Symptoms and treatment of serous mastitis. Treatment of inflammation of the mammary glands in women

This disease appears while a woman is breastfeeding, often several months after the birth of a child. At serous mastitis the mammary glands become inflamed.

Signs of illness

Often the disease develops as a result of congestion in the mammary glands. The symptoms of serous mastitis are similar to lactostasis:

These diseases can be distinguished by the location of the increase in body temperature. With lactostasis, the temperature rises mainly in the armpits, since this is where stagnation develops. Thus, the temperature in these areas will always be higher than in the area where stagnation absent.

With serous mastitis, the temperature also rises, but the difference in its values ​​in each armpit is insignificant. Another distinctive feature is that with serous mastitis, the body temperature does not fall, even after the glands are emptied, as with lactostasis. The woman's general condition is also not getting better.

Importance of mastitis treatment

Serous mastitis can also be determined in the laboratory by passing a general blood test. During inflammatory reactions, the number of leukocytes increases, and the ESR also increases.

If you do not try to cure serous mastitis, then after a few days the disease progresses to an infiltrative form. Compacted elements appear, they are dense and hot to the touch, the size of such compactions is a couple of centimeters. The woman’s condition is getting worse: migraines, lethargy and chills appear.

Then purulent lesions appear (this form of mastitis is the most dangerous and difficult to treat). Redness appears on the infiltrates, and the breasts increase in size. Body temperature rises to 40 degrees. It often changes abruptly: it sometimes increases, sometimes it decreases. This is due to the processes inside the infected focus. When the temperature drops, profuse sweating occurs. At this point, signs of intoxication appear: vomiting and nausea occur, there is no feeling of hunger.

Causes of mastitis

Serous mastitis can appear due to cracked nipples. The infection penetrates through them. The pathogens then penetrate into lymphatic system and spread throughout the mammary glands.

However, cracked nipples are not the only cause of mastitis. Various inflammatory processes in the tonsils, mouth, and sinuses, which occur chronically, can also trigger the development of the disease.

Mastitis after childbirth is explained by the woman’s immunodeficiency throughout pregnancy and for some time after childbirth. Therefore, there is a high probability of mastitis occurring after childbirth, when the body is weakest.

Treatment of mastitis

It is important to have a serous experienced practitioner. At the first or changes in the nipple that contribute to the development of the disease, it is wise to consult a doctor for advice and further treatment.

For staging accurate diagnosis you need to take a general blood test. It is also necessary to analyze milk to determine the resistance of infectious microorganisms to a particular drug. Therapy should be started at the first signs of the disease, before the test result is known, since milk contains infectious microorganisms, which are transmitted directly to the child. You may have to stop breastfeeding. Gynecologists and pediatricians often recommend this.

For mastitis with abscesses, therapy is carried out in surgery. Usually purulent areas are opened to prevent the development of complications.

Very important stage therapy includes measures to detoxify the body. Glucose and saline solutions. The use of immunomodulatory drugs is also appropriate.

If the condition improves, milk samples are taken again to determine its sterility. If the tests are acceptable, you can start breastfeeding. In mild stages, they begin after finishing taking antibiotics.

Most women have heard various folk recipes for mastitis. It is often recommended to apply leaves of various herbs in the form of compresses, etc. Cabbage leaves and honey cakes are often used. It is necessary to realize that self-medication is not always safe. This type of therapy does not have evidence base. You can treat mastitis with home remedies in combination with traditional methods

Folk remedies don't do what they should antibacterial effect, therefore, using only this method can cause even greater damage to health, since there is a risk of developing purulent mastitis and in the future - sepsis, that is, blood poisoning.

Prevention of mastitis

In the early stages, you should consult a doctor at the maternity hospital or antenatal clinic if signs of illness appear a few days after birth. Symptoms of the disease:

• Breast enlargement, the appearance of compacted elements, swelling, pain when groping.
• Mostly women feel fullness in the mammary glands in the morning, as well as pain.
• Body temperature often rises, chills and a feeling of weakness appear. As mentioned above, it is necessary to pump regularly and reduce fluid intake (from 600 to 900 ml per day).

It is necessary to put the baby to the breast and feed him as needed. All this improves milk flow, which creates the necessary conditions for the proper lactation process.

It is important to prevent the appearance of cracked nipples:

• Avoid feeding for too long to avoid friction.
• Stick to correct technique during feeding (create conditions for complete capture of the areola by the mouth).
• Moisten nipples with special preparations.

If cracks do appear on the nipples, then you need to take the treatment of this disease very seriously. After each feeding, the glands need to be emptied. Wipe the nipples with expressed milk, distributing it evenly until dry. You can apply drugs such as Purelan and Bepanten (after each feeding).

TO preventive methods You can also include a daily change of bra, every couple of hours - replacement of breast pads that prevent contact between underwear and nipples.

You also need to adhere healthy image life, proper nutrition and daily routine. It is important to avoid a lack of vitamins, maintain personal hygiene, keep the skin clean, but without excessive dryness, and take a shower with soap that is neutral in acid-base index.

Serous mastitis - dangerous illness, which can go into even more dangerous stages. It is often necessary to neglect breastfeeding for an indefinite period, which has a bad effect on the baby. Of course, it is better to prevent mastitis than to treat it. Be sure to “listen” to your body to avoid dangerous situations!

What to do with mastitis - video

Mastitis is a pathology that develops during lactation more often in first-time mothers. The disease is characterized by an inflammatory process in the mammary gland. If the pathology is not treated, it goes through 3 successive stages: serous, infiltrative and purulent mastitis. Thus, serous mastitis is the initial stage inflammatory process V mammary gland, which often occurs during breastfeeding. The disease can develop into a severe stage and requires emergency treatment.

Causes of serous mastitis

Mastitis develops as a result of lactostasis - stagnation of milk in the ducts mammary gland.

Causes of pathology:

• sluggish milk sucking by the baby;
• unpreparedness of the mammary gland for feeding;
• hearth chronic infection in organism;
• abnormalities and cracks of the nipples;
• decreased immunity;
• complicated postpartum period;
• improper attachment of the child;
• incomplete emptying of the mammary gland.

Etiology and pathogenesis

The milk plug, which clogs the milk duct, is a favorable environment for the proliferation of pathogenic microorganisms (streptococci, Proteus, staphylococci, enteropathogenic Escherichia coli). Bacteria can enter the breast tissue through cracks in the nipple or migrate from other sites of chronic infection. Anatomical features mammary gland: a large number of cells of adipose tissue, alveoli, sinuses, an extensive network of vessels and milk ducts create favorable conditions for the spread of inflammation and infection. Childbirth and natural feeding weaken the health of the young mother, the general and local immunity. If the body is not able to independently suppress the growth of microorganisms, they begin to multiply in the acini on a nutrient medium in the form of stagnant milk. This mastitis is characterized by the fact that the affected area of ​​the mammary gland is saturated with a clear liquid, rich in protein. Advanced lactostasis turns into the serous form of mastitis within 3 days.

Symptoms and signs of serous mastitis

It is important to know! When breastfeeding, serous mastitis in nursing mothers develops rapidly and requires emergency assistance. The neglected process quickly develops into a purulent form, which requires surgical intervention on the mammary gland.

Symptoms of serous mastitis:

1. swelling and tenderness of the breast;
2. increase in body temperature to 39 C degrees;
3. weakness and headache.

Diagnostics

If there are painful symptoms in the breast, a young mother should urgently consult a gynecologist or mammologist.

Important! Heat, severe weakness and symptoms of intoxication during breastfeeding are a reason to call an ambulance.

The doctor will examine and palpate. Upon examination, moderate infiltration is revealed without a clear limitation of the painful area. The doctor may prescribe clarifying tests: a general blood test, breast milk culture to identify the pathogen and determine its sensitivity to antibiotics. Ultrasound examination is rarely used; an experienced doctor makes a diagnosis at the palpation stage.

Treatment of serous mastitis at home

Important to remember! Even if treatment is carried out at home, it must be prescribed by a doctor. Self-medication is fraught with the transition of the disease to the stage when urgent surgery is required to remove the source of pathology.

The following drugs can be used to treat serous mastitis by a nursing mother:

• Gel Progestogel. The drug has as its main active ingredient the hormone progesterone, which blocks prolactin receptors, which leads to decreased lactation. The gel helps to activate the absorption of serous fluid; reduces compression of the gland ducts, the degree of edema, pain symptom. The gel is applied locally to the pathological area and is not absorbed into the blood; it can be used without harm for breastfeeding (when feeding a baby, the breasts are thoroughly washed to remove any remaining gel).
• Malavit– multicomponent natural remedy, which does not have a systemic effect. It is advisable to apply it in the form of compresses to the painful area to relieve swelling, redness and inflammation.
• Menovazin effective due to its effective composition: menthol, alcohol, novocaine and anesthesin. Alcohol and menthol dilate the ducts and activate local circulation, novocaine and anesthesin relieve pain.
• - delicate homeopathic remedy from natural ingredients.

Treatment in hospital

If treatment at home does not bring relief and the pathological process progresses, then hospitalization may be necessary. Serous mastitis is treated with conservative methods. Milk must be expressed every 3 hours. To facilitate the outflow of stagnant milk for a young mother, intramuscular injections no-shpa (2 ml) and oxytocin (1 ml). Novocaine blockade is used to relieve pain.

The doctor may prescribe antibiotics. Breast-feeding– is not a reason to ignore the assignment. After taking the drugs, the expressed milk is poured out. Feeding the baby can be resumed 12-24 hours after administration last dose antibiotic.

Most often, antibiotic therapy is carried out with Erythromycin. This is a drug that is relatively harmless during breastfeeding and can be used for successful treatment serous form mastitis.

Antibiotics that are contraindicated in nursing mothers:

• sulfonamides,
• lincosamines,
• tetracyclines,
• fluoroquinolones.

Useful video: The mechanism of development of serous mastitis in nursing mothers

Mastitis is an inflammatory process in the tissues of the mammary gland. It manifests itself as severe bursting pain in the chest, swelling, thickening, redness of the skin of the gland, a sharp rise in body temperature, and chills. Mastitis is diagnosed when visual inspection mammologist; additionally, it is possible to conduct an ultrasound of the breast. The disease can lead to the formation of an abscess, abscess, phlegmon, necrosis in the mammary gland, the development of sepsis and even fatal outcome. In case of microbial contamination of milk, breastfeeding will have to be stopped. In the long term, deformation of the mammary gland may occur, increasing the risk of developing mastopathy and breast cancer.

Symptoms of mastitis

Acute postpartum mastitis is the most common inflammatory complication lactostasis in nursing mothers. Sometimes develops without precedence pronounced signs stagnation of milk. Manifested by the appearance painful lump in the mammary gland, redness and increased temperature of the skin in the area of ​​​​induration, fever and general symptoms intoxication. As the pain progresses, the pain intensifies, the breasts enlarge and become hot to the touch. Feeding and pumping are extremely painful; blood and pus may be found in the milk. Suppurative mastitis often progresses with the development of a breast abscess.

Plasma cell mastitis is rare disease, developing in older women who have given birth repeatedly after cessation of lactation. It is characterized by infiltration of plasma cells into the tissues under the nipple and hyperplasia of the epithelium of the excretory ducts. This type of mastitis does not fester and has some common external features with breast cancer.

Neonatal mastitis is a fairly common condition in children of both sexes, manifested by swelling of the mammary glands and discharge when pressing on them (usually the result of the residual effect of the mother’s sex hormones). With the development of acute purulent inflammation and the formation of an abscess, surgical sanitation of the purulent focus is performed, but most often the symptoms subside after three to four days.

Diagnosis of mastitis

The source of inflammation in the mammary gland is determined by palpation. There is also an increase (sometimes moderate pain on palpation) axillary lymph nodes on the side of the affected breast. Suppuration is characterized by determining the symptom of fluctuation.

When mastitis is detected at the stage serous inflammation or infiltration, conservative treatment of mastitis is carried out. Antibiotic therapy is prescribed using strong existing funds wide range actions. Serous mastitis, as a rule, goes away in 2-3 days; it may take up to 7 days for the infiltrate to resolve. If inflammation is accompanied by severe general intoxication, detoxification measures are carried out (infusion of electrolyte solutions, glucose). In case of severe excess lactation, drugs are prescribed to suppress it.

Purulent forms of mastitis usually require surgical intervention. A developed breast abscess is an indication for emergency surgical sanitation: opening the mastitis and draining the purulent focus.

Progressive mastitis, regardless of its stage, is a contraindication to further feeding (including healthy breasts), since breast milk is usually infected and contains toxic tissue breakdown products. For a child, pathologically altered breast milk can cause the development of dysbiosis and functional disorders digestive system. Since treatment for mastitis includes antibiotics, feeding during this period is also not safe for the baby. Antibiotics can significantly damage the normal development and growth of organs and tissues. During the treatment of mastitis, you can express milk, pasteurize it and only then give it to the child.

Indications for suppression of lactation: lack of dynamics in serous and infiltrative mastitis within three days of antibiotic therapy, development purulent form, concentration of the inflammatory focus directly under the nipple, a history of purulent mastitis in the mother, accompanying pathologies organs and systems that significantly worsen general health mother.

Prevention of mastitis

Measures to prevent mastitis coincide with measures to prevent lactostasis, since this condition is a precursor to mastitis in the vast majority of cases.

To prevent milk stagnation, complete and thorough emptying of the mammary glands is necessary: ​​regular feeding and subsequent expression of the remaining milk. If a child is full of milk from one breast, next feeding it is first applied to the gland that was untouched last time.

You should not allow your baby to simply suck on the breast for comfort, without sucking out the milk. Cracks in the nipples contribute to the development of inflammation of the mammary gland, so it is necessary to prepare the nipples for feeding, carefully observe hygiene rules (clean hands, breasts), and correctly attach the baby to the breast (the child must grasp the entire nipple, including the areola, with his mouth).

One of the preventive measures for the development of mastitis can be called timely detection and sanitation of foci of infection in the body, however, it is worth remembering that general antibacterial therapy during lactation is contraindicated.

A significant proportion of women after childbirth suffer from inflammation of the mammary glands, therefore, to ensure adequate feeding of the child, treatment of serous mastitis must be started promptly and correctly. If the disease is not treated, it can be complicated by the appearance of ulcers - abscesses - in the tissues of the mammary glands, which are removed only surgically. Except serious problems With the health of the mother, a serous abscess threatens to deprive the newborn of milk, which is unfavorable for the development of the child.

Brief information about serous mastitis

The disease is one of the types of lactation mastitis.

The causative agents of the disease are staphylococcus, coli, streptococcus or protozoa. They penetrate the skin through microscopic damage, cracks, and into the nipple through the milk ducts. After getting inside pathogenic microorganisms develop rapidly and provoke suppurative processes, which are defensive reaction organism to the pathogen. One of the factors aggravating the disease is lactostasis, since stagnant milk provides the most favorable conditions for the proliferation of pathogenic microorganisms. Vivid symptoms of mastitis are breast swelling, hardening, painful milk production, and redness. Possible increase in temperature.

Therapy for serous mastitis

To treat serous mastitis, conservative measures are used, while the treatment of other types of disease requires surgical intervention. For effective treatment disease, the patient is recommended the following:

1. Bed rest to limit physical activity on a weakened body after childbirth. The regime includes constant stay in bed, walking around the ward is prohibited. Eating should also be done in bed. If it is necessary to visit the toilet, they resort to the help of nannies or nurses. If bed rest is not observed, the disease can cause complications on the cardiovascular system;

2. wearing a special bra for nursing mothers, which does not compress the breasts, but provides comfortable and correct position breasts, without disrupting the processes of formation and outflow of milk;

3. Frequent pumping is one of the main preventive methods to prevent lactostasis and serous mastitis. Frequent pumping is also used to treat serous mastitis. The benefits of this procedure are enormous. Firstly, the breasts are freed from stagnant milk that can ferment. Secondly, bacteria are deprived of their nutritious habitat. Thirdly, timely expressed milk does not compress the gland tissue and milk ducts and does not provoke stagnation in new areas. Doctors recommend organizing pumping 8-9 times a day;

4. Breastfeeding is mandatory. At the initial stage of mastitis, which is serous mastitis, breastfeeding is not prohibited. On the contrary, the child helps the mother empty the breast of stagnant milk;

5. reducing the amount of fluid consumed. A young mother will definitely be advised to drink less if her body produces enough milk for the baby’s needs. Therefore, a slight reduction in milk production will not negatively affect the baby’s needs, but will significantly help the mother cope with the problem of serous mastitis;

6. appointment medicines. Lactation mastitis in women is treated conservatively. The drugs are prescribed immediately, since within two days, if antibiotic therapy is delayed, the disease may enter the infiltrative stage and surgery will be required. In order to stop the suppurative process, the following drugs are recommended:

Amoxicillin;
Ospamox;
Flemoxin Solutab;
Amoxiclav;
Quinoccil;
Augmentin;
Moxiclave;
Zinnat;
Ospet;
Cefaclor.

The choice of drug is made by the doctor depending on individual characteristics patients. To improve milk flow, oxytocin and drotaverine are administered for pain relief.

When treating the disease, you should not use traditional methods - decoctions, compresses, washings. This can aggravate the process and lead to a worsening situation. Only a doctor should treat pathology.

Prevention of serous mastitis

Serous mastitis will not occur in a woman’s life if everything is taken preventive measures. Nipples should be washed daily, especially at night. warm water and wipe dry with a towel. This procedure must be done before birth. After the baby is born Special attention paid to breast hygiene during feeding. If a lot of milk is produced and it leaks, special pads that absorb excess milk are useful. Before and after feeding, the breasts must be washed and blotted with a dry cloth.

Video

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Serous mastitis is a pathology that often brings a lot of discomfort and disrupts the normal process of breastfeeding. This is due to the fact that mastitis develops more often in nursing mothers due to the characteristics of the feeding process. The prevalence of serous mastitis is high and the main task is to prevent the development of a purulent process with further complications. Therefore, knowledge of the causes and main symptoms will allow you to consult a doctor in a timely manner and prevent such consequences.

ICD-10 code

H70.0 Acute mastoiditis

Epidemiology

The epidemiology of serous mastitis is such that every second nursing mother experiences this pathology. Therefore, more than 90% of cases of diseases are of lactation origin. About 50% of cases of serous mastitis occur with complications in the form of infection and the formation of a purulent process, which indicates incorrect treatment tactics or untimely treatment. This must be taken into account to avoid such high performance complications, because then not only the mother suffers, but also the child, who must be weaned during this period.

Causes of serous mastitis

Knowledge of the main causes of the development of serous mastitis allows not only to prevent the development of this process, but also to better treat the disease on early stages, influencing all links of pathogenesis. Mastitis is an inflammation of the mammary gland, which is diffuse in nature, that is, both the parenchyma and milk ducts become inflamed. The word “serous” means that the process is favorable, that is, the inflammation is not purulent. In this case, the inflammatory infiltrate does not consist of many leukocytes, as in purulent mastitis, and from lymph and intercellular fluid. This indicates that the formation of pus can be prevented by timely intervention in the process.

A common cause of serous mastitis is Not proper care for the gland. A woman learns this process while still in the maternity hospital, so you need to listen and remember the main points. There is no need to wash the nipple before and after each feeding, but just wipe the nipple with a drop of milk. In this case, you do not need to rub the nipple too much to avoid the formation of cracks. Concerning hygiene procedures, then only a morning shower is enough, but you should not specifically wash the gland. Minimal intervention is the key to successful feeding. It is very important that when feeding, the baby covers the entire nipple, does not pull on it, but eats it calmly. In this case, cracks do not form so often, which is main reason development of serous mastitis. The pathogenesis of the development of serous mastitis is a disruption of the normal outflow of milk, which in turn leads to its stagnation. Breast milk– excellent nutrient medium For various kinds microorganisms, including bacteria. Therefore, only in the case of milk stagnation, the processes of absorption and secretion of lactic acids and other components are disrupted, which leads to a disruption of the cellular filtration process. At the same time, the process of formation and movement of intercellular fluid is also disrupted - this serous fluid penetrates into the breast tissue, forming an infiltrate. The process of lymph outflow is also disrupted, which further leads to even greater changes and thus inflammation of the gland tissue with serous contents occurs. If any amount of opportunistic bacteria gets into this serous infiltrate, then the inflammatory process may progress with the formation of purulent mastitis. But in this case, a prerequisite is damage to the skin, which is the entry point for infectious agents. This is why it is so important to avoid cracked nipples.

But it should also be said about the reasons for the development of serous mastitis in non-breastfeeding mothers, because this also happens. However, any woman can feel all the symptoms of this disease without being pregnant or in case postpartum mastitis. Then the most common cause of serous mastitis in a woman who has no other risk factors may be surgery or any intervention on the mammary gland. Very often young women who have not yet felt the joy of motherhood resort to the services of plastic surgery to increase breast size. In this case, they are warned about the possible complications of such a procedure, one of which is mastitis. This happens due to the fact that the anatomy of the milk ducts is disrupted due to compression by the implant, and this contributes to the development of artificial lactostasis. Therefore, very often a process such as mastitis can develop.

We should not forget about others external reasons the development of serous mastitis, because any operation entails the possibility of infection.

It is important to know about the causes and risk factors for the development of serous mastitis, not only in order to select adequate treatment, but also in order to prevent this disease.

Risk factors

Risk factors for developing serous mastitis are also important to know in order to avoid them. Among such factors, the first place is lactostasis - stagnation of milk in the mammary gland of a nursing mother. After giving birth, a woman begins to secrete milk to feed the baby, which normal conditions regulated by sex hormones. At the same time, the amount of milk that is necessary for the child is formed in the mammary gland. But when various violations, including improper feeding and care of the mammary gland, the process of normal lactation may be disrupted, which leads to the development of serous mastitis. Therefore, the main cause of serous mastitis can be called disturbances in the process of feeding and breast care. Therefore, it is very important to put a newborn baby to the breast without interruptions at night, at his request. This contributes to the normal development of the lactation process, because hormones are released at night that affect the milk ducts. This allows you to establish a normal lactation process during the first month of a child’s life, and to avoid various problems in the future.

Symptoms of serous mastitis

To understand the symptoms of this disease, first, it is necessary to find out the processes that occur in the gland tissue itself. The infiltrate that forms in the mammary gland can be localized or can spread throughout the entire tissue. Accordingly, there are main types of mastitis - localized and diffuse, which also differ in symptoms.

Also in some cases there may be a staged spread of the process. In this case, the following stages are distinguished:

1. local - at this stage the process occupies only a small area of ​​the gland;
2. advanced stage - characterized by infiltration of the entire gland;
3. complicated stage - when any complications appear.

The first signs of serous mastitis can be easily suspected when pain occurs during feeding for the first time and the child’s dissatisfaction with the milk eaten is visible. In this case, the infiltrate that forms compresses the milk ducts and the process of milk outflow is disrupted - therefore, when the baby suckles, he does not get enough. This forces him to exert even more effort, which causes breast pain when feeding. The severity of pain may be different character, but in most cases this is the first sign of such a pathology. Further, the lactation process becomes even more complicated, since lactostasis impairs the outflow of not only milk, but also the outflow of lymph, and the entire process of blood circulation in the gland. Therefore, the process of resorption of the infiltrate is complicated. Along with these symptoms, others appear. First of all, there is a feeling of heaviness and engorgement, which causes pain and discomfort. One gland increases in size and this also causes discomfort, but there are no systemic or local manifestations inflammatory reactions in the form of redness of the gland or a rise in body temperature.

There may be other symptoms - drops of clear, non-inflammatory liquid are released from the nipple before feeding or between feedings - this is the serous secretion that is the substrate of the disease. In this case, there are no purulent or bloody discharges - which indicates serous mastitis. Therefore, the main symptoms of serous mastitis lie in the woman’s subjective sensations, which at this stage is important to understand for differential diagnosis.

Further, as the disease progresses, when the serous secretion spreads to the entire gland, then it increases even more and the process of lactostasis is more pronounced. At the same time, not only does the feeding process become more complicated, but it is also difficult for a woman to even express milk. If such a process develops over the course of one week, then it is acute serous mastitis. Chronic process It is rare, because due to feeding disorders at this stage, women treat acute inflammation without allowing it to become chronic.

Serous lactation mastitis– this is what occurs most often, since the process itself is a risk factor for the disease. Therefore, the above symptoms are associated specifically with lactation mastitis. However, the treatment of such mastitis has some peculiarities. Non-lactation serous mastitis occurs precisely as a consequence surgical interventions. At the same time, the lactation process is in no way connected with mastitis. The symptoms are also similar, but the first sign may be the discharge of serous secretion from the nipple. This should alert the woman and force her to take action.

You need to know the main symptoms of mastitis in order to consult a doctor in time at the initial stage and avoid an unpleasant process. surgical treatment pathologies that have already arisen against this background.

Complications and consequences

Complications that most often occur with serous mastitis are purulent inflammation with the formation of purulent mastitis or an abscess. This occurs due to the lack of adequate treatment for the serous process, in which pathogenic microorganisms enter the infiltrate and cause an immune reaction with the formation of a purulent process. If such a process is limited to the capsule, then we're talking about about an abscess, which is serious complication and requires surgical treatment.

The consequence of untimely and inadequate treatment of serous mastitis can be phlegmon of the mammary gland - this is diffuse inflammation with destruction of glandular tissue. All these complications are dangerous because during the period of treatment of the purulent process the child should not breastfeed. This greatly affects the baby’s health, since this is the main nutrition for its normal development.

Also one of the consequences improper treatment Serous mastitis may involve the formation of cysts or galactoceles. These structures are formed due to the expansion of the milk ducts and their distal sections, which is accompanied by the accumulation of fluid in them. Such cysts carry potential danger, since their suppuration or complications when feeding future children is possible.

Diagnosis of serous mastitis

Diagnosis of serous mastitis must be timely - and this is the main thing that a nursing mother should remember in order to maintain normal lactation. Therefore, if any symptoms appear or if you have any questions, you should consult a doctor. You can even call a simple pediatrician over the phone who can answer you if feeding problems are related to normal physiological reasons or these are symptoms of a disease. And only in the latter case it is necessary to contact a specialist.

Diagnosis of serous mastitis should begin with collecting the patient’s complaints and clarifying the nature of feeding. It is necessary to find out whether normal lactation from the first days, and whether there was a problem with milk stagnation before. It is imperative to pay attention to a possible rise in body temperature. Then you need to conduct an external examination and palpation of the mammary gland. With serous mastitis, you can see compaction and a painful infiltrate in the thickness of the gland, but the area does not have redness. If you press lightly on the gland, it may discharge from the nipple. clear liquid. Such changes indicate a benign process.

The tests that are necessary in the diagnosis of serous mastitis consist mainly in excluding other pathologies and are general clinical. For diagnosis, it is necessary to take a general blood test, urine test, and blood sugar level. IN general analysis there should be no changes in the blood; when mastitis becomes purulent, then we can talk about some changes. Other tests should also not differ from the norm.

Instrumental diagnosis of serous mastitis is used more often for the purpose of differential diagnosis or for long-term treatment of an acute process. At the same time, the main thing diagnostic method is ultrasonography. This method uses ultrasound, which normally penetrates evenly through all layers of the mammary gland. If there is stagnation of milk, infiltration or serous fluid in interstitial tissue, this will be visualized on the monitor as different echoes. Such ultrasound diagnostics allows you to accurately determine the size and location of mastitis, and also makes it possible to determine the presence of a capsule. Also using this method diagnostics can monitor the effectiveness of treatment.

Differential diagnosis

Differential diagnosis of mastitis is very important, since treatment tactics for its different forms are different. The main pathologies with which differential diagnosis of serous mastitis must be made are purulent mastitis and abscess. Purulent mastitis is accompanied by severe pain in the chest, its redness, as well as the discharge of pus from the nipple. Whereas with serous mastitis there are no all these symptoms. Also, with purulent mastitis, there are systemic manifestations in the form of hyperthermia, headache, muscle pain and other manifestations of intoxication syndrome.

Breast abscess has similar clinical manifestations with serous mastitis, since this process is limited to the capsule and redness with purulent discharge there may not be. At the same time, just as with the serous process, engorgement and an increase in volume of the area without redness occurs. The only one distinctive feature an abscess fluctuates upon palpation, so it is very important to carefully examine the gland. If there is doubt during a visual examination, then the diagnosis can be confirmed using ultrasound.

Timely diagnosis and thorough differential diagnosis allows you to correctly diagnose and prescribe treatment.

Treatment of serous mastitis

The main principles of treatment for serous mastitis are to normalize the flow of milk, which relieves the severity of swelling and improves blood circulation and lymph flow from the area. This allows the serous fluid inside the gland to be absorbed and the problem resolves itself. In this case use non-drug methods treatment, and medicines can be used only symptomatically or for prophylactic purposes.

First of all, it is necessary to emphasize that if mastitis is serous in nature and the woman does not take antibacterial agents, then breastfeeding should be continued, because it improves milk flow and speeds up recovery.

You need to start treating serous mastitis with proper expression of milk. To do this, you can simply express with light massaging movements along the duct in a radial direction to the nipple, or you need to use a breast pump. After all, it is necessary not only to improve the flow of milk through the milk ducts, but to eliminate milk that has stagnated and can be a source of further infection. The use of such a breast pump must be correct, according to the instructions. Eliminating milk stagnation reduces swelling and allows serous fluid to be more quickly absorbed and excreted through the lymphatic drainage. Massage helps very well in the treatment of serous mastitis. The advantage of this treatment method is not only its effectiveness, but also the possibility of treatment at home. Massage in this case relaxes the muscle fibers of the milk ducts, stimulates their contraction, and thus the contraction of these fibers improves and milk is better released from the milk ducts, and then lactation itself improves. At the same time, compacted areas in the breast can be massaged and the outflow of milk from these areas can be normalized. Massage also improves blood circulation and lymphatic drainage from the breast, and this in turn relieves swelling due to serous mastitis. The result of this method depends on the correctness of all components of the massage and subsequent expression of milk. For correct execution massage movements should be neat and light to avoid pain and injury. The technique for carrying out this procedure is to use stroking, rubbing, kneading with neat smooth movements. Using the fingers of both hands, you need to carry out massaging movements from the top to the nipple. Next, you need to stroke around the gland towards the armpits - to the places of lymph outflow. After such a massage, you must express milk and you can put warm heating pad on the chest, which relaxes muscle fibers and improves blood circulation. The massage course should be carried out twice a day for a week. After just a few procedures, the effect will be noticeable in the form of a reduction in the size of the gland and the removal of serous infiltrate.

Medicines used for serous mastitis, are mainly aimed at local symptomatic action. Systemic medication is not required for serous mastitis. For treatment, compresses of ointments and tinctures are used. The main medications used for treatment:

1. No-shpa is a drug that has myotropic antispasmodic property, which is realized through the action on muscle fibers arterial vessels, and this also leads to their expansion and a decrease in pressure. For serous mastitis, the drug is used as combination treatment as a compress to improve milk flow and reduce the severity of symptoms. This is how the analgesic effect of no-shpa is realized for chest pain and engorgement. Additional effect the drug is its tocolytic effect, which allows it to be used even in the first days postpartum period. Side effects The drug may be manifested by dyspeptic symptoms - nausea, abdominal pain, stool disturbances. U inclined people the drug may cause allergic reactions varying degrees from simple rashes to severe swelling. A sharp dilation of blood vessels can cause a decrease in blood pressure and bradycardia. Extension peripheral vessels skin may manifest as hyperemia and excessive work sweat glands. The method of application of no-shpa and the dose used depend on the severity of the symptoms and the need for a quick analgesic effect. Dosage of tablets - 10, 20, 40 milligrams. Solution in ampoules of 2% in a volume of 2 milliliters. For complex treatment It is recommended to use no-shpa intramuscularly or in the form of tablets for severe pain syndrome, and also in the form of a compress for local treatment. To do this, you need to take several ampoules of no-shpa, dilute them in a glass, then moisten a gauze cloth folded in several layers and apply it to the compacted areas of the chest. You can apply dry gauze and film on top. It is better to wear loose underwear so that there is no strong compression. Such compresses need to be done several times a day.
2. Malavit is a natural medicine that contains many components - sage, mint, chamomile, yarrow, peony, calamus, calendula, oak, birch, pine bark, fir and cedar resin, as well as glycerin and other oils. Thanks to this composition, the drug has a decongestant, anti-inflammatory effect, relieves itching and soreness. The drug is available in the form of a solution for external use Therefore, for the treatment of serous mastitis it is necessary to use the drug as a compress. For such a compress, you need to take 50 milliliters of Malavit solution and you can add Dimexide to it, then make a gauze pad and soak it in the solution. It is better to do this compress several times a day or alternate its use with no-shpa compresses.
3. Progestogel- This hormonal drug, consisting of progesterone - natural hormone. Due to the release form, this product is convenient to use in the form of a gel for treatment. similar pathologies, especially if mastitis is lactation. Progesterone penetrates the breast tissue and reduces vascular permeability, relieves swelling and normalizes the mitotic activity of milk duct cells. Progestogel is not absorbed into systemic blood flow and doesn't call adverse reactions, but there may be slight redness or itching in the area of ​​application. Dosage and method of using the drug - a small drop of gel should be rubbed over the mammary gland, using this treatment twice a day. Precautions - do not use for more than two weeks, as possible local complications due to the composition of the drug.
4. Menovazin- this is an ointment that contains alcohol, menthol, anesthesin and novocaine, so the analgesic effect of the drug is revealed. Menthol also dilates blood vessels and improves blood circulation in the gland. The method of using the drug is to apply a small amount of ointment to the chest with massaging movements. Side effects possible in the form of redness at the site of use of the ointment, which is caused by the presence of menthol. If the itching sensation is severe, then you need to wash off the ointment. Precautions - do not use the drug if you are allergic to novocaine.

Vitamins for the treatment of serous mastitis can be used in complex therapy, especially if the diet of a nursing mother does not sufficiently provide everything nutrients. In this case, it is recommended to use complex vitamins in combination with microelements - Vitrum, Supradin, Undevit, Kvadevit.

Physiotherapeutic treatment of serous mastitis has a very good healing effect due to its active influence on the vessels and parenchyma of the gland. The main effect of such procedures is to improve lymphatic drainage and blood circulation, which relieves swelling, pain and inflammation. You can use many techniques, but only if there is no purulent inflammation. Electrophoresis is a method by which drugs penetrate the skin with ions under the influence of voltage. In this case, you can use Magnesia, Dimexide, Malavit and other antiseptics and anti-inflammatory drugs. This speeds up their effect and improves the effect of these drugs. Infrasound and high-intensity pulsed wave magnetic therapy can also be used.

Traditional treatment of serous mastitis

Traditional treatment of serous mastitis is used very often, since this process can be cured by such means without help antibacterial drugs. For this purpose, compresses from herbal infusions and medicinal products are used, which, together with proper expression of milk, are very effective. Basic folk recipes are:

1. Cabbage compresses are known for their pronounced effect on any swelling, including swelling of the mammary gland caused by serous mastitis. Cabbage leaf restores local blood circulation and normalizes milk secretion, which is very important in the treatment of mastitis. To prepare a compress, you need to take a cabbage leaf from the middle of the head, rinse it in warm water and place it on your chest, securing it with underwear on top. This compress is best done at night. In the morning you need to express milk.
2. Honey – known for its many-sided therapeutic effect a product that helps improve the filtration and absorption of serous fluid from the interstitial tissue of the mammary gland. It can be used as a compress in combination with other drugs, such as papaverine, magnesium sulfate or other ointments. To make a compress, you need to take honey in a semi-solid state, make a small cake out of it and apply it to your chest. Such a compress should be covered with cling film on top, which improves the warming effect. The duration of therapy is at least two hours a day.
3. Alcohol compress known for its warming properties, but only if there are no contraindications in the form of purulent inflammation. To prepare such a compress, you need to take alcohol, soak a gauze cloth in it, you can also add aloe juice, and apply it as a compress. But we should not forget about possible harm This compress is for a baby, so you need to wash your breasts before feeding.

Herbal treatment serous mastitis is also very effective, since the herbs can be used as a compress, as well as medicinal infusions or ointments.

1. Arnica is a plant that has very good effect when used correctly and systematically. This plant has a decongestant, antispasmodic, desensitizing effect. The drug also activates the processes of resorption of the infiltrate, stimulating the secretion of milk through the ducts, and thus improves blood circulation, thereby reducing heaviness in the gland and swelling. As a compress you need to use a tincture, for which you boil the herb in hot water. Treatment should be carried out in the morning and evening, by applying a compress to the affected areas.
2. Yarrow - has many benefits fatty acids, which are able to penetrate the skin and normalize lactation processes with relaxation of the milk ducts. To prepare a compress, you need to steam the herb and make a compress from the infusion. You can take it orally in parallel with the use of honey.
3. St. John's wort - used because of its antispasmodic effect, as well as because of its ability to reduce pressure in blood vessels and improve blood flow from the area of ​​inflammatory tissue. To prepare a compress, you need to infuse St. John's wort leaves in a small amount of water and apply several times throughout the day.

Homeopathy can also be widely used in the treatment of serous mastitis as a local remedy.

1. Mucosa compositum is a homeopathic remedy of inorganic origin. This tool improves local blood circulation in the mammary gland, and is also especially effective for cracked nipples and breast soreness. The dosage of the drug at the beginning of treatment is five homeopathic granules three times a day, then after two weeks you need to reduce the dose to three granules per day. Side effects are possible in the form of nagging pain or discomfort in the lower abdomen that goes away after a few days. Precautions - do not use the drug if purulent process in iron.
2. Echinacea is a natural homeopathic remedy plant origin. This plant is predominantly systemic means to improve lactation, since the plant stimulates the active secretion of milk. The method of using the drug is to use a homeopathic solution in ampoules, dissolving them in clean water. For lactostasis, dose half a teaspoon twice a day. Side effects can be in the form of increased blood pressure, tachycardia, insomnia. Stool disturbances in the form of passing are often observed. Precautions - if available arterial hypertension take with caution, under control of blood pressure - if it rises, you need to reduce the dose or stop taking the drug.
3. Merculius is a one-component drug that has a very pronounced antispasmodic effect due to the relaxation of cells in muscle fibers. To treat lactostasis, it is recommended to use ointment, which is especially effective for severe swelling and a feeling of heaviness in the chest.

Surgical treatment of serous mastitis can only be used if complications develop. If we are talking about infection and the development of purulent mastitis and abscess, then it is necessary to use surgery. In this case, the purulent focus is opened, drained, and active antibacterial therapy. In other cases, when serous mastitis has a benign course, then surgical intervention not required.

Prevention

Prevention of serous mastitis is very simple, so knowing the basic rules proper feeding and breast care can easily prevent any complication. The main preventive measures are as follows:

• You need to feed the baby according to his requests, not paying attention to night breaks and put him to the breast at least every three hours in the first month;
• Proper breast care between and before feedings is very important. You should not wash or rub the nipple vigorously every time - this is a risk factor for the formation of cracks. Before each meal, wipe the nipple with a drop of milk. A morning shower is enough and there is no need to wash the gland with soap or other means every time.
• adequate sleep and normal nutrition of a nursing mother are very important for normal milk production and the prevention of mastitis.

Forecast

The prognosis for recovery from serous mastitis is favorable with timely treatment measures.

Serous mastitis is an inflammation of the mammary gland of a non-purulent nature, which disrupts the normal process of feeding the child and causes discomfort wherein. The disease itself is not as serious as possible complications, which develop quickly if left untreated. Therefore, it is important to pay attention to any symptoms associated with chest pain, discomfort or disruption of normal feeding, as this primarily affects the health of your baby.