Signs of mastitis in a nursing mother. Video: symptoms and treatment of mastitis

Some women confuse the concepts of mastitis and mastopathy, not understanding what the difference is. Mastitis can occur at any time during lactation or even outside of it. This is inflammation of the breast tissue with a clear clinical picture. Mastopathy is cystic and hyperplastic changes that develop under the influence of hormonal disorders. In this case, the woman may not be bothered by anything.

Causes

Mastitis is inflammation of the breast tissue. According to ICD-10, it is encrypted under code N 61. It occurs when two conditions are combined: stagnation of milk and the presence of pathogenic microorganisms. By breaking this “chain” you can increase the chances of favorable outcome condition. Most often, lactation mastitis develops during the following periods:

• on the fourth to seventh day after birth– at this time, instead of colostrum, milk “arrives”; time is needed to regulate its quantity to suit the baby’s needs;
• when introducing complementary foods– at this point, the baby’s need for breast milk decreases, the breaks between feedings increase, which provokes stagnation;
• at the end of lactation– if you suddenly try to stop breastfeeding, there is a chance of developing mastitis.

Against the background of stagnation of milk, active reproduction of pathogenic microorganisms begins. Tissue swelling occurs, which compresses the milk ducts and aggravates the situation. If milk flow is not established in time, surgical intervention cannot be avoided.

Why does lactostasis develop?

Lactostasis is stagnation of milk in lobules. Every woman encounters it during breastfeeding to varying degrees. Lactostasis occurs due to increased milk production or a decrease in milk consumption by the child. The following reasons predispose to this:

• pumping - feeding on demand is recommended, but some women still adhere to strict time intervals;
• single breast feeding– each feeding should begin with a “new” breast, this way both mammary glands can be emptied evenly;
• shallow sucking– sometimes babies are “lazy” and suck milk only until they need to be applied special effort, and hind milk remains untouched and can stagnate;
• incorrect application– it is useful to change positions when feeding in order to empty all lobules equally;
• wrong underwear– during lactation, preference should be given to underwear made from natural fabrics; it should not pinch or squeeze;
• surgical interventions– if operations have ever been performed on the mammary glands (for example, fibroadenoma was removed, there was already mastitis), the likelihood of obstruction of the ducts is higher.

"Gate of Infection"

Pathogenic microorganisms enter the place of milk stagnation as follows:

• through nipple cracks– if applied incorrectly or if the child already has teeth (biting), wounds appear through which pathogenic microorganisms can penetrate;
• from foci of infection– sluggish chronic infection (for example, caries, pyelonephritis, sinusitis) or acute (cystitis, colitis, tonsillitis) easily penetrates the mammary glands with the flow of lymph or blood.

The main role in the occurrence of mastitis is played by staphylococci, streptococci, coli.

Symptoms of mastitis in a nursing mother by stage

Symptoms of mastitis in a nursing mother begin with signs of milk stagnation. Almost every woman has to deal with them, but not everyone realizes the danger of the situation and the need to resolve the problem. Lactostasis has the following manifestations:

• body temperature is normal;
• the mammary gland is full of milk;
• local pain may be detected;
• sometimes a tuberosity and compaction are palpated - a filled lobule;
• milk flow is not impaired, the baby happily takes the breast.

A woman notices an improvement in her condition after feeding or pumping. As the situation worsens, signs of mastitis appear in the nursing mother. The clinical picture largely depends on the stage. Information about this is detailed in the table.

Table - How mastitis manifests itself in a nursing mother by stages

Stage	Symptoms
Tissue infiltration – serous mastitis	- Body temperature rises; - clearly defined painful lump; - the skin over it is red and hot when palpated; - axillary muscles may become enlarged The lymph nodes; - the child sometimes refuses the sore breast; - a woman can express milk on her own, but the procedure is painful
Purulent stage	- Fever and symptoms of intoxication occur - weakness, lethargy, dizziness; - the mammary gland is red, veins are clearly visible; - the breast may swell, it becomes larger than the other; - the focus of milk stagnation is no longer so clearly visible due to its general stagnation; - purulent discharge may appear from the nipple; - expressing is extremely painful and it is impossible to express on your own, the baby refuses to take this breast
Abscess formation	- A woman notices throbbing pain in a specific area; - severe fever; - swelling, redness of tissues; - upon palpation, a softened area is detected among dense tissues if the abscess is close to the skin
Cellulitis and gangrene of the chest	- The woman’s condition deteriorates sharply, sometimes she becomes delirious; - the mammary gland is sharply swollen and cyanotic; - sometimes vein thrombosis develops; - not only breast tissue, but also muscles are involved in the inflammatory process chest, subcutaneous fatty tissue; - dark areas of skin appear - zones of necrosis

Phlegmonous and gangrenous mastitis are rare. Sometimes treatment requires amputation of the breast. These conditions pose a threat to a woman's life.

During breastfeeding, it is informative to measure the temperature in the elbow. IN armpit it will always be slightly higher due to the arrival of milk, which gives an incorrect clinical picture and is needlessly alarming.

Classification

Depending on the course of the disease, acute and chronic recurrent forms are distinguished. In the latter case, mastitis is associated with incomplete sanitation of the source of infection.

According to generally accepted ideas, inflammation of the mammary gland is possible only with breastfeeding. However, there is non-lactational mastitis among women. It can occur at any age and is most often associated with chronic infection in gland tissues. Classification depending on the location and area of ​​the lesion:

• subareolar - inflammation immediately under the areola and nipple;
• intramammary – lesion deep inside the mammary gland;
• retromammary - formation of a lesion in front of the pectoral muscles;
• total defeat– if several areas are captured;
• mastitis of accessory lobes– they are located in the armpits and occur in 10-15% of women, the clinical picture is normal, but pain, redness and other symptoms are concentrated in the armpits.

What to do

In the initial stages of mastitis and with lactostasis (in this case there is no temperature), you can try to cope with the situation on your own. But if there is no confidence or sufficient knowledge, it is better to use the services of midwives or a doctor.
General recommendations on how to cure mastitis while breastfeeding, the following:

• express or feed– to eliminate stagnation, it is necessary to evacuate milk; if the baby refuses to suckle, you should express yourself or use a breast pump;
• accept warm shower – water will help a woman relax mentally, and warm water relieves spasm of the ducts;
• take antispasmodics– without fear, you can take “No-shpu”, “Papaverine”, this will help improve the flow of milk.

The following should not be done:

• cause severe pain pumping;
• take pills to suppress lactation on your own;
• warm up at obvious signs inflammation;
• feed a child with purulent discharge.

Rubbing the seals with ice cubes helps a lot when milk stagnates. This must be done carefully, without injuring the tissue, but by massaging areas with stagnation. Cold will help relieve swelling and pain, after which it will be easier to express or feed.

Drug treatment

If the temperature rises persistently above 37.5-38 °C during the day, it is necessary to start taking serious medicines. Only a doctor prescribes them, self-administration may harm the baby. The following drugs are used in treatment regimens.

• Antibiotics. While taking some, you are allowed to continue breastfeeding (Cefazolin, Cefotaxime, Amoclav, Azithromycin), while others will have to temporarily express (Metronidazole, Clarithromycin). The regimen and dose of antibiotics for mastitis for a nursing mother is determined by the doctor.
• Antipyretic. All drugs in this group pass into milk. Ibuprofen is considered the most effective and safe for children.
• Antispasmodics. “Drotaverine”, “Papaverine” will help reduce tissue swelling, relieve pain and improve the flow of milk through the lobules and ducts.
• Oxytocin. Its natural release occurs when the nipples are irritated. For mastitis in a hospital setting, the drug can be administered intramuscularly or intravenously, stimulating the contraction of the ducts and facilitating the emptying of the lobules.
• Suppression of lactation. IN extreme cases, and also after surgical treatment Medicines may be prescribed to reduce milk production. This is Parlodel, Dostinex.

Traditional methods

Folk remedies effectively used together with the main treatment. The most popular ones include the following.

• Cabbage leaf. It is better to slightly treat the leaf with boiling water, then cool it and apply it to the problem area overnight.
• Baking soda . Not a large number of should be mixed with water until paste-like. Place on gauze and make a compress overnight.
• Alder or mint. Grind the dried leaves and soak them in water. Apply as a compress to your chest for several hours.
• . Fresh leaves Pour boiling water over and apply to seal areas, preferably overnight.

Operations

If, against the background of conservative treatment, there is no positive dynamics or signs of abscessation of the breast lobe appear, it is necessary surgery. To select the most suitable method On the eve of the intervention, an ultrasound scan of the mammary glands is required.
Typically, radial incisions are made to open the abscess, not reaching the areolar area. Drains are installed in them to actively remove purulent contents. It is possible to dissect the tissue in the fold under the mammary gland (if the abscess is located retromammary) or around the nipple if it is superficial.

For 10 days or more is necessary regular rinsing wounds, intensive antibacterial therapy is also carried out. If necessary, additional ointments are used - Vishnevsky, "Levomekol". In some cases, lactation must be completed completely if milk production supports inflammation.

Complications

Ignoring stagnation of milk or untimely treatment may result not only in opening and draining abscesses, but even in removing the breast. Therefore, if complaints arise, it is better to contact medical care. The consequences of surgical treatment in the future for a woman are as follows:

• a scar forms on the skin;
• the risk of future cancer increases due to tissue trauma;
• fistulas may form.

Women after any breast surgery should undergo regular medical examination– Ultrasound of the mammary glands and mammography after 45 years.

How to prevent illness

Prevention of mastitis during breastfeeding includes following the following recommendations.

• Correct application. IN postpartum period You need to learn how to put your baby to your breast. At the same time, it should capture not only the nipple, but also most of the areola. It is useful to change positions when feeding - sitting, standing, lying, right or left.
• Treatment of cracked nipples. If cracks do form, it is necessary to monitor breast hygiene and additionally lubricate with Bepanten after feeding.
• Comfortable underwear. You should choose special breastfeeding bustiers that have comfortable clasps.
• Self-massage. Before feeding, it is useful to carry out light massaging movements from the base of the mammary gland to the nipple.
• Feeding on demand. It is recommended to put the baby to the breast every time there is anxiety and crying, before and after sleep. This could be every half hour, and sometimes there will be a break of three to four hours.
• Maintaining hygiene. The mammary glands should be washed once or twice a day.
• Prevention of injuries. The chest should be protected from compression, blows, and damage that the baby may inadvertently inflict. When you sleep you need to choose comfortable position on the side or back so as not to injure the mammary glands.

The causes of lactation mastitis are hidden in stagnation of milk and the active reproduction of pathogenic microorganisms in this area. You can diagnose the disease at home by the characteristic clinical picture mastitis. If there is no effect from the self-treatment you should consult a doctor immediately to avoid serious consequences and, if possible, surgery. Reviews from women confirm that even after suffering from mastitis, lactation can be maintained.

Reviews: “Don’t joke with this!”

Hello! I haven’t fed for 8 months now, my baby is 1.8. For half a year I fed on demand, there were no problems with the breasts. When I started giving complementary foods, literally drop by drop, stagnation began. The suckling seemed to be normal, the breast did not feel full, after a couple of hours the temperature was 37.5. At first I couldn’t understand anything, I actively pumped, and it went away the next day. This happened 3 times, the last time it rose to 38, ran to a consultation, they prescribed physio, it went away. So nothing helps better than physio)

Rat, https://deti.mail.ru/id1002848092/

Oh girls, I don’t know what form of mastitis I had, but it was terrible! There was a lot of milk, but I didn’t express it because my son sucked every drop (on demand). When my son turned 1 month old, my chest suddenly began to hurt. It was impossible to even raise my arm on that side, the pain was hellish. The temperature rose sharply - 39.3, there was a chill, a fever, my chest was stone, I couldn’t touch it, green milk was seeping out. Well, my mom is a walking encyclopedia, she was sleeping and I’m going to treat me. I drank paracetamol (we were advised in the ambulance), and made compresses from starch and sunflower oil and expressed myself every two hours. My torment lasted 4 days and everything went away. The main thing is to believe! Now my son is 6 months old, he weighs 10300

Olga Semchenko, https://deti.mail.ru/id1007077110/

I did not take antibiotics, at my own peril and risk. Thank God, everything worked out. I put gauze soaked in furacillin alcohol on my chest (they actually advised me to use vodka, but there wasn’t any in the house at the time), with a cabbage leaf on top. And I pumped continuously for a day or two. But I want to tell you - the effectiveness of a child in terms of eliminating milk from the breast is much superior to pumping. Sashka saved me. I applied it to my sore breast more often than usual. When the temperature returned to normal, antenatal clinic I did it - I don’t know exactly what it’s called - in general, ultrasound softens the lumps in the breast and makes it easier to express milk. But when high temperature This seems to be impossible. There is only one “but”. I am a completely far from medicine person and I could very well be wrong, but if purulent mastitis has developed, then antibiotics are needed, and I have great doubts about the possibility of feeding the child.

Zhenya Shushkova, http://www.komarovskiy.net/forum/memberlist.php?mode=viewprofile&u=214&sid=0a7f9d36dbb9c35dbefdacb391267f37

In the first week of feeding, one of my breasts also became hard, became red, and my temperature rose. Besides pumping, ice helped me VERY well. In the freezer I froze ice in the form of cubes (then put it in a bag) or just bottled water. After each feeding, she pumped, then simply massaged, rubbed the tubercles and kept ice on the sore breast for 15 minutes (not directly on the body, through a T-shirt or gauze). When my midwife recommended this to me, I was honestly perplexed by how it was possible to put ice on my chest. Everywhere they write that you shouldn’t let your breasts get cold. It's okay, even when you hold it, it becomes easier. After the ice, I applied cabbage or a compress of cottage cheese (in gauze, and a plastic bag on top so that the clothes did not get wet) - but this is not very convenient, because... constantly subsides, you have to lie down. I didn't take any pills.

Svetik_and_Dimuljka, http://www.komarovskiy.net/forum/memberlist.php?mode=viewprofile&u=15&sid=0a7f9d36dbb9c35dbefdacb391267f37

I had mastitis when I was three months old. I flew out onto the balcony in early December to take off my underwear. I took it off, it’s called. The next day they took me to the ambulance with a temperature of 40. The doctor said that in another day the operation could not be avoided! Don't joke about it. They injected me with antibiotics, did UHF and much more. Fortunately, my daughter was lying with me. I fed her almost every hour and always started with a sore breast. Compresses are good only when milk stagnation and when the ducts are clogged. Then cabbage and honey. Stop feeding only if purulent discharge. Apply to the breast as often as possible, and in different positions. If your husband is nearby, let him help.

Tit, https://mnogodetok.ru/memberlist.php?mode=viewprofile&u=2050&sid=0facaae7d4f9ea84e6103784a9dca8a9

How does mastitis occur? What are its symptoms? Is it possible to treat mastitis during breastfeeding at home using folk remedies? When should you take antibiotics, and which ones? Do I need to wean? All about mastitis during breastfeeding in the recommendations of lactation consultants.

Mastitis is an inflammatory process in the tissues of the mammary gland. IN medical practice The disease occurs not only in breastfeeding women. It can affect both men and children, including newborns. But it is young mothers who are more susceptible to the disease than others, because their breasts are in the “risk zone”.

Causes

Contrary to popular belief that mastitis occurs as soon as the chest gets cold, the causes of the disease are found in something completely different. The only way to get cold breasts, lactation consultants joke, is by exposing them naked to the cold. Your mammary glands are inextricably linked with the processes in your body. And if you freeze in cold weather or, for example, get your feet wet, the immune system will weaken, and the disease will actually have a chance. However, this is typical for so-called recurrent or untreated mastitis, which recurs regularly.

The reasons primary disease lie in not proper organization breastfeeding, infection.

• Complicated lactostasis. In ninety-five percent of cases, lactostasis (stagnation of milk in the duct) goes away within one to two days with correct technique treatment. Active resorption of the breast is required, for which the baby is placed in it hourly. If it is not possible to cope with stagnation within four days, the tissue swelling becomes inflamed. A complication arises due to what the body sees as stagnant protein. breast milk"enemy" and directs forces there immune defense. Redness forms, the inflamed lobe becomes painful.
• Infection. It can “sit” quietly in the body until it gets a chance to “break out” out. The foci of infection are chronically inflamed tonsils(tonsillitis), carious cavities in teeth. Bacteria can enter thoracic ducts during a sore throat suffered by the mother. But the most shortcut for them - through cracks in the nipples.

Depending on how mastitis occurred during breastfeeding, there are two forms.

Uninfected mastitis

It is untreated lactostasis, which is complicated due to excessive tissue swelling.

Symptoms:

• deterioration of health against the background of an existing lump in the chest;
• temperature rise to 38 and above;
• soreness of the affected mammary lobe, swelling, redness.

To diagnose uninfected mastitis, lactation consultants recommend measuring body temperature in three areas: under the armpit, in the elbow, and in the groin. If it is higher in the armpit, it means that you have developed complicated lactostasis. It is the “simplest” form of mastitis, the treatment of which does not require antibiotics.

Infected mastitis

Develops as a result of associated infection. It can become a “continuation” of non-infectious mastitis if treatment is not started on time.

Symptoms:

• progressive deterioration of the woman’s condition;
• acute pain in the affected lobe, pain when touched and walking, redness, the chest becomes hot;
• an increase in body temperature, maintaining it for more than two days when using treatment tactics for uninfected mastitis.

The danger of infected mastitis is that without treatment with antibiotics it can develop into an abscess: the formation purulent cavities in the thoracic lobes. The abscess must be removed surgically or by suctioning pus during medical manipulations. Absence timely treatment poses a threat to a woman's life.

Treatment of mastitis

If you notice signs of mastitis while breastfeeding, you must begin treatment immediately. The sooner measures are taken, the faster your health will improve, and the less likely it is to develop complications. Be sure to consult a doctor, especially if several days have passed since the onset of the illness. But you can do a lot at home, too.

When to take antibiotics

Uninfected mastitis during breastfeeding resolves without the use of antibiotics, with the help of folk remedies and proper organization of the baby's feeding. But there are situations when without antibacterial drugs not enough. Treatment tactics are suggested by the famous Canadian pediatrician Jack Newman, founder of the first clinic to help nursing mothers, and a UNICEF expert.

According to Jack Newman, it is necessary to take antibiotics if:

• symptoms of the disease do not go away within twenty-four hours: temperature, redness, painful swelling persist;
• the disease proceeds without changes, the woman does not get better or worse within twenty-four hours;
• observed for twelve hours sharp deterioration conditions: increased pain, enlargement of the affected area or its hardening.

You do not need to take antibiotics if:

• there is reason to diagnose a woman with mastitis, but less than twenty-four hours have passed since its onset, and the correct treatment tactics are being used;
• Without taking antibacterial agents, the patient's condition began to improve.

Taking antibiotics must be discussed with your doctor. But many specialists do not risk working with nursing mothers, requiring them to temporarily stop breastfeeding. Be sure to tell your doctor about your intention to continue breastfeeding and ask for antibiotics that are compatible with lactation.

For the treatment of mastitis choose antibacterial agents, affecting Staphylococcus aureus. Traditional preparations based on penicillin and its modern synthetic analogue “Amoxicillin” are often ineffective against these bacteria. Combined antibacterial drugs are more productive:

• "Amoxiclav";
• "Clindomycin";
• "Ciprofloxacin";
• "Flucloxacillin";
• "Cephalexin";
• "Cloxacillin."

Jack Newman draws attention to the possibility of using these remedies without the need to interrupt breastfeeding. “There is no danger for the child,” he writes in the article “Milk Stagnation and Mastitis.” “The disease goes away faster if you continue to breastfeed.”

Prevention

As you know, preventing a disease is easier than fighting it. Recommendations for the prevention of mastitis during breastfeeding are the same as for the prevention of lactostasis.

• Feed often, regularly. Breastfeeding consultants insist on organizing a feeding regime “on demand”, as natural and physiological. Regular consumption of milk by a child without many hours of breaks is the best prevention stagnation.
• Change your positions. Place the baby in the classic “cradle” position, from under your arm, with the jack’s legs towards your head. Different poses During feeding, they allow you to release different lobes of the breast.
• Make sure you suck properly. The baby's lips should cover almost the entire areola of the nipple, and not just its tip, and the tongue should be located under the nipple. With this application, sucking does not cause discomfort to the mother, and the milk ducts work fully.
• Don't pump in vain. At correct mode There is no need for pumping during feedings. Otherwise, you risk getting hyperlactation - increased production milk, which often becomes the cause of regular mastitis.
• Choose your underwear wisely. The bra should not squeeze the breasts, interfering with the outflow of milk. Only wear one that is specifically designed for nursing mothers.
• Protect your chest from injury. Blockage of blood vessels can be caused by blows and bruises. If cracks appear, do not rush to wash them regularly with soap. This will strip away the skin's natural oily protective layer and open the way for bacteria. For breast hygiene, a daily warm shower is enough.
• Wean gradually. Big percentage mastitis occurs with the sudden introduction of complementary foods or weaning “in one day,” when the usual mode of breast release is disrupted. Breastfeeding should “leave” from the life of mother and child gradually. Then weaning and transition to an “adult” diet will take place without negative consequences for Mom.

And finally, have fun breastfeeding! Get enough sleep, rest more often, feel, first of all, like a woman, a beloved mother. In everyday life, be sure to attract helpers, do not carry heavy things. Not only yours depends on this emotional condition, but also health.

Mastitis - dangerous disease, but not all women encounter it during lactation. If it occurs, there is no need to be afraid. According to reviews, timely conservative treatment mastitis during breastfeeding, demonstrates highest efficiency. The disease will not end with an abscess and surgery if you are attentive to yourself and choose the right tactics of action at its first manifestations.

Print

When breastfeeding, difficulties may arise with the formation of lumps in the breast and stagnation of milk. If attachment is incorrect, infrequent feedings and problems with pumping, such difficulties can occur. serious complication– mastitis can develop in a nursing mother.

This is an inflammation of the breast tissue, both aseptic (sterile) and purulent, with the addition of microbial flora from the surface of the breast skin through the milk ducts. Let's find out what mastitis during breastfeeding is, the symptoms and treatment of this pathology.

Mastitis during breastfeeding

Mastitis is called inflammation of the breast tissue; during breastfeeding, it occurs as a result of stagnation in the milk ducts with the addition of an infection. This type of mastitis is usually called lactation mastitis, and it occurs in approximately 3-5% of lactating women.

How does mastitis begin in a nursing mother? It usually forms against the background of existing lactostasis (stagnation of milk in the breast with the formation of a compaction).

Initially, mastitis begins as a non-infectious, aseptic inflammation, but can quickly turn into a purulent process due to the penetration of microbes from the skin of the nipple into the gland tissue.

Signs of mastitis while breastfeeding

Often, mastitis during breastfeeding occurs as a result of the following reasons:

• Long-term lactostasis, stagnation of milk in the ducts. They are formed due to rare feedings, routine feedings, weakness of the child, which is why he cannot fully empty the breast, as well as feeding in one position, when not all lobes of the breast are emptied. Lactostasis may not lead to mastitis if it is quickly eliminated. But, when an infection is added to milk stagnation, purulent mastitis will develop.
• Reduced immunity, against the background of which any of the infections can develop.
• Cracked nipples as a result of improper attachment to the breast. Through cracks, infection penetrates into the mammary gland more easily and quickly.
• Wearing tight underwear causes compression of the ducts and stagnation of milk.
• Breast trauma, accidental bruise or compression, hematoma.
• Infections in the mother's body with the spread of microbial agents, including in breast tissue. These can be carious cavities, sinusitis, tonsillitis, etc.

Mastitis during breastfeeding: symptoms

Mastitis goes through several successive stages in its development. In the first, serous (aseptic) stage, symptoms such as increased temperature in the elbow, chills, and reddening of the skin in the area of ​​milk stagnation occur.

This stage is formed as a result of inflammation due to stretching and swelling of the ducts with stagnant milk. As long as there is no infection with microbes, every effort must be made to eliminate inflammation.

It is important to breastfeed your baby as often as possible so that the baby actively absorbs the areas of lumps and helps the milk flow.

With infiltrative mastitis, pain occurs during feeding, and weakness develops as in colds, the lymph nodes on the side of the armpit of the diseased gland may enlarge, milk flows poorly, and a pronounced, edematous seal forms at the site of the lesion.

In the absence of adequate treatment or improper treatment At this stage, the microbial component of inflammation joins and the transition of mastitis to purulent occurs. Microbes penetrate through the ducts of the gland from the nipple area to the area of ​​inflammation, which leads to the formation of a purulent focus, which sharply aggravates the course of the disease. At this stage there are:

• severe pain and swelling of the breasts
• severe chills with temperature rising to 40 degrees
• the skin of the chest becomes bright red, sometimes with cyanosis
• milk is secreted along with pus.

Against the background of such a course of mastitis, an abscess can form in the chest - a cavity filled with purulent contents, requiring surgical intervention.

Feeding during mastitis in a nursing mother

Against the background of mastitis, breastfeeding and regular breast emptying is one of the methods of treatment and prevention of further spread of the infection.

By emptying the breast, swelling and pressure inside the ducts are relieved. Even if there is purulent mastitis You can breastfeed.

Pus is a mixture of microbes killed by leukocytes; it will not harm the child’s health in any way and is not dangerous for him. Only against the background of drainage and treatment of a breast abscess can feeding from this breast be temporarily stopped, then the milk will need to be expressed.

Treatment of mastitis in a nursing mother

When the first signs of illness develop, you need to consult a doctor or at least a lactation consultant. Based on the clinic’s data, they will determine how to treat mastitis in a nursing mother.

First of all, you need to ensure complete emptying of the breast - through frequent feedings, and if the baby cannot cope, you need to additionally express it by hand or with a breast pump.

This will help eliminate congestion and maintain lactation for the future.

What to do first when dealing with mastitis in nursing mothers? Keep calm, provide yourself with a gentle regime and do not crush the gland, without further injuring the chest.

If the temperature rises due to mastitis in a nursing mother, it is necessary to use the usual antipyretics allowed during breastfeeding - paracetamol or ibuprofen.

They help lower fever and reduce inflammation. In addition to antipyretics, there are other methods to reduce the temperature of a nursing mother during mastitis.

This is the use of picking with a damp sponge, light clothing, cool shower. It is important not to limit yourself in fluids, since drinking eliminates toxins and inflammatory products.

Mastitis in a nursing mother: treatment with medications

Previously, when mastitis was diagnosed, drugs were prescribed to suppress lactation such as Parlodel and Dostinex.

To relieve pain, you can use ointments with analgesic and anti-inflammatory effects, or a cool compress for mastitis in nursing mothers.

The main treatment will be antibiotics for mastitis for a nursing mother. Broad-spectrum antibiotics that are compatible with breastfeeding are usually prescribed.

The selection of antibiotics should be done by a doctor, who will also prescribe the course of treatment and its duration.

In addition to antibiotics and anti-inflammatory drugs, a course of physiotherapy will be prescribed. If there is a formed abscess, it will be necessary surgery with opening of the abscess and removal of pus, followed by drainage of the wound.

Prevention of mastitis during breastfeeding

Naturally, when breastfeeding it is better to avoid lactostasis and mastitis, and organize breastfeeding correctly from the very beginning. How to avoid mastitis while breastfeeding?

It is important to ensure proper attachment to the breast to avoid cracks and stagnation of milk. It is important to change feeding positions so that the baby fully empties all lobes of the breast. It is necessary to protect your breasts from injury, wear comfortable natural underwear, and avoid sleeping on your stomach so as not to squeeze the ducts.

Other information on the topic

• 
  Is it possible to have seeds while breastfeeding?
• 
• 
• 
• 
• 

The process of breastfeeding a newborn baby does not always go without problems. It happens that a nursing mother develops acute inflammation mammary gland - lactation mastitis. In the postpartum period, this is one of the most common complications. But mastitis can overtake a woman several months later. At timely diagnosis And adequate therapy this disease can be overcome without problems, and many mothers manage to restore lactation after recovery. But if the disease is not treated, it progresses to more dangerous stages, and then surgery may be required. How to promptly recognize lactation mastitis and what methods of its treatment are most effective?

Lactostasis and mastitis in a nursing mother

A disease in which the mammary gland becomes inflamed is called mastitis. Very often it develops during breastfeeding. Its cause is stagnation of milk (lactostasis) due to infection of the mammary gland ducts. Mastitis that progresses while breastfeeding mother's milk, called lactation. About 5% of breastfeeding women experience this disease in the first months after childbirth. Most often, young mothers who have given birth to their first child are at risk, because absence plays a big role here. required experience in the process of establishing and maintaining lactation.

The disease develops in a certain sequence. Mastitis is preceded by lactostasis, which occurs when mother's milk stagnates in the lobes of the mammary glands. This phenomenon is observed in those women who rarely put the baby to the breast or adhere to feeding by the clock strictly at certain intervals. Another reason for stagnation of milk may be the inability of a weakened (premature) baby to suck as much milk as is produced.

Lactostasis itself is not so dangerous. But only in the absence of infection. When is it complicated by infection of the mammary glands? pathogenic flora, we are already talking about the development of mastitis.

Treatment must begin from the first period of the disease. Otherwise it will accept purulent form and serious complications will begin.

Causes and risk factors

Factors for the development of mastitis:

• with lactostasis, the milk ducts are clogged and favorable conditions for the reproduction of microbes;
• if the baby is not applied correctly to the breast and the mammary glands are not properly cared for, cracks appear in the nipples;
• in the presence of pustular diseases skin microbes penetrate the milk ducts;
• at diabetes mellitus the body's resistance to infections decreases;
• prolonged smoking impairs blood circulation in the chest;
• when taking glucocorticosteroids, pathogenic microflora develops;
• if there are implants in the breast, they begin to be rejected by the body;
• at malignant tumor its metastases reach the mammary glands.

All these factors indirectly influence the onset of the disease, however the real reason its development is the penetration of microorganisms into the mammary gland.

Some microbes live on human skin and mucous membranes and cause diseases when the immune system is weakened. Other pathogenic microorganisms enter the body from the outside.

The main causative agents of mastitis:

• Pseudomonas aeruginosa;
• streptococcus;
• staphylococcus;
• coli.

Infection in the mammary glands can enter through cracks that form in the nipples during feeding, when the baby is placed on the breast incorrectly

Stages of the disease and their symptoms

Lactation mastitis has three stages: it begins with serous, continues with infiltration and ends with purulent. Each stage is characterized by its own characteristics.

Serous

• Body temperature rises.
• Chest pain appears.
• The skin of the mammary gland in the affected areas turns red.
• Feels chilly.

The disease begins with inflammation resulting from stagnation of milk. The infection has not yet been able to penetrate the body, and you need to take it immediately preventive measures. It is not necessary to stop feeding your baby breast milk at this stage of mastitis development.

Pain during lactation does not occur immediately. If it becomes painful to feed your child, this means that mastitis has entered the second stage.

In the absence of treatment for initial stage, the infection spreads to the mammary ducts and glandular lobes

Infiltrative

• Painful condition, weakness.
• The lymph nodes in the armpits become enlarged and painful.
• The affected area of ​​the chest thickens.
• The milk begins to flow poorly.

At the second stage of mastitis development, redness of the skin appears on the affected area of ​​the chest

If you do not begin drug and procedural treatment at this stage, then pathogenic microorganisms will enter the milk ducts and the disease will move to the final stage: purulent mastitis will develop.

Purulent

• The breasts become swollen and painful.
• The temperature rises to 40 degrees.
• There is severe chills.
• Where the abscess has formed, the skin turns bright red, sometimes to the point of cyanosis.
• Pus is found in the milk.

Inflammation occurs, a purulent area is visible. At this stage the disease is considered severe.

Important! If an abscess has formed, then treatment can only be surgical. At the purulent stage of the child, breastfeeding is strictly prohibited!

Diagnostics

If mastitis is suspected, the doctor prescribes several tests.

• Blood collection at general analysis. It is very important to determine whether the white blood cell count is elevated and what the erythrocyte sedimentation rate is in order to assess the degree of inflammation.
• Study of milk from the nipple in the laboratory. In the same way, discharge from an abscess is examined, and the sensitivity of pathogenic microflora to antibiotics is checked.
• Carrying out ultrasound examination breasts
• Breast X-ray (if carcinomatosis is suspected).
• Identifying the type of infection.

The difficulty of making a diagnosis is that some diseases have symptoms similar to mastitis.

It is necessary to differentiate mastitis from a number of other diseases:

• breast cysts infected with infections;
• breast cancer;
• mastitis-type tuberculosis;
• syphilis;
• actinomycosis (infection of the breast with microbes of this type).

Therefore, it is very important to ensure that a specific pathological process is present in order for the treatment to be effective.

Breastfeeding with mastitis

The only indication for continuing breastfeeding is lactostasis. Mastitis is usually caused by bacteria that penetrate not only the mother's body, but also the milk. Consequently, the baby may get sick from drinking such milk. It is even more dangerous if the child gets antibiotics that are used to treat mastitis.

However, there is an option breastfeeding, when breast milk is expressed and necessarily pasteurized. This is done in order to destroy harmful microorganisms.

But on early stages mastitis, feeding can not be stopped. Signals to stop breastfeeding are the development of inflammation, swelling, and ulcers.

You cannot breastfeed a child even in cases where the woman is seriously ill or has previously suffered from purulent mastitis.

Treatment options

When it comes to mastitis in a nursing mother, there should be no errors in treatment. It is very important that therapy is started in a timely manner. This is especially true for the initial stage, when it is much easier to cope with the disease.

Possible complications

1. The disease will progress to a severe stage with purulent manifestations.
2. The condition will worsen, phlegmon or abscess will appear.
3. Mastopathy will develop in its most complex form.

You should consult a doctor immediately after detecting the first symptoms of mastitis.

First, conservative treatment is prescribed - medications And special procedures, - and only in advanced cases do they resort to surgical intervention. At purulent mastitis stop pathological process only possible surgically. After this, the woman’s condition improves and she can return to her normal lifestyle.

Conservative

This type of treatment includes medications, massage and physical therapy.

Groups of medications used in the treatment of mastitis as prescribed by a doctor

• Antibiotics. For mastitis, this is usually Gentamicin, Amoxiclav, Cefazolin or Oxacillin.
• Means to reduce lactation, such as Dostinex or Parlodel. You can't breastfeed. In this case, pumping should be carried out regularly until the seals are reabsorbed.
• Drugs that relieve inflammation and painful sensations. As a rule, non-steroidal.
• Ointment, cream or gel with anesthetic.
• Absorbable drugs. For example, compresses using dimexide.

Photo gallery: medications for the treatment of lactation mastitis

Movalis is a non-steroidal anti-inflammatory drug
Cefazolin - antibiotic
Amoxiclav is one of the most popular and safe antibiotics
Heparin ointment - absorbable agent
Compresses with Dimexide help relieve inflammation and treat ulcers
Dostinex is used to reduce the amount of milk or stop lactation

Physiotherapy

Physiotherapy for lactation mastitis are aimed at relieving swelling and resolving compactions in the mammary glands. The most common option is the appointment of ultra-high frequency therapy (UHF) procedures. At the initial stage of the disease, one or two procedures may be sufficient.

Massage

The famous doctor E. O. Komarovsky highly appreciates massage as a method of treating mastitis:

If there is no increase in body temperature, categorically do not give any medications internally. The most effective remedy- qualified massotherapy. Please note that it is not preventative (which is written about in the book), but rather therapeutic. Thus, everything depends on a qualified massage therapist. Where to find it is the main question. Most reliable way: in any maternity hospital, for a certain fee, they will show you the finger of a specific person who knows how to do this and wants to earn extra money in free time. And others safe ways no help.

However, a woman can perform breast massage on her own. It is not recommended to do it with force. Movements should be soft, circular. But the effect will appear only with regular procedures.

Algorithm of actions for massage

1. Raise your right hand behind your head.
2. With your left hand, move along the right armpit.
3. Use the palm of the same hand to right breast from the side, then from below, lifting the chest.
4. Then along the left side of the right chest in the direction from the collarbone.
5. Change hands and repeat the same movements right hand for the left breast. There is no need to touch the nipple circles or the nipples themselves.

Surgical treatment

If conservative treatment does not bring the desired effect or the disease has progressed to purulent stage, an operation is prescribed. In her simple version dissect the place where the abscess is based, and clean the tissues from the accumulated pus. Before this, the breasts are carefully examined using an ultrasound machine to determine the exact location of the affected tissues.

Folk remedies

Doctors believe that folk remedies will not help cure mastitis: they may be able to alleviate the condition, but they cannot overcome the infection. Only antibiotics can deal with it.

But you can, without giving up traditional methods, try and folk recipes. Here are some options for compresses for sore breasts.

1. Honey, sunflower oil and Kalanchoe. Sunflower oil With Kalanchoe juice and honey are mixed in a 1:1:1 ratio.
2. Coltsfoot. Fresh leaves are applied to the reddened areas of the chest. The plant will remove it.
3. Pumpkin and cabbage. Warm pieces of pumpkin and cabbage leaves can also fight inflammation. Cabbage has absorbent properties. Pre-prepare the leaf by pricking it with a fork and brushing it with honey. Leave the compress on overnight.
4. Sea buckthorn or camphor oil with potato starch. A paste is prepared from these components, which promotes the resorption of seals.
5. Apple with butter. You first need to peel it, then grate it and mix it with oil. It also helps with cracked nipples.
6. Burdock. You can simply crush its washed and dried leaf slightly, put it in your bra and walk with it until it gives up all its juices. Then put another one. Or you can squeeze juice from burdock leaves and take it orally, 1 tablespoon 3 times a day.

Photo gallery: Folk remedies for the treatment of lactation mastitis

Camphor oil helps milk flow and can be used to treat and prevent mastitis
Coltsfoot leaves - green compress for otmastitis
The juice from Kalanchoe leaves has wide range medicinal use
Pumpkin pulp has an anti-inflammatory effect
Cabbage leaves very comfortable as compresses on the chest
Sea buckthorn oil has anti-inflammatory and regenerating properties
Potato starch - important component compresses
An ointment is prepared from grated apple pulp and butter.
Bee Honey- one of the most active natural remedies for the treatment of inflammation
A compress of burdock leaves, as well as juice, helps against mastitis.

Prevention measures

The development of lactation mastitis can be avoided if you adhere to the rules of breastfeeding.

• Carry out the correct gentle hygiene care for the mammary glands.
• It is correct to alternate breasts during feedings.
• Use a protective cream with panthenol or lanolin to prevent cracked nipples (for example, Purelan, Bepanten).
• Feed the baby on demand, avoiding stagnation of milk.
• Do preventive massage for better milk flow.

Breast massage should be carried out regularly, at least once a day, only in this case it will be effective

Video: mastitis - safety precautions for nursing mothers

How to resume breastfeeding after mastitis

Because of mastitis, you should not lose the opportunity to feed your baby natural breast milk. After all, it is so beneficial for the health of the baby and the development of its immune system.

Lactation cannot be restored only after major surgery. Most often, breastfeeding after treatment of lactation mastitis is restored without problems.

To do this you need:

• do not stop feeding without a doctor’s recommendation;
• express regularly and do this even if there is little milk;
• drink plenty of fluids.

It is worth restoring lactation after treatment only if there is no threat to the mother’s health. Otherwise, it will be safer to transfer the baby to artificial feeding. If the mastitis was serious and the treatment was surgical, be sure to consult on this issue with a doctor you trust.

Video: symptoms and treatment of mastitis during breastfeeding

Lactation mastitis is not a death sentence. Breastfeeding, in the absence of risks to the health of the baby and his mother, can be fully restored after recovery. But here it is extremely important to diagnose the disease at the initial stage and treat it as early as possible. Late application seeking medical help when the disease has entered its final (purulent) stage will significantly complicate the situation. Surgical intervention- a last resort. In most cases, you can do without it. The main thing is to immediately seek help from doctors and breastfeeding consultants and strictly follow all their recommendations.

Inflammation mammary gland(mastitis) occurs acutely and chronically. In the postpartum period, as well as during the entire period of breastfeeding, acute lactation mastitis develops. Women who do not breastfeed sometimes develop nonlactation mastitis, but less frequently.

Reasons for the development of lactation mastitis

• frequent development stagnation of milk in the breast (lactostasis), especially in the postpartum period;
• decreased immunity in pregnant women due to hormonal changes and after childbirth due to stress and blood loss;
• the appearance of microcracks and abrasions on the nipples - a gateway for infection;
• structural features of the milk ducts and nipples, the functioning of the mammary gland;
• failure by a woman to comply with hygienic rules for caring for the mammary glands.

Most often, inflammation develops due to a complex of reasons. The causative agents of the infection are representatives of opportunistic microflora that constantly live on human skin: staphylococci, streptococci, E. coli, etc. With normal immunity, these pathogens do not cause disease, but in a woman in the postpartum period, immunity is reduced, this is the reason for the onset of infection.

There are also hospital forms of the disease, in which the infection is transmitted by contact persons who are carriers of the infection. Hospital forms of mastitis are more severe and less treatable.

Why do cracked nipples appear?

Cracks and abrasions of the nipples are of great importance in the development of inflammation. The reasons for their formation are:

• functional inferiority of the nipples and areola;
• malformations of the nipples - flat, inverted, large, small, grape-shaped;
• prolonged exposure to the child’s mouth and maceration (soaking);
• the child grasps only the nipple without the areola;
• insufficient milk, which creates significant negative pressure in the baby’s mouth and disrupts the integrity of the tissues;
• too much milk - overstretching of the nipple area occurs, which leads to tissue injury.

Types of cracks: superficial, deep and circular (located at the border of the nipple and areola). The formation of cracks occurs in three stages: catarrhal inflammatory process and maceration (soaking), crust and erosion. Prevention and treatment of cracks is main prevention inflammatory processes in mammary gland.

Important information! A nursing mother needs to promptly treat abrasions and cracked nipples and follow the rules for caring for the mammary glands.

What happens in the body of a woman suffering from purulent mastitis?

The process most often begins with stagnation in the mammary gland - lactostasis. This happens due to narrow milk ducts in first-time mothers, disruption of the integrity and functions of the gland tissue, etc. The infection enters the breast through microtraumas of the skin or through the openings of the milk ducts.

The penetration of infection is accompanied by curdling of milk in the milk ducts, their walls swell, their internal layers (epithelium) are damaged, and become permeable to infection. Inflammation, swelling and pain develop in the chest.

Symptoms and signs of the disease

Symptoms of inflammation must be distinguished from symptoms of lactostasis. With lactostasis, swelling occurs without redness of the skin and fever (there may be a slight low-grade fever), there is no pain, relief occurs after pumping.

When acute inflammation begins, a red spot appears on the skin of the chest, the size of which depends on the size of the forming infiltrate. The breasts become painful, pumping no longer brings relief. Sometimes it is impossible to express the breast from the first days of mastitis development due to severe pain. The transition of lactostasis to inflammation begins with severe fever and chills. The breasts become swollen and painful, and redness appears on the skin. Palpation reveals unclear areas of hardening.

For 2 – 3 days serous inflammation turns into infiltrative. Body temperature rises to maximum levels, health worsens, chest pain increases. A clear red spot appears on the skin, and an infiltrate can be felt under the skin.

On days 4–5 from the onset of the disease, the infiltrative process becomes purulent. The affected breast shows signs of liquid pus. In this case, the temperature is either constantly high, or takes on a hectic character (it rises sharply, then drops just as sharply). Nearby (axillary) lymph nodes become enlarged.

The gangrenous process is especially difficult. The chest swells sharply, the skin above it turns blue, becomes covered with blisters with brown liquid. Dying tissue is visible. Swelling takes over everything soft fabrics chest.

Important tip! At the first signs of mastitis, you should immediately consult a doctor.

Features of the course of purulent mastitis in the postpartum period and during breastfeeding

After childbirth, the disease begins approximately 5–7 days and is acute with a rapid transition from one phase to another. IN last years There is an increasingly frequent development of delayed forms of this process in the postpartum period. Such inflammation may not begin immediately, but at 3–4 weeks.

Treatment and help at home

Treatment should be started as early as possible. It is better when lactostasis has not yet turned into an inflammatory process. Prescribe rest to the mammary gland (an elevated position supported by special bandages or a bra), frequent feeding newborn expressing milk in the shower or using a breast pump. But it is believed that hand expression is more effective.

In the postpartum period, after each feeding, the nipples and areolas must be examined. When cracks and abrasions appear, the mammary gland is washed boiled water with soap, treat with alcohol and apply antiseptic ointment (Levomekol ointment is approved for use during pregnancy). This is a combination ointment that contains the antibiotic chloramphenicol and the immunostimulating and regeneration-accelerating agent methyluracil. To relieve inflammation, the nipple is lubricated with Vinilin, and Solcoseryl ointment is used to regenerate nipple tissue.

If the onset of serous or infiltrative inflammation is suspected, bed rest is prescribed, lying on the back or on the healthy side. Cold is applied to the mammary gland. This causes constriction blood vessels, reduces blood supply to the chest, inhibits metabolic processes it also contains milk secretion, relieves swelling and pain.

Cold is used for 1 – 2 days until body temperature normalizes. After this, physiotherapeutic procedures are carried out (Ural irradiation, UHF, etc.). A woman continues to breastfeed her newborn.

Treatment in hospital

If it starts purulent inflammation, the woman is hospitalized. Experts have different views on feeding a child with purulent mastitis, but most doctors believe that during the period of pus excretion with milk, it is better to stop feeding the newborn, but continue expressing milk.

Small abscesses are sometimes treated conservatively by puncturing the mammary gland under ultrasound guidance, pumping out the pus and rinsing the cavity with antibacterial solutions. At the same time, antibacterial therapy is prescribed.

The main method of treatment purulent processes is an operation. The abscess is opened and washed antiseptic solutions and then treated as open wound. Antibacterial therapy is required.