Mastitis in a non-breastfeeding woman with symptoms. Inflammation of the mammary glands in men
Happy is the woman who did not know what mastitis is. But unfortunately, this disease occurs quite often. Up to five percent of breastfeeding mothers suffer from mastitis and, as a rule, this disease most often affects first-time mothers. Therefore, it is very important to strictly follow the rules of breastfeeding and basic sanitary standards. However, mastitis is an insidious disease. It affects not only nursing mothers, but also women over thirty, newborns and even adult men...
The fact is that breast mastitis is inflammatory disease mammary glands, which is caused by various microorganisms. Trigger The development of mastitis can be caused by a cold or infection through microcracks in the nipples. There are two types of mastitis - lactation, which occurs in nursing women, and fibrocystic.
The trouble of nursing mothers
As a rule, mastitis in nursing women develops in the first three months after the birth of a child. Mastitis during breastfeeding can be caused by a violation of milk flow through the ducts. As a rule, this is due to both simple inexperience and improper feeding of the baby, and inept actions when pumping. This is why lactation mastitis most often affects women giving birth for the first time.
If pumping and feeding are improper, microcracks appear on the nipples, which become entry points for infection. Staphylococcus aureus and other types of microorganisms penetrate through cracks into the breast and cause inflammation. Sometimes mastitis in nursing is a consequence of postpartum infection. But this happens extremely rarely.
Signs of mastitis
Once mastitis has begun to develop, it is impossible to recognize its symptoms. The disease manifests itself acutely: the temperature suddenly rises to 38-39°C; The breasts increase in size and become dense and sensitive. At the same time, a woman may have chills, nausea, weakness, and weakness, which resemble flu symptoms. Further, the signs of mastitis increase rapidly. After a while, it is simply impossible to touch the breast, it is so painful to the touch. After 2-3 days, a lump appears in the breast, the skin turns red, and a burning sensation and pain are felt when feeding.
Most often, mastitis in a nursing mother develops in one breast. It almost never appears after 6 months - most often it affects a young mother in the period 2-3 weeks -3 months after the birth of the child. Unfortunately, if mastitis appears, the woman is at risk - the incidence of recurrent mastitis is quite high. If treatment is not started on time, trying on yourself “tested” grandmother’s recipes, retold by friends, then the disease will quickly develop into purulent mastitis. In this case drug treatment may no longer be effective and surgical intervention will be required.
Other types of mastitis
Women after thirty years of age may develop non-lactation mastitis. It affects weakened women who have problems with the immune system and sluggish pathological processes in the body. In this case, the signs of mastitis may not be so obvious and overlap with the symptoms of other diseases, which makes diagnosis difficult.
After forty to sixty years, symptoms may resemble mastitis-like breast cancer. For diagnosis, tissue is excised in the area of the lump to rule out cancer.
Non-lactation mastitis in women can be caused by injury to the mammary gland, sudden climate change - non-lactation mastitis is a very common occurrence after a holiday in warm countries in winter.
Mastitis in men is very rare, but still occurs. First of all, this is a sign hormonal imbalance in organism; Mastitis often appears in those who suffer from diabetes. Sometimes men who have undergone gender reassignment surgery and breast implants also develop mastitis, but such cases are rare. As a rule, treatment of male mastitis is done without surgery, using medications.
Mastitis occurs in children. Mastitis most often occurs in newborns, which develops in the first weeks of life due to infection. Microorganisms penetrate through the blood from another source of infection or from the outside, through skin lesions. We must remember that childhood mastitis develops very quickly and has a rapid course. After a day or two, the disease enters purulent stage. You should not think that if the newborn is a boy, then he cannot get mastitis - childhood mastitis equally often affects both boys and girls.
Mastitis manifests itself as a common inflammatory disease - the temperature rises, the child becomes apathetic or, conversely, excitable, and refuses to eat. One mammary gland is enlarged. On the first day of illness there is no redness, then swelling, redness, and soreness appear. Breast mastitis in a child requires prompt medical attention at the first suspicion. Babies are treated in the hospital with antibiotics and vitamins.
Mastitis affects girls in adolescence- this is usually the fault hormonal changes body, leading to temporary weakening protective forces. Treatment of mastitis in adolescents is similar to the treatment of non-lactation mastitis in adult women.
Treatment of mastitis
Despite the severity of the symptoms, mastitis in women is treated successfully and quickly enough. Conservative and surgical methods treatment. If mastitis is diagnosed quickly and is not advanced, then antibiotic therapy is prescribed for two weeks. The disappearance of painful sensations is not a reason to discontinue medications. If treatment is interrupted, mastitis may return.
At the same time, to alleviate the condition, applying ice to the chest, drinking plenty of fluids, warm shower. No matter how much it hurts, you can't stop breast-feeding or pumping. If purulent mastitis has developed, it is better to express milk. Otherwise, milk will accumulate in the breasts and mastitis will worsen.
If antibiotic therapy does not produce results and mastitis has entered the purulent stage, then surgical intervention: the abscess is opened in the hospital.
Prevention of mastitis
Lactation mastitis is better prevented than treated! From the very beginning of feeding, follow simple rules that will help avoid breast infection. Before and after each feeding, you need to wash the mammary glands and wipe with a weak disinfectant solution. Be sure to change the baby's position, placing him on each breast in turn, but only after he has completely emptied the first breast. Express the remaining milk.
There is no need to allow the baby to play with the breast - if he is already full and is just playing around, then stop feeding. Due to the constant presence of the nipple in the child's mouth and biting, microcracks may appear on them, through which the infection can easily penetrate into the mammary gland.
Any cracks in the chest that appear should be immediately lubricated with a solution of brilliant green.
It is especially necessary to carefully monitor the health of teenage girls, not allowing them to overcool the mammary glands or engage in sports that can lead to breast injury.
The main thing to remember is that at the first signs of illness there is no need to self-medicate, look for forgotten recipes in books, or follow the advice of neighbors and good relatives. Mastitis can be cured quite quickly and without any complications if you consult a doctor in time.
Mastitis is a purulent inflammatory process of the mammary gland, in which the patency of the ducts is disrupted. Most often, the disorder occurs in women while breastfeeding.
The disease is caused by the activity of pyogenic microbes (mainly streptococci and staphylococci). The infection enters injured nipples through clothing, household items and from the child. The disease can also develop as a secondary infection through lesions of the genital organs during the postpartum period.
Types of mastitis in adults
Lactational. Occurs in women during breastfeeding child. The main factors in the development of the disease are wearing uncomfortable underwear, improper attachment to the breast and pumping. This leads to nipple lesions and congestion, which are most favorable for infection and the development of pathogenic microflora.
Fibrocystic (non-lactational). This type of mastitis affects not only women, but also men of different age categories. Causes injury mammary glands, climate change ( abrupt change belts) and failure hormonal levels. Metabolic disorders ( diabetes) are an additional factor in the onset of the disease.
Symptoms of the disease
The primary signs of mastitis are pronounced and their appearance is typical for all types of the disease. Main symptoms:
if the pathology has postpartum character, it manifests itself during the first month after birth;
the temperature rises sharply (up to 39 - 40 degrees), accompanied by characteristic features- pain in the head, fever alternating with chills, and severe weakness;
strong painful sensations and the fever rises.
If a visit to a specialist is postponed and proper curative therapy, the disease progresses to acute phase inflammation. After two days, the skin turns red, the breasts swell and a lump appears, accompanied by pain.
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Treatment options
At primary symptoms Mastitis should begin treatment immediately under medical supervision. As urgent measure(before visiting a specialist), cold may be applied to the inflamed area.
Treatment is prescribed on an individual basis, based on the form of the disease and the characteristics of its course.
At the first stage of the pathology (not aggravated by acute purulent lesions), it is eliminated conservative ways. For lactation mastitis, medication therapy is carried out if the patient feels well, with a temperature below 37.5 degrees and only one lump in the mammary glands.
To eliminate an abscess in nursing women, they are prescribed antibiotic drugs acceptable during feeding. In some cases, in order to respect the interests of mother and baby, lactation may be temporarily or completely stopped.
For mastitis, cephalosporins and penicillin group antibiotics. They are used intramuscularly, intravenously or in drinking mode. For elimination pain syndrome anesthetics are used.
Antibiotics are taken simultaneously with the elimination of the causes that led to the development purulent pathology. As an addition, desensitizing therapy, physiotherapy (laser therapy and UHF), taking vitamin preparations and elimination of anemia.
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If after two days of treatment there is no effect, in order to avoid complications of inflammation, the specialist prescribes a more radical measure - surgery, in which the abscess is opened and the affected areas of tissue are removed.
In women who are not breastfeeding, general symptoms may be similar to those of cancerous tumor in the area of the mammary gland. In this case, to identify accurate diagnosis a small affected part is plucked off to perform an analysis confirming the non-cancerous nature of the disease.
The main measure to prevent the occurrence of mastitis will be its timely prevention. Women during lactation should avoid injury to the nipples and congestion by expressing milk on time. In addition, it is important to strictly adhere to the rules of personal hygiene and wear comfortable underwear (special bras recommended for use have been developed for nursing mothers).
At the slightest suspicion of mastitis, you should contact a mammologist and your treating gynecologist.
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 represented mainly by 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 glandular structures - lobules. The lobules contain mammary glands, which are winding tubes with extensions at the end (alveoli). Milk is produced in the alveoli, and the tubes act as excretory ducts and open at 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 of 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), the 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 of serous inflammation to a severe 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 acute stage Therefore, chronic forms of mastitis are rare.
Serious purulent mastitis with severe course It is rare among patients at the moment, and only as a consequence of delayed or incorrect therapy, or in case of significant deviations in work 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 during. 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 has infectious 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 tissue, and the inflammation begins to spread quite quickly, involving a large amount 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. Are being created ideal conditions 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 mammary glands;
- purulent processes in the skin or subcutaneous tissue of the mammary gland (,), when inflammation begins to invade the underlying tissues;
— 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 clinical course 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 light current. The mammary gland becomes uniformly dense to the touch and slightly painful to the touch. The temperature in the serous form of mastitis can reach 38°C. Serous mastitis detected in time 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). A characteristic feature is pronounced swelling and enlargement of the mammary gland, an inverted nipple and a bluish tint to 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 serious complication of 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 ineffective treatment acute process. Much less often, chronic mastitis is primary. General state the patient does not suffer much, the affected mammary gland may be slightly increased in size, 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). " Entrance gate» 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 as painful lumps without clear boundaries. The amount of expressed milk decreases significantly and body temperature rises.
If lactostasis is not eliminated in the next 3–4 days, a secondary pathogenic flora, 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 help. qualified assistance: If a woman does not contact a specialist, does it too late, or tries to cope with the disease on her own, the likelihood of developing a severe infectious process becomes 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 the proper development of 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 appearance of all kinds of mechanical damage– cracks, scratches, irritations, etc. Through such damage, microbes enter deep and provoke the development of a severe septic complication – mastitis of newborns.
Neonatal mastitis may develop due to improper care for 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. Purulent discharge from the nipple and fever may occur. Breastfeeding women often indicate symptoms of lactostasis that precede the development of acute mastitis and/or the presence of cracked nipples.
At visual inspection 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:
— General analysis blood 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, an ultrasound scan of the mammary glands is prescribed. 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 lactostasis is an improvement in 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 disease yet, but there are complaints of discomfort in 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 ensure complete emptying of the gland by installing correct mode feeding and expressing milk. If symptoms increase, fever develops (temperature rise above 37.5°C), severe pain, there is a need for antibacterial therapy. 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 for the initial forms of 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 serious, 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 purulent processes, the number of women interested in 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 in the 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.
- Proper nutritious 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 is difficult to disagree that with such 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.
Hello my dear readers!
Today I will tell my story.
On January 27, I was driving in a car with my husband and suddenly felt dizzy and nauseous. 15 minutes later we arrived home, appeared sharp pain in the chest, as if it were full, although she had previously fed the baby. After 30 minutes I felt a chill, an hour later the temperature was 39. Wild fever. Every part of my body began to hurt, from my fingertips to my scalp. And all this developed in 2 hours. Before this, there were no prerequisites for the development of the disease at all.
At night there was terrible vomiting. Lasted almost all night. Honestly, together with the above symptoms, this is tough. Since I had already survived this misfortune before))), this time I decided to act immediately, quickly, as prescribed by the doctor who cured me once before. I didn’t go to the hospital, I decided to give my body some time, I didn’t see a doctor. Of course, this is bad and I advise you to immediately consult a doctor with such symptoms.
Why didn't I see a doctor?
Firstly, I immediately knew what my diagnosis was, because I had experienced the same thing before.
Secondly, I live in a city where there is no mammologist at all, but with good gynecologist who understands this matter is really very difficult. I knew that if I went to the hospital, they would look at me like I was a fool, that I had been a nursing mother for 9 WHOLE MONTHS, and they would say either go die or stop nursing immediately. I wrote about one of these cases. These 2 options are not for me. And it was hard to drive 60 km with a temperature of 39.
And the purpose of writing this article is to help people like me. Those who are left alone with their illness where there are no doctors.
How was I treated?
Antibiotic Amoxiclav (500 mg) 3 times a day.
Diclofinac injections once a day. (2-3 days)
Regular pumping (after about 3-4 hours).
This was the hardest part. The next day, my natural breast size 2 turned into 5. During the whole day I managed to express only 100 ml. Probably because the ducts became inflamed and the milk could not pass through. The whole next day I lay with a fever, and any attempt to get up made me dizzy until I fainted. At night again vomiting, fever and no strength.
All of the above medications are approved for nursing mothers. They do not pose a danger to your baby, since they enter milk in very small quantities and are quickly excreted from the body.
The next morning it became easier, the breasts decreased slightly in size, although they remained the same red. The temperature has dropped. Expressed more milk along with pus. I realized that things were getting better. Today is the 6th day of the development of the disease, I feel very good, it’s just painful to feed.
All this time, my son Vladushek was content with one breast. Although it has been proven that it is not dangerous for a child to feed from a breast affected by mastitis, I simply did not want my baby to ingest dirty milk. Therefore, I proved to myself that, if desired, it is possible to feed a child with one breast.
Well, that's probably all. My shortest article is coming to an end. I will be very glad if someone finds mine useful good experience mastitis treatment. It’s better, of course, that this never affects you. Believe me, it hurts a lot.
By the way, all three times I had mastitis on one breast. I want to look for information on this topic, maybe this is not a coincidence. If you have any comments on this matter, please write.
In general, I believe that no disease comes to us just like that. So we deserve it. Maybe they offended someone by accident or were offended, maybe they showed indifference or strong anger and irritation. Maybe it didn't help anyone. Any illness is food for thought. You need to analyze your actions, draw conclusions and try not to do it again.
Well, that's it, bye everyone. Oksana Litvinova.
Mastitis is an inflammation of the parenchymal layer of the mammary glands that occurs for numerous reasons. Shape, dimensions and anatomical features Breasts are individual, so the range of norms is quite wide. Female breast has a lobular structure. All lobes are large, articulated with each other by intervals of connective tissue with alveolar structure. The alveolus is lined with a thin epithelial layer with excretory duct. Multiple small ducts connect into large ones, where colostrum and milk accumulate. Any disturbances associated with the outflow of milk and congestion can trigger the development of mastitis.
Code according to MBK 10: 091-092
What is this
Mastitis in a nursing mother is an inflammation of the mammary glands in the area of the breast parenchyma. The disease is diagnosed in only 5% of all lactating women. With each passing decade, the disappointing statistics are decreasing, which indicates that the female population is literate about breastfeeding. Mastitis is more common in rural areas, where there is no qualified advisory and medical assistance regarding issues of fulfilled motherhood. The disease is registered mainly 2-3 weeks after birth, but in some cases it can occur later. There are two main types of mastitis:
lactation(associated with breastfeeding in women);
non-lactational in women and men(related to other reasons).
In the majority of women, only one gland is affected, with the left one being more common than the right one. This is due to the ease of expressing milk. right hand left mammary gland. During the first 3 days after birth, a woman produces colostrum, which is more reminiscent of whey in composition. The substance is enriched with fats and proteins. The required volume of milk matures by the 12th day of a baby’s life. Stabilization of volume occurs by 6 months of the child’s life. Average duration The lactation period lasts from 6 to 24 months, which depends on the woman’s capabilities and desires.
The main condition for the development of mastitis is the formation of congestion in the ducts of the mammary glands. When an infection occurs, mastitis occurs infectious nature, in the absence of one - non-infectious. The risk group includes primiparous women due to poor development glandular tissue. Today, there are many methods for attaching a baby to the breast, and modern breast pumps for quickly emptying the mammary glands.
Causes
The inflammatory focus of mastitis in women is formed under the condition of the pathogenic activity of Staphylococcus aureus. Pyogenic bacteria cause serious illnesses from purulent lesion skin, before the disease internal organs and tissues (osteomyelitis of bones, meningeal infections, pneumonia). IN Lately the combined pathogenic activity of Staphylococcus aureus and gram-negative Escherichia coli is sown.
Causes of lactation mastitis
The cause of typical postpartum mastitis often lies in hospital infection (insufficient asepsis, roommates, crowds of relatives). Infection can occur through household contact. IN in rare cases Mastitis is caused by a newborn child infected with a staphylococcal bacterium. This can occur with umbilical sepsis, pustular skin lesions. For pathological activity of staphylococcus in the body healthy woman many factors must come together. The main causes of lactation mastitis are the following:
scars and scars on the mammary glands;
anatomical defects of the breast (shape of the nipple and areola);
woman's history of mastopathy;
pathological pregnancy, complicated childbirth;
postpartum fever;
emotional and mental disorders after childbirth;
exacerbation of existing chronic diseases.
Insomnia, weakened immunity, loss of energy, lack of sleep - all this can contribute to the development staphylococcal infection. It should be understood that Staphylococcus aureus is present in the environment everywhere and is an opportunistic bacterium. When creating a favorable environment for the growth and development of coccal colonies, inflammatory foci of various localizations arise.
Causes of non-lactation mastitis
Non-lactation mastitis can occur in men and women as a result of reduced immunity, trauma, excess weight And hormonal disorder. Other causes of non-lactation mastitis include the following:
hypothermia;
emotional disorders, mental illness;
pustular skin diseases in the chest area;
damage of any nature.
Decreased immunity in many cases is the main reason for the development of pathogenic microflora in the human body. The severity of advanced forms of lactation and non-lactation mastitis is the same, as is the degree of harm to human health.
Symptoms
The symptoms of mastitis are quite easy to distinguish from classic lactostasis. In both cases, congestion, pain, and tension in the chest are noted, but there are 3 main features that make it possible to determine lactostasis:
severe pain when pumping;
absence of fever, malaise;
in one or more lobes of the mammary gland a movable compaction with clear boundaries is palpated.
Usually, lactostasis disappears on its own with proper pumping or intensive feeding of the baby. If over the course of several days the compaction in the area of the affected breast does not decrease, and the temperature rises to 37 C°, then the onset of mastitis can be suspected.
Serous form
Serous mastitis is initial form purulent mastitis. The affected tissues become saturated with serous exudate, which can result in an inflammatory process. The main symptoms are:
slight malaise;
breast swelling;
pain when emptying the gland;
temperature increase.
Sometimes, with the serous form, a woman recovers on her own, but if the condition worsens, the temperature rises to high values, then further progression of mastitis occurs.
Infiltrative form
The disease at the stage of infiltration formation (pronounced compaction) is the second stage of mastitis formation. The main symptoms of the infiltrative form are:
tenderness in the affected breast;
slight redness;
temperature rise to 37-38 C°.
The tissues remain unchanged, there is no swelling. An increase in temperature is associated with milk entering the bloodstream through damaged ducts. In the absence of treatment, after 5 days a purulent form mastitis.
Destructive or purulent form
At this stage of development of the pathology, the patient’s health sharply worsens due to symptoms of intoxication of the body. Nausea and malaise increase, the temperature reaches 40 C°. The breast tissue resembles a honeycomb soaked in purulent exudate. Other signs are also included:
redness of the breast;
swelling of the nipple, areola;
enlargement of the affected breast;
severe pain during palpation and pumping;
enlargement and tenderness of the axillary lymph nodes.
The purulent form is dangerous due to the spread of pus through the bloodstream, infection of internal organs or systems, especially in the presence of chronic diseases.
Infiltrative-abscessing form
Abscess mastitis is characterized by the formation of cystic cavities with purulent exudate. On palpation of the infiltrate, softening is noted, the boundaries become unclear. Almost all women experience fluctuation syndrome (fluid transfusion in the cavities) when palpated. At this stage, purulent foci are formed with different localization:
near the nipple (subalveolar);
inside the mammary gland (intramammary);
subcutaneous (in subcutaneous fat):
behind the mammary gland (retromammary).
As the disease progresses, the infiltrate resembles a cluster of multiple abscesses of varying sizes. Considering the small size of the abscesses inside the seal, the infiltrate may falsely appear homogeneous and resemble the infiltrative form of mastitis. Fluctuation syndrome is observed in only 10% of women.
Phlegmonous form
Phlegmonous mastitis is expressed in total enlargement and swelling of the mammary gland. The skin in the affected area is red, sometimes bluish-red, the nipple is slightly retracted. On palpation, patients experience severe pain, fluctuation syndrome is clearly expressed, involving almost 3-4 quadrants of the glandular structure in the process. The indicators of clinical and laboratory research are also violated:
protein levels in the urine change;
leukocyte formula with a shift to the left (increased leukocytes and inflammation);
decrease in hemoglobin in the blood.
It should be noted that the phlegmonous stage occurs already 7-10 after the initial stage of mastitis. In the absence of adequate treatment, the final stage occurs pathological lesion mammary gland.
Gangrenous form
IN pathological process the vascular system is involved. The formation of blood clots prevents adequate blood supply to tissues, leading to their necrosis. On the surface of necrotically changed areas of the skin, blisters with sanguineous contents appear. The affected breast takes on a bluish or purple-bluish tint in all quadrants of the mammary gland. The patient becomes seriously ill clinical condition with reduced blood pressure, thready pulse, confusion. Treatment for this form of mastitis is only surgical.
To eliminate the risks of rapid progression of mastitis, especially in women located far from medical centers, any moving lump into pain is considered the initial stage of mastitis. Already at the onset of lactostasis, you should prepare for consultation with specialists.
Diagnostics
Which doctor should I contact for mastitis? If you suspect any lump or pain, you should consult a surgeon or mammologist. In the absence of these specialists, you can resort to the help of a general practitioner who can initially determine pathological changes. Diagnosis of mastitis does not present any particular difficulties, and all measures boil down to the following:
studying the patient’s complaints and clinical history;
visual examination of the mammary glands (nature of discharge, condition of the nipple and skin, anatomical features);
palpation of the mammary glands (determining lumps, pain intensity);
collection of urine and blood tests;
bacteriological examination of milk;
milk cytology and pH determination;
ultrasound of the mammary glands (for destructive changes in glandular structures);
puncture of the infiltrate to study pus and identify the pathogen.
In controversial situations, they resort to X-ray examination of the breast. In case of chronic mastitis, it is important to carry out a differential diagnosis regarding breast cancer. In such cases, a biopsy is performed and histological examination biological material.
Treatment of mastitis
Treatment of mastitis can be carried out both at home and in a hospital setting. In the early stages of mastitis, women do not need to interrupt breastfeeding; on the contrary, complete emptying of the mammary glands is necessary. What to do in the initial stages of mastitis?
Early stage
For lactostasis and serous mastitis, treatment is conservative. Therapeutic tactics include intensive pumping and massage of the mammary glands. Activities are permissible if:
the condition lasts no more than 3 days;
general condition remains stable;
no temperature;
blood tests are normal;
there are no signs of inflammatory nature.
Expressing is done every 2-3 hours. They begin to express or feed the baby first from the healthy breast, then from the affected breast. If the baby has not finished eating, it is recommended to express completely and give a high-quality massage.
Desensitization therapy
Desensitizing therapy is aimed at improving milk production, preventing the development of mastitis, eliminating and resolving the infiltrate.
The main drugs for the treatment of lactostasis ( early stage mastitis) the following are considered:
Magnesia. Magnesium sulfate is used as a pronounced antispasmodic, hypotensive, choleretic agent. Widely used in clinical practice, thanks to its beneficial properties.
Dimexide. The drug for lactostasis is used as a conductive agent that stimulates milk flow. Dimexide has anti-inflammatory and antimicrobial effects.
Oxytocin. Hormonal drug to stimulate lactation, birth process. The drug selectively affects smooth muscles, vascular system and milk ducts.
No-shpa. Antispasmodic agent intended as adjuvant therapy lactostasis. The drug has a pronounced myotropic effect, which has a stimulating effect on milk secretion.
Amoxiclav. A drug for etiotropic therapy for inflammatory processes, belongs to the group of combined antibiotics. It is used during preserved lactation without harm to the child’s health.
Malavit. Used as therapeutic compresses simultaneously with other drugs. It has disinfecting properties and stimulates the normal flow of milk through the milk ducts.
Progestogel. Gel for the treatment of lactostasis, widely used in clinical practice. The drug has specific effect on breast tissue, penetrates deeply into cells, reduces permeability vascular walls. During treatment, swelling decreases, milk flow normalizes, and the infiltrate resolves.
All medications are prescribed by a doctor based on general clinical picture diseases. If symptoms rapidly increase due to the progression of pathology, therapy is prescribed for a short period.
Late stages
Conservative therapy lasts about 4 days, in the absence of therapeutic effect don't continue. If conservative therapy does not produce results, then drug treatment is prescribed:
antispasmodics (Drotaverine, No-shpa);
non-steroidal anti-inflammatory drugs (Ibuprofen, Ketoprofen);
antibiotics of the group of cephalosporins, macrolides.
At the same time, UHF therapy, ultrasound, and electrophoresis are performed to resolve the infiltrate and normalize the function of the mammary gland. If a woman undergoes treatment on an outpatient basis, then constant examinations of the woman are required at least every 48 hours. If there is no positive dynamics for recovery, the woman is hospitalized.
Surgical intervention
The operation is performed in a hospital under general anesthesia. The main aspects of effective surgical treatment lactation mastitis the following are considered:
the importance of the aesthetic component of the incision (location of the scar, its length);
postoperative drainage of the wound canals and constant washing;
radical treatment of an opened purulent lesion.
The gangrenous and phlegmonous stage of the pathology requires full-scale surgical intervention. Subsequently, plastic surgery of the affected breast may be required. Installation of a drainage system is carried out when 2 or more quadrants of the glandular structure are affected. Drip irrigation of the wound surface is carried out for almost 2 weeks from the moment of surgery to full recovery women. Particles of epithelium, pus, mucous membranes, and blood should completely disappear from the washing water.
In the early postoperative period, intensive antibiotic therapy is prescribed. Antibiotics for mastitis after surgery prevent recurrence of the pathology. More often practiced intramuscular injection cephalosporin antibiotic (Ceftriaxone, Cefazolin, Cephalexin, Cefoxitin). In severe cases of mastitis, the antibiotic Tienam is prescribed.
It is recommended to stop breastfeeding in case of phlegmonous and destructive form. Expressing is also prohibited due to painful sensations and constant trauma to the wound. Drug therapy, also negatively affects the condition of the woman and child. Usually, lactation is stopped with medication, with double use of the drug Bromocriptine. Other methods of stopping lactation (tightening or ligating the mammary glands) are prohibited.
Mastitis - serious complication typical lactostasis, therefore, if there is any suspicion of the development of compactions and difficulty in the outflow of milk, you should contact a surgeon, mammologist or therapist.
Proper breastfeeding usually eliminates the risk of developing congestion, so competent consultation with specialists is important. For prevention, women should promptly treat all infectious diseases, carious teeth, purulent formations on the skin, monitor the child’s nutrition, and fully empty the breasts. A timely reaction will preserve not only health, but also the possibility of maintaining breastfeeding.
