What causes mastitis? Lactation or postpartum mastitis

Mastitis is purulent inflammatory process 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 mellitus) are an additional factor in the onset of the disease.

Symptoms of the disease

The primary signs of mastitis are pronounced and their appearance is 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 symptoms - pain in the head, fever followed by chills, and severe weakness;

severe pain occurs in the mammary glands and fever increases.

If a visit to a specialist is postponed and proper curative therapy, the disease enters the acute phase of inflammation. After two days, the skin turns red, the breasts swell and a lump appears, accompanied by pain.

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Treatment options

If you experience primary symptoms of mastitis, you should immediately begin treatment under the supervision of a doctor. 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 the penicillin group of antibiotics are usually prescribed. They are used intramuscularly, intravenously or drinking regime. To eliminate 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, treatment may include desensitizing therapy, physiotherapy (laser therapy and UHF), taking vitamin supplements and eliminating 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 stagnation 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 infectious inflammation mammary glands, which most often develops in women after childbirth and is associated with breastfeeding.

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

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

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

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

The initial stages of lactation mastitis can usually be dealt with using simple measures: massage, changing feeding and pumping techniques, and physiotherapy. Late stages of the disease are very difficult and require antibiotics, weaning of the child and surgical intervention. After surgery, rough scars often remain that spoil appearance mammary glands and force a woman to turn to plastic surgeons.

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

Symptoms of mastitis

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

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

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

The serous stage of mastitis is replaced by an infiltrative stage - while symptoms persist, an area of compaction is identified in the gland, sharply painful when palpated. At this stage, mastitis can be stopped without surgery and the infiltrate can be forced to resolve.

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

Causes of mastitis

The direct cause of mastitis is usually bacteria - Staphylococcus aureus or other microbes that occur on the surface of human skin. The infection enters the mammary gland through microdamages on the nipple or excretory ducts milk passages. It is believed that the source of infection may be the newborn himself, who transmits the microbes to the mother during feeding.

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

Lactostasis

Primary (physiological) lactostasis (milk stagnation) most often occurs in women after the first birth, which is associated with impaired preparation of the mammary glands for feeding.

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

If you don't take action at this time necessary measures, pathological lactostasis develops within a few hours. Its symptoms:

the breast becomes dense, lumpy, hot to the touch;
there is a feeling of heaviness and soreness in the mammary glands;
getting worse general health, the temperature may rise.

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

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

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

If milk stagnation has developed in you after discharge from the maternity hospital, contact medical care see a gynecologist or breastfeeding specialist in antenatal clinic.

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

Chronic mastitis

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

Risk factors for developing mastitis

Some women are predisposed to milk stagnation and the development of mastitis. Factors that increase the likelihood of these conditions include:

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

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

Causes of non-lactation mastitis

Non-lactation mastitis most often develops in women aged 15–45 years:

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

The immediate cause of non-lactation mastitis is usually an infection. Bacteria can enter the mammary glands through the bloodstream from the lesions chronic inflammation about the body, for example, with chronic tonsillitis, cystitis. In addition, non-lactation mastitis can be a consequence of injury, including nipple piercing.

Neonatal mastitis

This disease can develop in children of both sexes and is associated with hormonal changes. After childbirth, a high level of maternal hormones is maintained in the child’s body for some time. When their levels decrease (usually 4–10 days after birth), the baby may experience engorgement of the mammary glands and even milky discharge from them. In itself, physiological engorgement of the glands in newborns does not require treatment and goes away on its own.

But during this period, the baby’s mammary glands are very vulnerable. If they become infected, mastitis may develop. The entry of bacteria is facilitated by non-compliance with hygiene rules, rubbing the mammary glands, attempts to squeeze milk out of them, diaper rash and skin diseases. The development of neonatal mastitis is accompanied by fever, restlessness and crying of the child, redness and enlargement of the mammary glands. Such symptoms require urgent appeal see a doctor.

Diagnosis of mastitis

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

The basis for diagnosing mastitis is examination of the mammary gland. Feeling it can be painful, but the doctor needs this to determine the stage of the process and further treatment tactics. In case of lactostasis, during the examination the doctor can “decant” the breast, which will immediately bring relief.

Additional examination

As an additional examination, the following is prescribed:

general analysis blood from a finger - shows the presence and severity inflammatory reaction;
bacteriological examination milk and analysis of the sensitivity of pathogens to antibiotics - shows whether the milk contains microbes in quantities capable of causing mastitis (over 5 * 102 CFU/ml), and also provides information about those antibiotics that act on the sown microbes;
ultrasound examination breast (ultrasound) - allows you to accurately determine the stage of mastitis and its prevalence, the location of inflamed foci, their size, the presence of ulcers, etc.

Treatment of mastitis

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

In no case do not delay time, hoping for traditional methods and advice from “experienced” friends. Cabbage leaf, honey cakes or urine therapy remained in people's memory just because in old times, when there were no antibiotics and other effective medications, were the only means of help.

Now accumulated great experience in treatment postpartum mastitis. For these purposes it is used as non-drug methods, and medications. Purulent stages of mastitis necessarily require surgical treatment. Moreover, the sooner the operation is performed, the better its therapeutic and aesthetic result.

Is it possible to breastfeed during mastitis?

According to the official position Russian medicine If mastitis develops, breastfeeding must be stopped. During treatment, the child is weaned and transferred to artificial feeding. In exceptional cases, at the stage of serous mastitis, the doctor may allow feeding with a healthy breast. However, infiltrative and, moreover, purulent stage are clearly an indication for stopping feeding.

Weaning a child from the breast is a very unpleasant measure for every mother, because there is nothing healthier for a baby than breast milk. However, with the development of mastitis, such a measure is necessary. Continuing to feed may harm the baby because:

The main cause of mastitis is Staphylococcus aureus in large quantities excreted in milk. Staphylococcus is the causative agent of many infections, especially dangerous for young children. When it gets on the mucous membranes, staphylococcus causes a sore throat and otitis media, when it gets into the gastrointestinal tract intestinal tract- toxic infection (staphylococcal toxins are one of the main causes food poisoning milk and dairy products for children and adults). Antibodies that the baby receives from breast milk, cannot always protect him from this bacterium, much less from its toxins.
Various medications are used to treat mastitis: antibiotics, antispasmodics, antipyretics, etc. As breastfeeding continues, the baby drinks a cocktail of these medications with the mother.

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

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

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

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

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

Treatment of non-purulent mastitis

Serous and infiltrative stages of mastitis are treated conservatively - without surgery. For treatment, medications are used, as well as physical therapy.

Milk is expressed every 3 hours. First, express the sore breast, and then the healthy one. Your doctor may prescribe antispasmodics (drugs that dilate the milk ducts) in the form of tablets or injections before pumping.

Sometimes they do it before expressing novocaine blockade mammary gland. To do this, using a long thin needle, a solution of an anesthetic (novocaine) is injected into the soft tissue behind the mammary gland - a substance that interrupts nerve impulses from the gland to the brain. After the blockade, the pain goes away for a while, the milk ducts open, which makes pumping much easier. As a rule, antibiotics are added to the anesthetic solution to create their therapeutic concentration in breast milk.

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

Antibiotics are essential component mastitis treatment. For better effect antibacterial drugs prescribed as intramuscular or intravenous injections. During treatment, the doctor may change the antibiotic based on the results bacteriological analysis milk and antibiotic sensitivity test.

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

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

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

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

Treatment of purulent mastitis

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

The operation is usually completed with stitches. If postoperative period proceeds safely, the stitches are removed in 8–9 days. After surgery, antibiotics and physiotherapy are prescribed to improve wound healing.

Prevention of mastitis

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

The physiological mechanisms of milk formation, its accumulation in the breast and release during feeding are very complex. For them correct formation A close bond between mother and child is very important. Therefore, the initial measures to prevent mastitis are:

early breastfeeding (in the first 30 minutes after birth);
mother and baby staying together in the maternity hospital.

Every woman after giving birth should learn how to breastfeed correctly. With improper feeding, the risk of cracked nipples, stagnation of milk (lactostasis) and subsequently mastitis increases.

Technology proper feeding the woman must be trained by her attending obstetrician-gynecologist or midwife. For any questions regarding breastfeeding, you can contact the maternity hospital staff.

Basic rules of breastfeeding:

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

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

3. You need to hold the baby securely with your hand next to you, after making sure that even if you fall asleep during feeding, the baby will not fall. To do this, you can place a pillow under your arm or fence off the edge of the bed with a blanket cushion.

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

5. The most important point is proper latching on the breast during feeding. The baby should take the breast with a wide open mouth, not only the nipple, but also most of the areola. Lower lip The baby's breast should be turned outward while sucking.

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

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

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

How to express milk correctly

In cases of lactostasis, manual expression is more effective, although this is a very labor-intensive and sometimes painful process.

To make milk easier to let out before expressing, you can do soft massage mammary gland.
When expressing, place your fingers on the periphery of the areola (at the border of the skin and the nipple circle), do not pull the breast directly by the nipple.
Alternate pumping with stroking movements from the periphery of the breast to the areola of the nipple.

Breast care

The skin of the mammary glands, especially the papillar circle, is very vulnerable; infection can penetrate into the mammary gland through lesions on the skin. Therefore, you must adhere to the following rules:

during pregnancy and after childbirth, wear cotton underwear that does not tighten the breasts, but reliably supports the mammary glands to avoid compression;
Linens need to be changed daily, washed in hot water and iron with an iron;
during lactation, it is advisable to use special nipple pads that absorb secreted milk; Without special liners, underwear quickly becomes rough from drying milk and injures the skin;
If cracks form in the nipples, consult a gynecologist at the antenatal clinic.

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

Mastitis is an infection of the breast tissue that causes pain, swelling, a feeling of heat and redness of the breast skin. Mastitis is often accompanied by fever and flu-like symptoms. This disease most often affects women who are breastfeeding, but in in rare cases it does not develop during lactation.

In 90% of cases, mastitis is diagnosed in nursing mothers. Statistics indicate that the disease occurs in 16% of new mothers and 74% of first-born mothers. Most cases of mastitis occur in the first three months after childbirth. At the same time, the woman may experience extreme fatigue, and it becomes very difficult for her to care for the child.

Sometimes women wean their baby earlier than planned due to mastitis, although in reality it is possible to continue breastfeeding with this disease.

Mastitis in a nursing woman

In a woman after childbirth, mastitis makes itself felt within a day. More often, mastitis in nursing women develops as a result of the accumulation of milk and the addition of bacteria (staphylococcus) to it, which penetrate the woman’s mammary gland, causing a severe inflammatory process of the tissues.

If a nursing mother experiences signs of lactostasis, she should immediately consult a doctor postpartum ward in the maternity hospital or in the antenatal clinic if the situation arose after discharge from the maternity hospital.

If you have mastitis, breastfeeding is prohibited. In addition, when treating mastitis in mandatory antibiotics are used that penetrate into mother's milk. Even with a temporary suspension of breastfeeding during mastitis, it is necessary to express milk regularly and thoroughly. This procedure will speed up recovery and maintain lactation.

To prevent lactostasis and mastitis, it is important to attach the baby to the breast during the first two hours after birth, stay together between mother and child, and freely feed the newborn. This helps empty the milk ducts and create conditions for normal lactation.

Causes of mastitis

Mastitis occurs when bacteria enters the breast tissue through cracks and other breaks in the nipples. These bacteria may be on the surface of your skin or in your baby's mouth. They begin to multiply in the mammary glands, causing symptoms of mastitis.

Risk factors for mastitis are:

cracked nipples;
history of mastitis;
feeding in only one position;
bra too tight.

If you've ever had mastitis, there's a good chance you'll get it again while nursing the same or future children. Risk repeated diseases increases due to delayed or inadequate treatment.

Stages of mastitis

There are three stages of mastitis:

serous;
infiltrative;
purulent.

The serous stage of mastitis is manifested by a large increase in temperature and deterioration of the condition. The mammary gland becomes denser, increases in volume, and pain increases during feeding and pumping. In case of delayed treatment serous mastitis within 1-3 days it enters the infiltrative stage.

Symptoms of mastitis

In most cases, problems arise in the first days after the birth of the child. First dangerous symptom mastitis – the occurrence of even small cracks in the nipples.

After this, bursting pain in the mammary glands often appears. The breasts swell, become tight and very dense, the skin turns red, touching the breasts becomes very painful. This condition is aggravated by a significant rise in temperature and the occurrence of chills.

Symptoms of mastitis:

pain;
lump in the chest;
breast enlargement;
chills;
redness;
pain in the mammary glands;
temperature increase to 39°C;
general deterioration of health;
weakness;
headache.

At the first symptoms of mastitis, you must immediately consult a doctor and begin treatment immediately as prescribed. With treatment and following all recommendations, recovery occurs within a few days, otherwise mastitis progresses in a couple of days to more severe form(infiltrative).

Very soon the inflammatory process intensifies, and lumps up to 3 cm in diameter, hot to the touch, appear in the thickness of the gland. There can be several seals, while elevated temperature is preserved, and general condition worsens significantly.

With such signs of mastitis, symptoms of intoxication (weakness, dizziness, headache) are added. If not taken radical measures In the treatment of mastitis, a severe form occurs - purulent.

Symptoms of purulent mastitis

Symptoms of purulent mastitis:

severe redness of the skin;
increasing swelling;
breast enlargement;
an admixture of pus is visible in the milk;
pain intensifies.

The temperature during this period can rise and fall sharply, depending on the course of the inflammatory process caused by microorganisms. A decrease in temperature is usually accompanied by profuse sweating, and a fever is usually accompanied by severe chills.

Signs of mastitis at this stage:

lack of appetite;
nausea;
chills;
pain throughout the body;
breasts are hot to the touch.

Descriptions of the main symptoms of mastitis

Treatment of mastitis

The treatment strategy for mastitis depends on the nature, duration of the disease and the extent of the affected area.

Which doctors should I contact for mastitis?

Infectious forms are treated with targeted antibiotics prescribed by the doctor. In order to achieve the desired result when carrying out bacterial culture, the type of pathogen and its concentration are determined.

In borderline conditions between mastitis and lactostasis, first of all, use antiseptics and monitor the dynamics. Only if the situation worsens, they switch to antibiotics.

You need to express milk every 3 hours, but if there is an abscess, you should not touch the breast. If formed pus bags– doctors open them surgically or pump out pus through a needle, wash the mammary gland and prescribe antibiotics.

When treating mastitis it is prescribed local use cold, immunomodulators and physiotherapy. Acute non-purulent mastitis is not an obstacle to breastfeeding, but if the milk contains pus, breastfeeding is prohibited!

If you have problems with your breasts during breastfeeding, consult a doctor, do not self-medicate, it is dangerous!

Whether or not to continue breastfeeding while taking antibiotics will be determined by the doctor who prescribed the medication. With reduced immunity and erroneous treatment of mastitis and self-medication, the disease will progress to the phlegmonous and even gangrenous stage.

Folk remedies for treating mastitis at home

It must be remembered that folk remedies for the treatment of mastitis at home should be used only with the permission of the attending physician.

Stir rice starch in water until it reaches the consistency of sour cream. Apply to a bandage and apply to the sore spot. After 3 hours everything will resolve.

From potato starch And sunflower oil prepare an ointment and lubricate the hardened areas of the breast with it.

Prepare a mixture from 50 g of tangerine peel and 10 g of licorice roots. Divide it into 2 servings and take it as a water decoction 2 times a day. The same decoction can be used to make external lotion to the hardened area of the chest. Tangerine peel quickly suppresses the growth of staphylococci, which usually causes purulent mastitis.

Tie grated carrots, a mixture of bean flour with soapy water, or fresh cabbage leaves, fresh leaves of coltsfoot, or large burdock with the shiny side to the hardened area of the chest.

Peel the narcissus bulb, chop and mix with thick rice porridge or rye flour, spread on the sore chest and change 2-3 times a day, washing off the hardened crust with warm water.

Diagnosis of mastitis

Mastitis is diagnosed based on the characteristic signs that the doctor detects when examining and palpating the mammary gland. Besides, axillary lymph nodes enlarge and painful when touched. In conditions of suppuration, a peculiar symptom of fluctuation will appear.

The type of bacteria and sensitivity to antibiotics are determined using bacteriological testing. In addition, blood and urine tests are done for diagnosis. Sometimes the diagnosis of mastitis is supplemented by ultrasound of the mammary gland and echography of the breast. These methods provide information about the course of mastitis.

In addition, ultrasound visualizes the abscess and helps to see necrotic areas. Ultrasound - precise process: the specificity and reliability of this technique reaches 90%. If in doubt, a fine-needle aspiration biopsy is performed.

Complications of mastitis

In the absence of adequate treatment for mastitis, an abscess can form in the breast - a cavity filled with pus. In this case, the pus has to be removed by resorting to surgical methods. To avoid this and other complications, you need to contact your doctor as soon as you notice signs of mastitis and follow all of his instructions exactly.

Questions and answers on the topic "Mastitis"

Question:Good afternoon, after treatment for mastitis I still have swelling. What should I do next? I'm not breastfeeding.

Answer: Hello. Do you need face-to-face consultation doctor for examination and other diagnostic measures.

Question:Hello! I have mastitis due to a blocked duct. The mammologist expressed the pus with his hands and said that it was not an abscess yet and there was no need for a puncture. He ordered the child to be fed with this breast. After straining the redness on the same breast on the other side, you will have to go and strain it again, perhaps there is pus in another duct. Temperature 39, Augmentin prescribed. Lumps remain in the breast, the doctor said that there is no need to strain it yourself, only until relief occurs if the child refuses. Compresses, heat, and physiotherapy were categorically prohibited. Question: how else can you help yourself and speed up the healing process?

Answer: Hello. You should not be treated at home - follow the recommendations of your doctor.

Question:Hello. I have infant. I feed him milk, which I express. Since the problem with the nipple is right breast. Everything was fine for a month. Now my right breast hurts. It has increased in size, and one half is hard as a rock. I don't understand why. I'm pumping completely. Who should I contact? What should I do?

Answer: You have all the signs of lactation mastitis. It is necessary to urgently contact a surgeon for an examination and ultrasound. Based on the results, the necessary treatment for mastitis will be selected.

Question:Hello, please explain whether any other tests need to be done: my child is 1.2 months old, I was breastfed for 8 months, I am 37 years old, at the moment the right breast is bothering me, a small lump, about the size of a pea, is palpable; during lactation, the right breast was twice as large, and there was more milk there, and the child suckled more often on the right breast. An ultrasound scan showed signs of uneven moderate ductectasia from 0.11 to 0.24 cm. Area of inflammatory infiltration. Lotions with Dimexide are recommended. But the procedure did not eliminate the compaction. Is there anything else worth doing? Thank you!

Answer: In our opinion, you should consult a mammologist. The lump you described may be a completely harmless complication of limited inflammation of one milk duct against the background of lactostasis, however, this assumption still needs to be confirmed. The doctor will prescribe for you additional examinations, possibly a mammogram.

Question:After giving birth there was no milk. My son was already 2 years old when I was diagnosed with mastitis, it progressed to purulent, I went to the clinic where they cut me alive (I couldn’t go to the clinic because of the child) because. local anesthesia it didn’t work in the chest, then every day they washed and bandaged (drainage was inserted), took antibiotics and gave injections. 1.6 months have passed, I feel a lump on the same breast again, there is no temperature, like the first time, I am in shock, what should I do? I won't survive this anymore.

Answer: You should see your doctor again. It is quite possible that this time everything will be fine, but it is better that you are seen by a doctor as soon as possible.

Question:Is it necessary to express milk after feeding? If you don’t do this, something will change and how it will affect the child.

Answer: After feeding, it is recommended to express milk to prevent lactation mastitis.

Question:Hello. I am 25 years old. I gave birth to a daughter on November 5 this year. Due to improper attachment to the breast, severe cracks have formed on both nipples. I apply Bepanthen and Avent cream to my skin. Before every feeding I wash my breasts, plus I regularly wear breast pads. Today my breasts started to hurt a lot when I lightly touched them, there are no lumps or lumps, I express regularly. Sometimes it starts to shiver. Tell me, is this mastitis? and where is the best place to go. Thanks in advance for your answer.

Answer: Based on the symptoms you describe, we can assume the onset of mastitis. Consult a mammologist or surgeon for advice.

Question:I have mastitis. First swollen left breast, then it was formed big shot when you touch it it hurts. No temperature yet. How to treat this, and is it possible without surgery?

Answer: You need an urgent consultation with a surgeon. It is necessary to perform an ultrasound examination of the mammary gland; puncture of the compacted lesion may be necessary. If the diagnosis confirms the diagnosis of mastitis, then it is necessary to start antibacterial therapy. Decision on necessity surgical intervention will be determined by the attending physician based on the dynamics of the process.

Question:A 20-year-old girl was diagnosed with fibrous mastopathy. Please give me a consultation. What to do, what to do?

Answer: Treatment under the supervision of a mammologist is necessary. You may need hormonal correction.

Question:I am 18 years old. In 2012, upon examination, a diagnosis of mastopathy of the right breast was made. Please tell me, is it possible to play sports, in particular, do chest exercises with mastopathy? Thanks in advance for your answer.

Answer: With mastopathy, there are no restrictions for playing sports (that do not injure the breast tissue). All you need is regular monitoring of the condition of the mammary glands by a mammologist.

Question:I am 29 years old, one child, breastfed until 10 months. I finished breastfeeding in June, and before the New Year I discovered a lump in my breast, the size of a pea, right under the nipple. I contacted a gynecologist, she gave me a referral for an ultrasound, but it was only in February. Apart from breast cancer, nothing else pops into my head. What could it be?

Answer: This is not necessarily a cancerous (malignant) tumor. Most often in the areolar area (nipple area) occur cystic formations, benign fibroids. Therefore there is no reason to panic. It will be necessary to perform an ultrasound of this area. And for 100% reliable determination the structure of the compaction may require a biopsy and microscopic examination of the biopsy sample.

Question:Good afternoon. Please tell me how to cure mastitis and why it is dangerous? I saw a doctor. An incision was made on one breast, but there was no pus there. They prescribed antibiotics (Medocef) once a day and a compress (Dimexide) + Levomekol. Is this treatment correct? I've been undergoing treatment for a week now. Maybe you can tell me something. How to express and knead your breasts correctly?

Answer: If you have mastitis, breast massage is contraindicated. The treatment is prescribed adequately - you must follow the doctor's recommendations.

Question:Hello. The child is completely on guard. I recently got mastitis. I just called the doctor (gynecologist) and she diagnosed mastitis based on the symptoms. I was shivering, the temperature was 38. The skin around the nipple on only one side (a small area) was red, swollen and painful. The doctor prescribed an antibiotic (over the phone) and a glucose drip with ascorbic acid. I didn’t do all this, I just breastfed and that’s it. The next day there was no fever. And the redness subsides. This is already the third mastitis in four months. Tell me what should I do and should I take antibiotics? They also threaten me with mastopathy in the future. Is this true?

Answer: At the first sign of mastitis, there is no need to take an antibiotic. It is necessary to properly massage the painful area and express all the milk to the last drop after the child has eaten. Try to protect your breasts from drafts and empty them on time. If the temperature persists, purulent contents appear from the nipple and the lump is very painful, you should consult a surgeon.

Mastitis is an inflammatory disease of the breast tissue. As a rule, it develops in postpartum period(approximately three to four weeks after discharge from the hospital) in breastfeeding mothers, especially first-time mothers. However, there are cases of the disease occurring in women outside the lactation period, as well as in men and children, including newborns.

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

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

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

The appearance of cracks or small defects in the nipple area is a kind of gateway for infection. Usually, if bacteria enter the mammary gland, our defense system can cope with it. But since in postpartum period Since the female body is very weakened, in most cases it is not able to cope with infections on its own. As a rule, immediately after the appearance of cracks in the nipples (which happens in approximately the majority of women after discharge from the maternity hospital, especially in first-time mothers), bursting pain appears in the mammary gland, which at the same time swells greatly, thickens, becomes tight, and the skin turns red. All this condition is accompanied by an increase in temperature. There are many reasons for the appearance of cracked nipples, but the most common is considered to be non-compliance by the nursing mother. elementary rules hygiene before and after feeding the baby.

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

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

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

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

Signs of infiltrative and purulent mastitis.
The infiltrative stage of mastitis is characterized by a pronounced inflammatory process and a more severe general condition of the woman. When palpating the mammary gland, a clear inflammatory compaction (infiltrate) with redness of the skin above it is observed, which becomes larger and the redness intensifies. The high temperature does not subside; there are sudden temperature changes. Fluctuation occurs (in medical terms, oscillation), indicating the presence of fluid (pus) in the cavity.

In the phlegmanous form of mastitis (when the abscess is not delimited by a capsule from healthy tissues), the body temperature remains at 40˚, accompanied by chills and weakness. The mammary gland significantly increases in volume, the skin above it takes on a swollen, shiny, reddened appearance with a bluish tint. Inflammation of nearby lymph nodes is observed.

In the gangrenous form of mastitis (tissue necrosis due to circulatory disorders), the woman’s general condition is characterized as extremely severe: body temperature is 40 - 41˚C, pulse is rapid 120 - 130 per minute, the mammary gland is greatly enlarged in size, the skin over it is swollen, covered with blisters containing bloody contents with areas of tissue necrosis. Swelling affects surrounding tissues. A blood test shows the presence of severe inflammation.

Chronic purulent mastitis.
The chronic form of breast mastitis is quite rare. It develops against the background of a rather long local treatment penicillin injections mainly for purulent mastitis. With this form of the disease, the condition of the patients is characterized as satisfactory: the body temperature is normal, or does not rise above 37.5-37.8 C. Upon palpation, some mildly painful compaction is felt, not fused to the skin. At chronic form Symptoms of the disease are mild. The mammary gland is painful and slightly enlarged, in rare cases there is inflammation in the nearby lymph nodes with a slight or, rarely, high fever.

Let me note once again that treatment of mastitis in the early stages of development is conservative, that is, antibiotics, anti-inflammatory drugs, etc. are prescribed. Purulent forms diseases can only be treated with surgery.

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

Mastitis and breastfeeding.
Regardless of the stage and form of mastitis, you cannot feed a child, because milk even from a healthy breast (not to mention a sick one) may contain huge amount bacteria that are dangerous for the baby. In addition, when treating this disease, antibiotics are prescribed, which, if released into mother's milk, can harm the baby. If you temporarily stop breastfeeding, you should not give up expressing milk; it is simply mandatory, and it must be done regularly and with special care. Firstly, complete emptying breast treatment during illness significantly speeds up recovery. Secondly, pumping will help maintain lactation so that after recovery the mother can return to breastfeeding.

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

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

The inflammatory process that is localized in the mammary gland is called mastitis. The disease most often occurs in women aged 15-45 years. At a young age, mastitis is caused by increased blood and lymph circulation, while in the premenopausal period it is caused by hormonal disorders.

Inflammation often occurs in nursing mothers, especially in the first three months after the birth of a child. In this case, they talk about lactation mastitis. The disease is not the prerogative of only women childbearing age, the inflammatory process can develop in both men and newborns. In this case, fibrocystic mastitis is implied.

Causes of mastitis

As with any inflammation, the cause of mastitis is penetration mammary gland pathogenic microorganisms. This can happen externally, for example, due to damage skin in the area of the mammary gland, and from the inside, when there are foci in the body chronic infection, such as tonsillitis, carious cavities, diseases of the genital area. In nursing women, the inflammatory process most often develops in response to stagnation of milk, blockage of the ducts, or the presence of cracks in the nipples. The cause of mastitis in newborns is the residual effect of maternal sex hormones.

Symptoms of mastitis

According to the nature of the inflammatory process, several stages of mastitis are distinguished:

Serous.

Infiltrative.

Purulent.

Abscessing.

Phlegmonous.

Gangrenous.

The first three stages are interconnected; it is in this sequence that a purulent focus is formed. Further, the development of mastitis is possible in three directions: either an abscess forms, in which the purulent focus is limited, or phlegmon, when inflammation engulfs the entire mammary gland, or necrosis (death) of tissue occurs.

The symptoms of mastitis depend on the stage of the disease. At the very beginning, patients experience a sharp rise in temperature, chills and weakness appear, and sweat begins to appear profusely. The mammary gland increases in volume, becomes dense, and appears sharp pain bursting in nature, the surface of the skin above the site of inflammation acquires a reddish tint. With lactation mastitis, signs of inflammation occur against the background of a decrease in the amount of milk produced. In most cases, breastfeeding women have cracks in their nipples; it is through them that the infection penetrates into the mammary gland.

If mastitis is not treated or treated incorrectly, the patient’s condition worsens sharply. In the background high temperature The redness of the skin over the source of inflammation intensifies; upon palpation, the affected area is clearly identified. During the transition to the phlegmonous stage, the mammary gland sharply increases in volume, the skin acquires a bluish tint. The inflammatory process affects the lymph nodes located near the sore breast. In the gangrenous stage of mastitis, the symptoms mentioned above are accompanied by blisters with bloody contents and areas where tissues necrotize (die). Swelling, in addition to the mammary gland, also spreads to nearby tissues.

Mastitis can be complicated by the development of sepsis, when pathogens enter the bloodstream. It is also possible for the inflammatory process to spread to the lymph nodes, in this case they speak of lymphadenitis, and lymphatic vessels, lymphangitis develops. When the abscess spontaneously opens, a long-term non-healing fistula forms at this site.

Treatment of mastitis

Taking into account the severity of the disease and the possible adverse outcome, the treatment of mastitis should be taken very seriously. To avoid complications with mastitis, self-medication is strictly prohibited. In most cases, the means used do not eliminate the cause of mastitis, and this leads to the inflammatory process developing further, threatening more serious consequences.

As a rule, treatment of mastitis consists of prescribing antibiotics, infusion drugs and immunoglobulins. This therapy allows you to reduce the effects of intoxication and increase the overall resistance of the body. For lactation mastitis, lactation suppressants are used to reduce the amount of milk produced.

Purulent forms of mastitis are a direct indication for surgical intervention.

Folk remedies for the treatment of mastitis

IN alternative medicine There are many recipes, the purpose of which is to eliminate foci of inflammation in the mammary gland. But folk remedies for treating mastitis should be used only in combination with therapy prescribed by a doctor. On initial stages You can apply leaves of cabbage, coltsfoot, and burdock scalded with boiling water to the affected area. Flatbreads made from flour and honey have a good effect. Tea made from medicinal sage or an infusion of a mixture of hop inflorescences and leaves will help reduce lactation walnut and sage.

Prevention of mastitis

For nursing mothers, the main measures to prevent mastitis are hygienic care of the mammary glands and organization correct mode feedings. It is necessary to ensure that the mammary gland is completely emptied. To prevent the appearance of cracks during mastitis, the child must be taught to properly latch onto the nipple from the very first feeding.

TO preventive measures mastitis also includes timely recovery of chronic foci of infection, management healthy image life, organization proper nutrition, maintaining immunity at the proper level, protecting the mammary glands from injury and hygiene procedures.

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