body.

It is easy to adapt to such rules. Moreover, they do not require much effort and time. These recommendations simply need to be made a mandatory condition of your life in the first few months of feeding your baby.

How mastitis can be dangerous

The consequences of the disease can take a very negative turn only if the disease is too advanced. If in the early stages of the disease it is not properly addressed, then as a result, phlegmonous or gangrenous forms of mastitis can develop, which, in turn, pose a huge threat to the health of every woman. If the disease does not respond to treatment with drugs, then experts may recommend amputation of the infected mammary gland.

After mastitis, you need to be as attentive and careful as possible. Any violation of the recommendations may trigger the re-development of this disease.

Mastitis is a fairly common disease that almost every woman who has given birth has to deal with. Its occurrence is impossible to predict, but it is quite possible to do everything to ensure that it does not disturb you. All it takes is a little effort on your part. Don’t forget, the health of her baby depends on how well the mother monitors her health. Therefore, the breasts need to be given due attention, both during pregnancy and after childbirth.

Author Bozbey Gennady Andreevich Update date: November 4, 2017 0

Breastfeeding is a great opportunity to raise a healthy and developed child, this is the wonderful side of motherhood, but there are also some problems that, although not inevitable, are quite possible. During lactation, sometimes troubles arise, one of which is lactation 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 Greek language. It is to him, as well as to Latin, that doctors owe the ability to name every 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, location of the lesion, prevalence, etc.

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

• By origin:
• Lactation (in women who have given birth).
• Non-lactational (in all others, including infants).

According to the process:

• spicy,
• chronic.

According to the nature of inflammation:

Non-purulent, in turn divided into

• serous,
• infiltrative;

• abscess;
• phlegmonous;
• gangrenous.

There is also a special type of disease - infiltrative-abscessing, which combines two forms, which are included in the name.

Lactation or postpartum mastitis

As the name suggests, breastfeeding women suffer from this disease. According to statistics (ICD-10 code - O.91) occurs in different regions countries in 2-18% of cases of successful births. 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 childbirth changes the ability of the mammary gland to adapt to changes in a woman's hormonal status. Moreover, more experienced mother She is better able to position the baby correctly and observe personal hygiene standards.

Causes of acute mastitis

Staphylococcus aureus is considered to be the direct “culprit” for the development of acute mastitis (purulent and non-purulent). This microorganism constantly lives on the skin and mucous membranes of almost half of healthy people, without causing any disease for years. However, when provoking factors appear, it 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 coli and Pseudomonas aeruginosa, streptococcus, enterococcus, Proteus, etc.

Sometimes (for example, with granulomatous mastitis) the microbial flora is only secondary cause pathologies, and autoimmune damage to the gland comes to the fore. However, this particular type of disease has been studied very little, and it is assumed that it is only one of the manifestations of systemic granulomatosis.

Here's what increases the risk of developing this pathology:

• lactostasis;
• pathological pregnancy and childbirth;
• presence of concomitant diseases.

Signs of mastitis in a nursing mother

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

• injuries,
• scar changes after operations,
• stiff nipple and its cracks,
• elongation, thinness and tortuosity of the milk ducts,
• diffuse or focal fibrocystic mastopathy;

and subjective, that is, violation of feeding technique and non-compliance with the regime (feeding “on demand”).

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

Serous mastitis

This is the very first stage of the disease. An inflammatory reaction begins, 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 palpating the chest, apart from pain, there are no other signs of inflammation; it is impossible to feel the pathological focus. When expressing milk, the amount of milk may be less than usual.

Infiltrative form

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

Acute purulent mastitis

In the absence of proper treatment or when treating mastitis with folk remedies, a purulent process develops within 3-4 days. From this point on, conservative treatment becomes ineffective.

Abscess form

When the process moves into the abscess phase, the patient's condition begins to deteriorate, the phenomena of severe intoxication increase, and the body temperature in a third of patients soars sharply to figures exceeding 38°C. The skin over the lesion is intensely red, the pain is sharp. When palpated, a clearly defined compaction is determined, in the center of which there is an area of ​​softening.

Infiltrative-abscessing form

The course of this form is more severe 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 abscess is that a large compaction 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 area of ​​the outbreak.

Phlegmonous form

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

Gangrenous form

This is the most dangerous form mastitis, in which the woman’s condition becomes severe or extremely severe. In this case, purulent melting is not limited to just one area of ​​the mammary gland, but covers it all. Often the process spreads beyond the organ, affecting the tissue of the chest. All symptoms are pronounced, the patient is experiencing severe weakness, there is no appetite, there are headaches, aches in the bones and muscles. Temperatures above 39°C are a common occurrence during the gangrenous process.

Local manifestations are also striking: bluish-purple skin, detachment of the epidermis with the appearance of blisters filled with fluid mixed with blood above the lesion. Areas of complete tissue necrosis (necrosis) 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 urine test.

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

Lera, you should contact a surgeon and strictly follow his instructions. You may need to see your GP first for a referral.

Treatment of mastitis

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

For non-purulent forms, treatment is as follows:

• 8 times a day you should express milk first from a healthy and then from a diseased gland. Milk can be given to the baby only after pasteurization. If 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 production).
• Antibiotics are prescribed wide range actions, antihistamines, vitamins C, B.
• Also recommended novocaine blockades with the use of an antibiotic in the absence of allergies to either novocaine or the corresponding drug.
• Semi-alcohol compresses are also used for mastitis. It is prohibited to use any ointment dressings.
• At good effect from the start of treatment, it is possible to prescribe UHF to the site of inflammation one day after the start of taking the drugs.

For purulent mastitis, treatment without surgery is impossible. Opening an abscess is fundamental principle surgery, and not a single folk remedy or taking drugs orally or by injection can force the body to “deal” with pus. That is why several types of surgery have been developed, allowing in most cases to avoid any cosmetic defects or dysfunction.

For surgery, all patients are hospitalized in the surgical department. The intervention is carried out in an 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 surgical treatment of purulent forms of mastitis:

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

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

After surgery, immediate closure of the wound with sutures is possible, but in case of extensive lesions, the surgeon may decide to perform two-stage wound closure followed by plastic surgery of the defect with a skin flap.

Immediately after surgery, 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 especially amoxicillin and the like) are not sufficiently effective to suppress microbial flora.

Depending on the microorganism that caused the suppuration, drugs from 1 to 4 generations (cephalexin, cefazolin, cefuroxime, ceftriaxone, cefotaxime, cefpirome) can be used. At severe forms diseases accompanied systemic manifestations inflammation, as well as for sepsis, thienam is prescribed. Of course, we are not talking about taking drugs orally; 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. Possible termination breastfeeding and with the persistent desire of the mother to do this. In these cases, use special drugs, suppressing milk production - parlodel, dostinex.

It should be noted that there is a tendency to prescribe drugs with unproven or unstudied effectiveness. So, sometimes traumeel is prescribed for mastitis - a homeopathic remedy intended for use only in traumatology and orthopedics. At least this is all that is said in the instructions from the manufacturer. 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-lactation mastitis

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

The symptoms of mastitis in non-lactating women are exactly the same as in lactational women. A feature of its course is the more frequent and rapid abscess formation, compared to lactation. The disease itself is milder and responds better to treatment, but more often becomes chronic and recurs.

Treatment for this form of the disease is exactly the same as for its lactational form. In newborns, the abscess is also opened and then drained.

Chronic mastitis

This disease is most often the result of an acute process that was treated incorrectly or insufficiently effectively. The symptoms resemble those of an acute form of the disease, however clinical picture It is distinguished by its “pallor”: there are no acute symptoms of intoxication, the general condition is rarely affected, there is no redness of the skin at the site of inflammation, palpation is not painful. Upon careful examination, a very dense infiltrate is palpated.

Sometimes chronic mastitis occurs in the form of a fistula, when a breast abscess 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 stop completely, 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 tissue is removed, they are excised in the fistula canal, after which the wound is sutured according to the same rules as for acute form. Prescribing antibiotics is mandatory.

Treatment of mastitis with folk remedies

The tendency of our people to keep everything under control forces them not to turn to doctors who use methods incomprehensible to mere mortals, but to look for alternative ways fight the disease. Treatment of mastitis with folk remedies most often consists of either applying some kind of compress to the chest, or drinking certain decoctions, infusions or teas from plants considered medicinal. Practice, however, shows the complete inconsistency of such methods. The risk is enormous, because often too much time is spent understanding 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 did not heed the warning, here are a few traditional medicine recipes that are believed to help cope with the disease:

• From ghee, rye flour and fresh milk make a bun in the evening, leave it overnight to “reach”, and then apply it to the sore breast.
• Burdock and coltsfoot leaves 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 bedtime.

The use of Vishnevsky ointment for mastitis can also be compared to traditional medicine. The xeroform included in its composition, according to its antiseptic properties much inferior modern drugs(for example, chlorhexidine). Tar, also contained in the drug, has a predominantly irritating effect, “thanks to” which almost always the non-purulent form of the disease turns into a purulent one, worsening its course and making surgery absolutely necessary.

Unfortunately, there are no statistics on cases of recovery from such treatment, however, any surgeon has in his arsenal a dozen stories about how a woman lost her breast due to the fact that she did not see a regular doctor for too long, preferring the recommendations of newspapers like “Granny’s Pharmacy” "

Prevention of mastitis

Prevention of mastitis should begin during pregnancy. To do this, you should take a warm shower daily (preferably twice a day), and also additionally wash your breasts with water at room temperature, and then rub it with a clean terry towel. This makes the nipples more resistant to mechanical damage, inevitable especially in initial period feeding.

After feeding, the breasts 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 dry completely. After this, put on a bra (only cotton or cotton!), in which a sterile napkin or gauze is placed.

The nutrition of a nursing mother must be complete and must include sufficient quantity protein, necessary for 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 - all this improves the body's resistance to infections and does not cost a penny. It is necessary to completely eliminate smoking and the use of even minimum quantities alcohol.

Mastitis or mastopathy: what is the difference?

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

The first sign of mastitis is an increase in temperature. Even with mild forms of the disease, the temperature may rise, which is not typical for mastopathy. The second sign is the connection with the monthly cycle. Pain during mastopathy intensifies before menstruation and weakens or even disappears after the end of bleeding. The third sign is the lack of connection with lactation. Mastopathy occurs in both women who have given birth and 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 appears, then we are talking about mastitis.

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

Inflammation of the mammary gland is a fairly simple pathology to diagnose, but very insidious to treat. Procrastination, ignoring medical prescriptions, self-medication can lead to loss of lactation, breast deformation, and in some cases, sepsis and death. Only timely consultation with a doctor will help prevent life- and health-threatening consequences.

Hello. A lump appeared in my chest. The doctor said it was mastitis and prescribed antibiotics. But they are dangerous! Is there any folk remedy for treating mastitis? Well, recipes that helped someone exactly? Zhanna, 36 years old

Zhanna, unfortunately, traditional medicine methods rarely help. There is an opinion that their effectiveness is zero, but in fact, those whom they allegedly helped actually had lactostasis, which they got rid of by pumping. Do not ignore the surgeon’s instructions, otherwise there is a high risk of developing an abscess and surgery may be necessary.

Gennady Bozbey, Emergency Medicine Doctor

Ask a free question to a doctor

Breast mastitis is an inflammation of the mammary gland tissue in women. Previously, this disease was called differently - breastfeeding. Most often, the inflammatory process occurs unilaterally. It spreads quite quickly, so if at least one symptom appears of this disease immediate treatment should be started.

Most often, mastitis in women occurs during breastfeeding or during last days pregnancy. In rare cases, the appearance of the disease has been observed in newborns and non-lactating teenage girls. Breast mastitis, the symptoms of which are identified in this category of patients, is called non-lactational.

In order to minimize the risk of this problem and learn how to avoid mastitis altogether, you should familiarize yourself with the reasons why it appears.

The development of the disease begins after bacteria enter the tissues in the chest area. This can occur through nipple damage such as cracks. The infection may be on the woman's skin or in the mouth of the newborn baby she is nursing. After this, the bacteria begin to multiply rapidly, and symptoms of the disease appear noticeably. Inflammation of the mammary gland in women nursing babies can occur for the following reasons:

• The presence of cracks and other damage to the nipples;
• The only position for feeding. Breastfeeding must take place within various poses, otherwise a significant amount of milk may remain in the mammary gland;
• An ill-fitting bra. A nursing woman should choose underwear that is comfortable and not tight. The bra should support the breasts, keeping them in their natural state.
• Repeated inflammatory process. If health problems arose during your first pregnancy, there is a high probability of them occurring again. Also, the possibility of disease increases with untimely or incorrect therapy. Treatment is necessary when the first symptom of irritation is detected.

In addition to the above, lactostasis is considered one of the main reasons for the onset of the development of the inflammatory process. Congestion in the mammary gland is a kind of impetus for the appearance of mastitis. Prolonged absence milk serves as the basis for the formation of a favorable environment in which bacteria multiply. The infection that arises after this can cause not only inflammation, but also fever with suppuration.

Non-lactation irritation of the mammary gland

In addition to the inflammatory process that occurs during lactation, another type of problem may develop. To understand the question, what is non-lactational mastitis, you need to familiarize yourself with information about the reasons for its appearance. Among these are:

• Damage mammary glands subsequent injuries;
• Presence in the chest foreign bodies. These include implants and piercings;
• Formation of ulcers;
• Impaired metabolism;
• Various procedures carried out in violation of sanitary and antiseptic standards.

The non-lactating species is rare. In addition to it, mastitis of newborns is isolated. The reasons for its occurrence are maternal hormones that enter the young body during pregnancy or lactation, as well as poor child care and non-compliance with hygiene rules.

General symptoms and warning signs of mastitis

As stated earlier, unilateral type mastitis most often occurs. In rare situations, a bilateral inflammatory process occurs.

To find out how to recognize inflammation of the mammary glands and get rid of mastitis in time, you should study information about its symptoms.

1. Unpleasant sensations.
2. Swelling and increase in the size of the diseased area of ​​the body.
3. Increased body temperature and chills.
4. Detection of blood or pus in the milk of a nursing mother.
5. Pain during breastfeeding and pumping.
6. Decreased appetite and loss of strength.
7. General weakness of the body.

These criteria are the first signs of inflammation of the mammary glands. If at least one of the symptoms of the disease is detected, treatment should be started immediately. Only a qualified medical professional can prescribe the correct procedure and tell you how to cure mastitis and what to do if infected. If you consult a doctor in a timely manner, this disease can be cured within a few days.

It is worth noting that self-medication is not recommended during this period of time. Otherwise, the risk of complications and severe forms of the disease increases.

Complications of inflammation of the mammary glands

Belated and wrong treatment problems in nursing women can cause a number of complications.

1. Sepsis. Too advanced a stage of the disease can cause blood poisoning.
2. The presence of a significant number of purulent foci during inflammation on the body entails health problems such as pneumonia, meningitis, and osteomyelitis.
3. Infectious-toxic shock.
4. Fistula formation.

Stages of the inflammatory process

In order to determine one or another stage, it is recommended to familiarize yourself in more detail with the characteristics of each of them.

1. Serous. This stage is considered the initial stage. Often, the symptoms of mastitis in this case are almost impossible to distinguish from lactostasis. Learning to distinguish one illness from another is not at all difficult. Due to stagnation of milk, nursing mothers may complain of heaviness and discomfort in the area of ​​the sore breast. With lactostasis, the pumping procedure becomes painful, but in this case there is no shortage of milk. Stagnation is temporary, so if the illness lasts more than 2 days, you should think about serous mastitis. An increase in body temperature and a general deterioration in the patient’s health are other indicators of the first period of infection. Sometimes there come times when serous period goes away on its own. Otherwise, the next stage begins.

1. Infiltrative stage. The second form of mastitis can be characterized by the presence of a dense, uniform compaction in the sore spot. It increases in size, but there are no other visual changes - redness or swelling. In the absence of therapeutic therapy at this stage of the problem, purulent formations appear, and the next form of the disease process occurs.

1. Destructive. During this period, toxins contained in purulent formations penetrate into the patient’s blood. There is a significant increase in body temperature - up to 39-40 degrees. Other health problems immediately appear - frequent headaches, lack of appetite, sleep disturbances.

Consultation on how to determine one or another stage of the problem, and how treatment of mastitis in nursing women should proceed, can be obtained from the attending physician. The destructive form of the disease can be seen visually - the affected area of ​​the breast turns red and increases in size. The veins in this area of ​​the body become pronounced. In each situation, treatment of mastitis should be carried out immediately.

Forms of the disease

Based on their temporary nature, there are 2 types of irritation of the mammary gland:

• acute;
• chronic.

In the first version, the disease appears suddenly, its signs are clearly identified. Most often this happens in the postpartum period.

The chronic form of breast damage occurs when the serous stage is treated incorrectly. Its main characteristic is the presence of irritation during a certain period of time. Effective treatment in this case is only possible with the help of surgical intervention. A thorough sanitation of the milk ducts and subsequent competent antibacterial therapy are necessary.

Treatment

If primary signs of a problem are detected, you should immediately contact a doctor treating the disease - a mammologist. Only a qualified doctor will tell you exactly what to do with mastitis, how to accurately determine inflammation of the mammary gland and select treatment.

Before you begin to treat breast inflammation, you need to determine the nature and stage of development of the disease, the causes of its occurrence, as well as the volume of the affected area of ​​the body and the duration of the disease.

The most common treatment method is antibiotics. To achieve a favorable effect in the shortest possible time, the selection of medications is carried out by the doctor individually for each patient. Proper prescription of medications will help quickly expel the infection from the body.

In cases where the manifestation of the inflammatory process is similar to lactostasis, it is recommended to drink antiseptics and monitor the dynamics of the disease. In more complex cases, when harbingers of mastitis indicate its final stage, surgical intervention is necessary. An operation is performed during which the pus is sucked out from the affected area.

How to treat mastitis at home

There are many traditional medicine recipes that will help get rid of the causes of breast disease.

1. Rice starch compress. You can relieve the symptoms and treatment of mastitis using rice starch diluted in water. The resulting mixture should resemble sour cream in consistency. Using a bandage, you need to apply the product to the sore spot. You can see the effect of this method of treating mastitis after 3 hours.

1. Pumpkin. Heat a piece of sweet vegetable pulp in microwave oven and apply to the painful area. Change every 15 minutes.

1. Apple. You can remove cracked nipples using grated apple mixed with butter.

1. Narcissus. Chopped narcissus root mixed in equal proportions with rye flour and boiled rice will prevent the mammary gland from becoming very inflamed. Apply the resulting mixture to the affected area of ​​the body several times a day.

1. Particular attention should be paid hygiene procedures. Contrast massage with jets of warm and cool water while taking a bath will relieve painful sensations.

The symptoms and signs of mastitis are most often pronounced, so it is very difficult not to notice the development of this health problem. Familiarization with primary information about inflammation of the mammary glands will provide a sufficient level of knowledge on how to treat this disease. The emergence of concerns about its development should serve as an impetus for immediate consultation with a doctor.

Mastitis is inflammatory disease breast (mammary gland), which usually develops after childbirth and is characterized by severe pain in the chest, redness and enlargement of the mammary gland, a feeling of discomfort during breastfeeding, an increase in body temperature and other symptoms. The main reason for the appearance of mastitis is bacterial infection, causing inflammation of the breast.

The course of mastitis occurs in several periods. If it wasn't necessary treatment, the disease may progress into a purulent form, fraught with dangerous complications. By identifying mastitis in the early stages and promptly starting treatment, it is possible to prevent the progression of purulent inflammation of the breast.

Causes of mastitis

The main reason why a disease such as mastitis develops is penetration of bacteria into breast tissue.

Bacteria can get into the breast in several ways:
through blood, if present in female body chronic foci of infection (pyelonephritis, chronic tonsillitis, etc.),
through nipple cracks - small skin defects in the nipple area provide a favorable environment for infection.

Under normal conditions, when a small number of bacteria enter the mammary gland, the woman’s immune system is able to suppress the infection. But after childbirth, a woman’s body is in most cases weakened and cannot effectively resist bacteria.

Plays an important role in the development of mastitis lactostasis, the occurrence of which is associated with rare feedings or incomplete/insufficient expression of breast milk, leading to its stagnation in the ducts of the mammary glands. The milk present in the ducts of the mammary glands serves as a favorable environment for the proliferation of bacteria, since milk contains a large amount of nutrients.

Risk factors for mastitis

In most cases, mastitis manifests itself through 2-4 weeks after a woman is discharged from the hospital.

There are a number of factors that increase the risk of mastitis:
large mammary glands,
presence of cracks in the nipples,
“irregular” shaped nipples (inverted or flat nipples) make it difficult for the baby to suck the breast, as a result of which during feeding the mammary glands are not emptied sufficiently, which leads to the appearance of lactostasis,
lactostasis – If milk is not expressed sufficiently, it stagnates in the ducts of the mammary glands. Usually, with lactostasis, the outflow of milk from one lobe of the mammary gland is disrupted due to its blockage with a “plug” of thickened milk.

Signs of lactostasis are:
painful sensations in the mammary gland,
nodules (lumps) in the chest that disappear after massage,
uneven flow of milk from the affected area of ​​the breast.

Usually, with lactostasis not complicated by mastitis, body temperature does not increase. If lactostasis is not cured within three to four days, it turns into mastitis. The first symptom of mastitis development is increase in body temperature to 37-39 degrees.
neglect of hygiene rules by a woman during breastfeeding (before and after breastfeeding),
existing infectious diseases chronic(pyelonephritis, tonsillitis, etc.).

There are two main types of mastitis:
lactation ( another name - postpartum) - develops in nursing mothers,
non-lactational – mastitis, which is not associated with breastfeeding. This type of mastitis is quite rare and is formed due to injury, compression of the mammary gland, and also as a reaction to hormonal disorders occurring in the body.

Fibrous and cystic mastitis are nothing more than cystic fibrous mastopathy.

Stages of mastitis development

During postpartum (lactation) mastitis, there are several stages:
early stage – serous mastitis – the main characteristics of which include an increase in body temperature, pain when feeling the breasts, an increase in the volume of the mammary gland,
infiltrative mastitis develops in the absence of adequate treatment for serous mastitis, with it fever appears, and a painful lump forms in one area of ​​the mammary gland,
purulent mastitis – This is suppuration of the chest area.

Signs and symptoms of mastitis

Mastitis is usually distinguished by acute development- this indicates that Symptoms appear quickly (within a few hours - a couple of days).

The main signs and symptoms of mastitis are:
body temperature increases to 38 degrees, which is evidence of the presence of an inflammatory process in the body. As a result of an increase in temperature, chills, headaches, and weakness appear;
constant painful sensations in the chest of an aching nature, which intensify during breastfeeding;
an increase in the volume of the mammary gland, redness of the skin in the area of ​​inflammation, the skin becomes hot.

If mastitis is not cured in time (in the early stages), it progresses to a purulent form.

The main signs and symptoms of purulent mastitis are:
body temperature rises to 39 degrees or more, there is sleep disturbance, severe headaches, poor appetite,
severe pain in the mammary gland, pain is felt even from a light touch,
V axillary area there is an increase in lymph nodes, which to the touch appear as small, dense, painful formations.

Diagnosis of mastitis

If you experience any of the symptoms listed above, you should Seek medical help immediately. Diagnosis of mastitis consists of identifying the characteristic signs of the disease, which are detected when a doctor performs palpation and examination of the mammary gland.

To confirm the diagnosis of mastitis, a general blood test is performed, which can indicate an inflammatory process in the body. Also carried out bacteriological examination milk, which is necessary to identify the type of bacteria and determine their sensitivity to antibiotics. In some cases, when diagnosing mastitis, the method of ultrasound examination (ultrasound) of the mammary gland is used.

Mastitis and breastfeeding

For mastitis breastfeeding is prohibited, regardless of the form of the disease. This is due to the fact that in breast milk, both from the patient and from healthy breasts, may contain many bacteria that pose a danger to the child. In addition, in the treatment of mastitis antibiotics are mandatory, which also pass into mother's milk and can harm the baby. Even if breastfeeding is temporarily suspended during mastitis, it is necessary to express milk regularly and thoroughly. This procedure will not only speed up the recovery process, but will also help maintain lactation in the future so that the woman has the opportunity to continue breastfeeding.

Treatment of mastitis

The treatment of mastitis is influenced by factors such as the form of the disease (purulent, serous mastitis, etc.), as well as the time that has passed since the onset of the disease.

When treating mastitis, we are guided by the following basic principles:
stopping the growth of bacteria,
relieving inflammation,
anesthesia.

Purulent mastitis can only be treated with surgery. Treating mastitis on your own is strictly prohibited!

Promotes a faster and more painless recovery from mastitis, complete or partial suppression of milk production (lactation). After recovery occurs, lactation can be resumed. Usually lactation is suppressed with the help of special medications (for example, Dostinex, Parlodel etc.), which are prescribed exclusively by a doctor.

Treatment infiltrative and serous, i.e. non-purulent forms of mastitis held conservative methods, without surgical intervention. It is necessary to express milk every three hours to avoid stagnation, which contributes to the growth of bacteria. To get rid of pain in the chest, local anesthetic drugs are used, such as, for example, novocaine blockades.

Antibiotics are the main medicines for the treatment of mastitis. Having determined the sensitivity of the bacteria, a specific antibiotic is prescribed. As a rule, they are used to treat mastitis the following groups antibiotics:
cephalosporins ( Cefradil, Cefazolin and so on.),
penicillins ( Amoxiclav, Oxacillin and so on.),
aminoglycosides ( Gentamicin) and so on.

Antibiotics are taken either orally, intravenously or intramuscularly.

Treatment of purulent mastitis is based on surgical intervention. The operation is performed using general anesthesia. After surgery, antibiotics are mandatory.

When antibiotics are stopped and bacteriological tests show that the milk does not contain bacteria, breastfeeding can be resumed.

Traditional methods of treating mastitis are not recommended since the vast majority of herbs do not have the ability to destroy the infection that has penetrated the mammary glands. Every delay in the treatment of mastitis is fraught with the appearance of purulent forms of the disease, which pose a threat to a woman’s life.

Prevention of mastitis

Every woman should spend preventive actions aimed at preventing mastitis. The main ones are listed below:
1. Before and after breastfeeding, it is necessary to strictly follow the rules of hygiene. A woman during the feeding period should monitor the condition of her body, since she is in close contact with the newly born child. Daily shower is required. Before the breastfeeding procedure, you need to wash your hands and both breasts with warm running water, after which you need to blot them with a soft towel (you cannot roughly wipe the mammary glands, because the skin on them is very delicate and cracks may appear on it).
2. One of the risk factors for the development of mastitis is the appearance of cracks in the nipples. To soften the skin around the nipples, lanolin-based vegetable oils are applied to the skin after feeding.
3. As a measure to prevent lactostasis, the child should be fed on demand (it is not recommended to adhere to a feeding schedule). During feeding, you need to make sure that there is no retention of milk in one of the lobes of the mammary glands (it is contraindicated to squeeze areas of the mammary gland with your fingers; there is no need to hold the breast). The milk that remains after feeding the newborn needs to be expressed (this can be done either manually or using a breast pump). If a lump (milk stagnation) has occurred in one of the lobes of the mammary gland, it is necessary to give the baby a position during feeding in which his chin will be facing the lump. To eliminate lactostasis, when feeding, you can gently massage the dense area until it becomes normal.