Understand that mastitis has begun. Why does the disease develop? Risk factors for mastitis are

The term "mastitis" comes from two words: mastos, meaning breast, and the ending -itis, meaning inflammation. Thus, mastitis is an inflammation of the breast.

In most cases, accounting for 80-85%, the disease develops in women after childbirth. It rarely occurs in non-breastfeeding women. In some cases, the infection affects pregnant women and newborns.

Causes and mechanisms of the development of the disease

In 9 out of 10 cases of mastitis, it is caused by Staphylococcus aureus. The pathogen enters the mammary gland through nipple cracks that occur in a nursing mother. In more rare cases, microbes penetrate first into the ducts of the gland, and then into its tissue when feeding a child or expressing milk (intracanalicular route). There are very rare cases when the infection is brought from other purulent foci through the blood or lymphatic vessels(hematogenous and lymphatic pathways).

Increases the risk of mastitis lactostasis - stagnation of milk, accompanied by engorgement of the mammary glands.

Lactational mastitis often affects women who do not have the skill of breastfeeding. It develops in about every twentieth puerperal, of which more than 77% are primiparous.

The infection can affect the glandular tissue itself, or the parenchyma, or spread mainly through the connective tissue layers, forming interstitial inflammation. In response to the entry of the pathogen into the gland, the body responds with a reaction aimed at its removal.

In the focus of penetration of microbes, blood vessels expand, blood flow increases. Brought with blood immune cells- lymphocytes. One group of lymphocytes directly captures and destroys microbial agents, while helping another subgroup "recognize" their antigens. Another group of lymphocytes, based on information about the antigenic structure, begins to produce antibodies. Antibodies attach to the surface of microbes, then such complexes are also destroyed. As a result of the decay of microbial cells and the lymphocytes themselves, pus is formed.

Increased blood flow to the gland causes its swelling and redness of the skin, its function is disturbed, pain occurs, and the temperature in the focus of the disease rises. With intense inflammation, the released active substances act on the entire body, including the thermoregulatory center in the brain, changing its settings. Appears general reaction in the form of fever and intoxication (poisoning).

The mammary gland has structural features. After childbirth, its function is significantly enhanced. During this period of a woman's life, physiological immunodeficiency is also noted. All these factors determine the difference between the course of mastitis and other acute infectious processes.

Lobular structure of the mammary gland, a large number of fat cells, the presence of cavities and ducts leads to poor limitation of the inflammatory process and its rapid spread. Serous and infiltrative forms quickly turn into purulent, which is prone to a protracted course and is often complicated by sepsis.

Classification

Types of mastitis are usually determined by the stage of its development, sometimes the nature of the disease comes to the fore (specific forms):

Spicy:

A) serous;

B) infiltrative;

B) purulent:

abscessing;
phlegmonous;
gangrenous.

Chronic:

A) purulent;

B) non-purulent.

Specific (rare forms):

A) tuberculosis;

B) syphilitic.

Symptoms of mastitis

Symptoms of mastitis in lactating women usually develop in the second or third week after childbirth. In most patients, acute stagnation of milk first occurs, which has not yet been complicated by microbes entering the gland. This condition is manifested by a feeling of heaviness in the mammary gland, tension in it. In individual lobules, small seals can be felt. They have clear boundaries, are quite mobile and painless. Externally, the skin is not changed, common manifestations No. However, various microorganisms, including staphylococci, accumulate in the ducts of the gland during lactostasis. It is necessary to cure lactostasis within 2-3 days. Otherwise, it will turn into mastitis.

If pyogenic microorganisms penetrate into the tissue of the gland, after 3-4 days it develops serous mastitis. It begins with an increase in body temperature to 38-39 ° C, accompanied by chills. The general condition of the woman worsens, weakness, sweating appear, headache. The pain in the mammary gland gradually increases, becoming very strong, especially during feeding or pumping. The gland itself is enlarged, the skin over it turns a little red. When probing, small painful seals are determined. Signs of inflammation are determined in the blood: leukocytosis, an increase in the erythrocyte sedimentation rate up to 30 mm/h.

If treatment is delayed, infiltrative mastitis develops after 2-3 days. Manifestations of general intoxication intensify - fever with chills, pouring sweat persists. A woman complains of severe weakness and weakness, severe headache. In the mammary gland, on palpation, an infiltrate is determined - the painful area is more thick fabric, which does not have strictly defined boundaries. It can be located around the nipples (subareolar), deep in the tissue (intramammary), under the skin (subcutaneous), or between the gland and the chest (retromammary).

At the same time, enlarged painful axillary lymph nodes can be detected, which become a barrier to the spread of microorganisms through the lymphatic tract.

This stage of the disease lasts from 5 to 10 days. After that, the infiltrate can resolve on its own, but more often it suppurates.

Purulent mastitis

Purulent mastitis occurs with high fever (39 ° C or more). Sleep is disturbed, appetite is lost. Increased local symptoms of the disease. In one of the sections of the gland, fluctuation appears, or softening - a sign of the appearance of pus in the focus. Depending on the degree of damage to the mammary gland, several forms of the disease are distinguished.

With phlegmonous mastitis, the body temperature reaches 40 ° C. The mammary gland significantly increases in size, the skin above it is shiny, reddened, swollen. There is enlargement and pain axillary lymph nodes.

With the gangrenous form, the patient's condition is very serious. High fever is combined with an increase in heart rate up to 120 per minute and above, a decrease in blood pressure. There may be acute vascular insufficiency- collapse. The skin over the enlarged mammary gland is edematous, blisters and areas of dead tissue appear on it - necrosis. In the blood, pronounced leukocytosis, an increase in the erythrocyte sedimentation rate, a shift leukocyte formula to the left, toxic granularity of leukocytes. Protein appears in the urine.

There is subclinical purulent mastitis, in which the symptoms are not pronounced. Erased signs of mastitis are also determined in its chronic course.

Acute mastitis can cause severe consequences:

lymphangitis and lymphadenitis (inflammation of the vessels and lymph nodes draining lymph);
milk fistula (more often after spontaneous opening of the abscess, less often after surgical treatment, it can close on its own, but for a long time);
sepsis (penetration of microbes into the blood with damage to various internal organs).

Separate forms of mastitis

Some types of inflammation of the mammary glands have features. These forms are less common, so they are worse diagnosed.

Non-lactation mastitis

Causes of breast inflammation outside of feeding are associated with general changes in organism:

hormonal changes during puberty or;
immunodeficiency states, diabetes, chronic infections, malignant tumors;
iatrogenic mastitis - after operations on the mammary glands, for example, for cosmetic purposes.

At non-lactational mastitis usually determined by moderate soreness and swelling of the mammary gland, an increase in axillary lymph nodes. If the process turns into a purulent form, the body temperature rises, pain intensifies, and the general condition worsens. The formed abscess can open onto the surface of the skin or into the lumen of the gland channel, forming a long-term non-healing fistula.

Treatment is not lactational mastitis based on the same principles as mastitis in nursing mothers.

Mastitis of the newborn

During the neonatal period, a child has a sexual crisis - a condition accompanied by engorgement of the mammary glands. If at this time the causative agent of the disease enters the tissue of the gland, it will cause inflammation. Most often, staphylococcus enters the mammary gland of a child. by contact, especially if he has purulent process on the skin (pyoderma) and mechanical irritation of the glands.

At the beginning of the disease, a unilateral enlargement of the mammary gland occurs. The skin above it is not changed at first, and then it turns red, soreness appears. Soon hyperemia (redness) of the skin becomes pronounced. If the gland tissue undergoes purulent fusion, fluctuation is determined. The child does not eat well, worries, constantly cries, his body temperature rises. Often, the purulent process spreads to the chest wall with the formation of its phlegmon.

Treatment of the disease is carried out in a hospital. Antibiotics, detoxification therapy are prescribed. For infiltration apply local methods and physiotherapy. The formation of abscesses is an indication for surgical treatment.

With timely treatment, the prognosis of mastitis in newborns is favorable. If a large part of the gland in a girl collapses, then in the future this may create problems for her with breast formation and lactation.

Prevention of this condition lies in the careful care of the skin of the child. During a sexual crisis, it is necessary to protect his mammary glands from mechanical irritation with clothing. With significant engorgement, you can cover them with a sterile dry cloth.

Diagnostics

If the signs of inflammation are pronounced, the diagnosis of mastitis does not cause any particular difficulties. The patient's complaints are assessed, she is asked about the duration of the disease and the connection with the feeding of the child, the concomitant pathology is clarified, and the mammary glands are examined and palpated.

In blood tests, an increase in the number of leukocytes and an erythrocyte sedimentation rate is determined. In severe cases, anemia develops, protein appears in the urine.

Important information can be given bacteriological examination milk, and with the development of sepsis - blood.

To evaluate the process in dynamics, ultrasound examination of the mammary glands is often used.

However, there are also diagnostic difficulties. If the patient does not have fluctuation and reddening of the skin, then she often has unrecognized purulent mastitis, and she is treated conservatively. In many cases, this is caused by self-medication with antibiotics, when the patient "lubricates" them clinical picture, and the doctor sees the already changed course of the disease.

The erased form of the disease is characterized by normal or slightly elevated temperature no body, swelling and redness of the skin. However, the gland remains painful for a long time, and when it is probed, an infiltrate is determined. In this case, a puncture of a purulent focus can help in the diagnosis, especially with an abscessed form.

Treatment

What to do with mastitis?

It is urgent to contact the surgeon at the place of residence. Therapy should be started as early as possible, until the purulent form of the disease has developed.

Is it possible to feed with mastitis?

In mild cases, feeding the baby can be continued. With purulent mastitis, breastfeeding should be stopped, because at the same time, both microbes and antibiotics and other drugs can enter the baby's body.

How to treat mastitis?

For this purpose, conservative and surgical methods are used.

If the patient is in a satisfactory condition, the temperature is not higher than 37.5 ° C, the duration of the disease is less than 3 days, the infiltrate is only in one quadrant of the gland and there are no local signs of inflammation (edema, hyperemia), conservative therapy is prescribed. If it does not bring effect within two to three days, an operation is necessary.

The therapy is carried out in a hospital. Treatment of mastitis at home is possible in exceptional cases only with mild forms of the disease. The treatment regimen includes the following areas:

Expression of milk every 3 hours, first from a healthy gland, then from a sick one.
The introduction of no-shpa intramuscularly three times a day for three days for half an hour before the next decantation.
Retromammary novocaine blockade with the addition of antibiotics daily.
Antibiotic treatment a wide range intramuscular action (penicillins, aminoglycosides, cephalosporins).
Desensitizing therapy, vitamins B and C.
Semi-alcohol compresses on the gland once a day.
Ointment "Traumeel S", removing signs of local inflammation.
When the condition improves in a day, UHF or ultrasonic physiotherapy is prescribed.

It should be especially noted that cold or warming agents (including the popular folk remedy - camphor oil) should not be used for conservative treatment acute mastitis. These methods can mask the course of a purulent process or, on the contrary, cause it to spread rapidly.

With a high body temperature and the presence of an infiltrate in the gland tissue, surgical intervention is required. With severe lactostasis, which is also accompanied by similar symptoms, you must first free the gland from milk. For this, a retromammary novocaine blockade, No-shpu and Oxytocin are injected, then the woman expresses milk. If fever and infiltration were caused by lactostasis, after pumping, the pain disappears, the infiltrate is not determined, the body temperature decreases. With purulent mastitis, after complete decantation, the tissues of the gland remain painful induration, the fever persists, the state of health does not improve. In this case, surgical intervention is prescribed.

Operation for mastitis

The operation is carried out under general anesthesia. When choosing access to the hearth, its location and depth are taken into account. When the abscess is located subareolarly or in the center of the gland, a semi-oval incision is made along the edge of the areola. In other cases, external-lateral incisions are performed or they are carried out along the fold under the mammary gland. Radial incisions are not currently used, since they leave rough scars that are poorly hidden under linen.

After making an incision, the surgeon removes all purulent-necrotic tissue of the gland. The resulting cavity is washed with antiseptics, a drainage-washing system is installed to drain the fluid and wash the wound with antibiotics and antiseptics after the operation. The wound is closed with a primary suture. This allows the formation of a closed cavity, which is gradually filled with granulations. As a result, the volume and shape of the breast is preserved.

In some cases, it is impossible to perform such an operation, for example, with anaerobic microflora or a large skin defect.

Immediately after the operation, the cavity is washed with a solution of chlorhexidine in a volume of 2-2.5 liters per day. Washing is stopped approximately on the fifth day, provided that inflammation is relieved, there is no pus in the cavity, and its volume is reduced. The sutures are removed 8-9 days after the operation.

In the postoperative period, conservative therapy is carried out, which includes antibiotics, desensitizing drugs, vitamins.

Prevention

For a woman after childbirth, the prevention of mastitis is very important. Following some simple doctor's recommendations will help to avoid stagnation of milk and the development of inflammation.

A woman should know the rules of breastfeeding:

apply the baby alternately to each mammary gland, changing the breast during the next feeding;
before feeding, wash your hands, it is advisable to wash the areola;
feed the child for no longer than 20 minutes, preventing him from falling asleep;
Express milk leftovers after feeding.

It is necessary to prevent the appearance of cracked nipples:

wash the areola and nipples with warm, then cool water without soap;
periodically rub the nipples with a towel;
Change your bra and panty liners regularly.

With the appearance of lactostasis, the following tips will help:

before feeding, make a warm compress or breast massage;
feed a child from a diseased breast twice as often as from a healthy one;
do cold compresses on the chest after feeding;
drink more fluids;
See your doctor for advice on breastfeeding.

If within two days it is not possible to cope with the phenomena of lactostasis, it is necessary urgent appeal see a doctor, as the likelihood of developing mastitis is high.

Mastitis (breast) is an infectious and inflammatory disease that occurs in the mammary glands. Lesions spread rapidly, capturing healthy tissue. Illness, left to chance, leads to dangerous complications. Against its background, sepsis, abscess, phlegmon and gangrene develop. If mastitis occurs, home treatment is carried out with medication and folk remedies.

The breasts usually become inflamed postpartum period. This happens due to increased milk production. Breastfeeding women develop lactational mastitis. The disease manifests itself in 2 forms:

unilateral (more common);
bilateral.

There is non-lactational mastitis - a pathology not associated with milk production and breastfeeding. The symptoms of this form of the disease are blurred. Inflammation is localized, it does not capture neighboring tissues. Such breasts often take a chronic form. Sometimes it occurs in newborn girls. Hormones received from the mother in excess lead to the disease.

By the nature of the flow, mastitis is distinguished:

spicy;
chronic;
serous;
purulent.

Causes

Factors causing mastitis, a bunch of. The most common cause of lactation is Staphylococcus aureus.. After contact with harmful bacteria on the skin, the appearance of pathology is provoked by such reasons as:

mastopathy;
postoperative scarring;
peculiarities anatomical structure body;
severe pregnancy;
complicated childbirth;
chronic diseases;
disturbed sleep;
postpartum depression.

Most often, inflammation of the mammary glands occurs in women who have given birth to their first child. They lack the skills breastfeeding and expressing milk. Stagnation in the breasts leads to the development of the inflammatory process.

Non-lactational breast appears with a weakened immune system. Her reasons are:

hypothermia;
aggravated infections;
associated pathologies;
neuropsychic and physical overload;
silicone implants;
breast trauma.

The provoking factor in this case is bacterial infection. The causative agent is the same as in lactation breasts - staphylococcus aureus.

Symptoms

The initial stage of the postpartum and non-lactation form is serous mastitis, which is often confused with milk stasis. Both pathological conditions accompanied by:

heaviness in the mammary glands;
uncomfortable sensations;
minor tissue thickening.

But with lactostasis, the duration of which is only 1-2 days, the temperature does not rise, milk oozes easily from the nipple. With mastitis, the seals grow, the temperature is elevated. Serous exudate accumulates in the lesions.

In the future, the disease passes into the infiltrative stage. In the inflamed area, a seal is formed without clear boundaries. The breasts swell, hurt, the temperature rises. The skin does not change.

In neglected states, a destructive chest develops - dangerous pathology. If purulent mastitis occurs, the woman suffers from the following symptoms:

intoxication;
heat, jumping up to 40 degrees;
loss of appetite;
disturbed sleep;
headache.

With purulent mastitis, the skin turns red, the lymph nodes in the armpit increase. The disease can turn into an abscess, phlegmon, gangrene.

Drug therapy

For the treatment of simple forms of breast use methods of conservative therapy. Carry out the treatment of serous mastitis as follows:

Non-lactational mastitis is able to spontaneously disappear. If the disease does not go away, drug therapy is carried out.

Treatment at home

Treatment for breast cancer is started after consulting a doctor. When breastfeeding, most medicines are forbidden to use. Therefore, mastitis is treated with folk remedies, for the preparation of which honey, plants, camphor are used.

cabbage leaves

Cabbage effectively fights breasts. The leaves of the plant are used for applications. Make compresses like this:

Cabbage fights edema, inflammation, resolves seals.

Oils

For the treatment of mastitis at home, camphor and castor oil are used. They make applications.

Camphor oil with mastitis helps relieve pain, eliminate inflammatory process. Thanks to it, seals are reduced.

Castor oil quickly relieves exacerbation. Rubbing it into the chest, apply a film and a warm bandage.

For older patients, peppermint oil helps to get rid of mastitis. The tool stimulates blood circulation, fights puffiness. 3-5 drops of mint ether are added to 1 tablespoon of vegetable oil. The mixture is rubbed into the chest at night.

With mastitis, applications with honey are made:

Salt applications

Women should know how mastitis is treated with saline compresses. This is an affordable remedy for getting rid of the disease at home. Salt applications are effective for mild and neglected forms of breasts. Salt draws out exudate, relieves swelling, inflammation, improves blood circulation.

Cooking method saline compress simple: water is heated to 50 degrees, 1 tablespoon of salt is dissolved in it. In a cotton napkin, cuts are made for the nipples (they will avoid irritation of the epithelium in this area), the fabric is impregnated with a solution, applied to the chest, covered with polyethylene, and fixed with a warming bandage. Remove the application after cooling.

Applications for purulent breasts

The following methods help to cure purulent mastitis:

herbal extracts

Carrying out the treatment of mastitis at home, compresses alternate with lotions from plant extracts. At the same time, they drink herbal teas and decoctions of herbs. Prepare them using the following recipes:

Compresses are warming procedures. Doctors note that thermal applications can aggravate the disease, so they are forbidden to use during exacerbation and temperature. To avoid undesirable consequences, use the funds recommended by the doctor. In severe forms of the breast, alternative methods are ineffective, and the disease is treated surgically.

Update: December 2018

Mastitis is an inflammatory process in the area of the parenchyma and in the zone of lactating breast tissue. The disease develops only in 2 - 5% of lactating women. Despite the fact that acute mastitis can occur in women at any time, it often occurs 2 to 3 weeks after birth (82-87% of cases), but may be later.

This is explained by the anatomical and physiological changes that occur in the breast at the beginning of the secretion of colostrum and milk. In 90-92% of patients, only one mammary gland is affected, and the left-sided one is more often than right-sided mastitis (right-sided right hand easier to express, so left breast empties better than the right one).

The main condition for the development of mastitis is congestion in the chest (see), which can either be accompanied by an infection (often hospital), or not - non-infectious mastitis.

Primiparous women are at risk for mastitis because they:

there is a physiological imperfection of the ducts of the mammary glands
underdeveloped glandular tissue that produces milk
underdeveloped nipple
besides, there is no experience
No ().

About the lactation period

The shape, size and position of the breasts are very individual, vary widely within the normal range and depend on:

age
phases of the menstrual cycle
general physique
lifestyle
the state of the female reproductive system.

Anatomy of the mammary glands

The breast of a woman has a lobed structure, large lobes are separated by intervals of connective tissue into 20-40 segments, each of which consists of alveoli. The alveolus itself is lined with a single layer of epithelium. glandular type with the excretory duct, which are interconnected into large ducts in which breast milk accumulates. Shared ducts, merging with each other, excretory ducts open at the tip of the nipple.

In the region of the border of the halos, the ducts have extensions called the lactiferous sinuses. Around glandular structures, the breast space is filled with adipose tissue, which determines its size and shape, along with the development of the glandular lobules themselves. A woman's breast is surrounded by a whole complex of lymph nodes, so when the breast becomes inflamed, they increase in size and are painful. The lymph nodes into which lymph flows from the mammary gland:

axillary (97% outflow)
supraclavicular
subclavian
peristernal
mediastinal and bronchopulmonary

What happens to the breast during pregnancy and immediately after the birth of the baby

Synthesis and release of breast milk for feeding the baby starting from the second trimester of pregnancy, when the production of colostrum is gradually activated.

Colostrum - more like whey than regular milk, with great content proteins and fats, is secreted up to the first approximately 2-3 days from the moment of the birth of the child, and then is replaced by transitional and mature milk.
Maximum amount of milk matures by 6 - 12 days of the postpartum period.
Stabilization period- when the formation of the optimal amount of milk allocated for the nutrition of the child occurs, this period lasts for the first 3-6 months of breastfeeding.
Average duration of lactation ranges from 5 to 24 months.

Why does mastitis occur?

causative agents of mastitis

There are 3 main causative agents of lactational mastitis, first of all:

70% of lactating women with mastitis have Staphylococcus aureus
staphylococcus albus
streptococcus

As a rule, these infectious agents are resistant to penicillins. Rarely sown β-hemolytic streptococcus, fecal enterococcus, coli, Klebsiella pneumonia, up to 1% Mycobacterium tuberculosis. Most often, anaerobes are detected, which are mainly represented by staphylococci. Also, epidermal staphylococcus aureus can be sown in the crops, but it is not pathogenic, it enters the milk from the nipples that were not processed before the sowing, and does not cause any purulent process in the chest.

infection

Infection can be both community-acquired and nosocomial - it occurs by contact with infected linen, care items, etc. Prognosis with nosocomial infection will be more severe than community-acquired infection.

Adult carriers- with classic mastitis after childbirth, the source of infection can be latent bacteria carriers (more often from medical personnel, roommates, their relatives), who become ill with mild, erased manifestations of purulent or infectious inflammatory pathologies. It is believed that 20-30% of people are carriers Staphylococcus aureus.

A newborn - a baby can also become a source of infection, which can be a carrier of bacilli, and a patient with inflammatory diseases of the nasopharynx, oral cavity, pharynx or pyoderma (pustular skin disease).

One hit of Staphylococcus aureus on the skin of the chest is not enough for the occurrence of mastitis, for its development, the presence of provoking factors is necessary:

Local anatomical factors provoking mastitis:

nipple defects - lobed nipple, inverted flat nipple, etc.
mastopathy
rough scars after surgical interventions ( severe forms mastitis in the past, removal benign neoplasms etc.).

Systemic functional factors:

abnormal course of pregnancy- late toxicosis, threats of abortion, premature birth
pathology of childbirth - blood loss during childbirth, trauma birth canal, manual separation placenta, first birth with a large fetus
postpartum complications- bleeding, postpartum fever, exacerbation of concomitant diseases.

Decreased tissue resistance to the pathogenic influence of microorganisms against the background of a decrease in the work of local and general immunity after childbirth, hypovitaminosis, comorbidities, pathologies of childbirth and pregnancy - create favorable conditions for the development of mastitis.

The mechanism of occurrence of mastitis

milk stasis

When milk stagnates, it contains a small amount of bacteria that accumulate in the ducts of the gland. Over time, milk coagulates and undergoes fermentation processes, which provokes the destruction of epithelial cells lining the milk ducts and alveoli.

Curdled milk, together with particles of desquamated epithelium, blocks the milk passages, causing lactostasis. When stagnant, bacteria multiply rapidly and cause infectious inflammation. An increase in pressure in the chest disrupts the processes of blood circulation - venous congestion. Edema contributes to a decrease in the overall reactivity of the tissue, which creates excellent conditions for bacterial growth.

Inflammation leads to significant soreness of the breast, which naturally complicates the expression of milk, creating a vicious circle: lactostasis increases inflammation, inflammation exacerbates lactostasis.

Cracked nipples

The infection, as a rule, penetrates through cracks in the nipples, infection is possible during the expression of milk or breastfeeding, less often the infection spreads through the blood and lymph. In 25 - 31% of cases of all mastitis, nipple cracks are also recorded at the same time, which makes it possible to trace the relationship. And although cracks in the nipples are found in 23 - 65% of all lactating women, when mastitis develops only in 3 - 6%, nevertheless, the prevention of the occurrence of cracks serves as a simultaneous prevention of the development of mastitis.

The main reason for the development of nipple cracks is improper attachment of the child - incomplete grasping of the breast by the child. Wrong care behind the breast can also contribute to the aggravation of cracks (see).

Often, it is the occurrence of cracks in the nipples, forced pumping (and not thorough emptying of the breast at the same time) that causes lactostasis and, as a result, mastitis.

Diagnostics

If symptoms of mastitis occur, a nursing woman should contact a gynecologist, mammologist or surgeon. After examining the breast and evaluating the patient's complaints, the doctor may refer to the following tests:

urinalysis and complete blood count
bacteriological (number of bacteria in 1 ml) and cytological (number of leukocytes) examination of milk from both glands
except clinical symptoms, in diagnostics initial forms mastitis will be significant laboratory research the secret of the female breast. Normally, it has a slightly acidic reaction (pH - 6.8). Inflammation provokes a change in the acidity of milk towards an increase in pH, which can be explained by an increase in the activity of alkaline phosphatase.

To diagnose erased forms of lactational mastitis, use:

ultrasound (with destructive forms mastitis) to determine the exact localization of the purulent area
thermal imaging, thermography
in rare cases, mammography is used for serious indications
puncture of the infiltrate (with phlegmonous and abscessing forms) followed by bacteriological examination of pus.

Mastitis classification

Depending on the clinical signs, the number of leukocytes and bacteria in the analysis of breast milk, there are:

lactostasis
non-infectious mastitis
infectious mastitis

Using only the clinical signs and symptoms of mastitis, it is impossible to determine the absence or presence of infection. In the absence of effective evacuation of breast milk, non-infectious mastitis will develop into infectious mastitis, and this, in turn, can lead to the formation of an abscess. IN clinical practice The following classification of mastitis is applied:

According to the course of the inflammatory process: acute (registered in 85 - 87% of cases in the postpartum period) chronic	By functional state: lactational (of greatest interest to clinicians) non-lactational	According to the location and depth of the lesion: surface deep
According to the nature of inflammation: serous, infiltration (most often recorded in nulliparous women (80%) in age group 17 - 30 years old) purulent (in turn, it has an extensive classification that directly reflects the degree of spread of infection and changes in the chest) gangrenous		According to the prevalence of the process: limited diffuse

In addition, some breast diseases cause similar signs, as the symptoms of mastitis in nursing, so it must be distinguished from:

boils, carbuncles
abscesses, phlegmon
erysipelas, which are combined into one concept - paramastitis
in chronic mastitis, differential diagnosis with (biopsy of suspicious material and its histological examination).

Symptoms

What is the difference between breast engorgement and full chest? When the breast swells, both lymphatic and venous drainage is difficult, pressure in the milk ducts increases, both breasts swell and swell. A similar picture is with a breast filled with milk, but there are differences:

full of milk breast- hard to the touch, heavy, warm, but no swelling or redness, and no visible shiny surface, milk spontaneously leaks from the nipple, the baby is easy to suck and milk flows easily.
engorged chest Painful, enlarged, swollen, looks swollen and may be shiny, with blurry areas of reddened skin, the nipple sometimes stretches to a flat state, the child has difficulty attaching to the breast and also sucking, since milk does not flow easily from the breast.

Serous form of mastitis, unlike milk stagnation

Acute inflammation must be distinguished from simple stagnation of milk, the causes of which may be: abnormal structure of the nipple, short frenulum in a child, improper attachment, underdevelopment of the milk ducts in nulliparous, untimely pumping, intensive milk production.

	lactostasis	SEROUS MASTITIS
State start	Acute lactostasis is a bilateral process, and most often develops between 3-5 days after birth, i.e. in the days of the rush of milk.	Stagnation of milk when pyogenic microflora is added for 2-4 days, and sometimes days, turns into a serous form of mastitis. It usually starts abruptly: with the onset of chills temperature increase general weakness, apathy acute pain in the chest
Condition of the gland, skin	With stagnation, the tumor-like formation corresponds to the contours of the lobules of the mammary gland, mobile, with clear boundaries and a bumpy surface, and most importantly, painless and without redness.	Due to the presence of an infiltrate, the breast increases in size, palpation becomes sharply painful, and the infiltrate itself is not clearly defined.
Pumping	When pressed, milk is released freely - pumping is painless and after it relief is always felt.	Pumping is extremely painful and does not bring relief.
General state	The general condition of a woman with acute stagnation worsened slightly. Body temperature, lab tests blood and milk - within normal limits. With milk stasis, two main clinical sign inflammation: redness and fever.	Persistent subfibrillation 37-38C or in an acute process immediately 38-39C. A clinical blood test shows signs of inflammation - an increase in the number of leukocytes, an increase in ESR.

With non-infectious mastitis at an early stage, spontaneous recovery is possible - the seal resolves, the pain subsides, the temperature returns to normal. With an infectious, as a rule, without treatment, the process passes into an infiltrative phase. Doctors advise any severe engorgement of the mammary glands with an increase in body temperature to be considered the initial stage of mastitis in order to start diagnosis and adequate treatment in a timely manner.

There are cases when banal lactostasis occurs with severe soreness of the breast and a violation of the general condition of the woman, then after careful decantation of milk after 3-4 hours, the infiltrate is re-palpated and examined:

With lactostasis, the temperature decreases, the pain subsides and the condition returns to normal.
With a combination of mastitis and lactostasis after 3-4 hours, the painful infiltrate is palpable, the condition does not improve, the temperature remains high.

Infiltrative stage

In the absence of adequate treatment, after 2-6 days, the process can move into an infiltrative phase, which is characterized by a greater severity of clinical symptoms, and a worsening of the woman's condition.

An infiltrate without clear contours forms in the affected breast.
The affected breast increases, the skin over the infiltrate does not turn red yet and there is no edema yet, an extremely painful affected gland.
In 80% of patients, body temperature rises to 38.0 - 41.0, with treatment it can be reduced to 37-37.5C.
Signs of intoxication: weakness, headache, lack of appetite.

In the absence of therapy, the infiltrative form of the disease after 4-5 days passes into a destructive stage, serous inflammation becomes purulent and breast tissue resembles a honeycomb with pus or a sponge soaked in pus.

Destructive - purulent and gangrenous mastitis

An increase in general and local symptoms of inflammation will indicate the transition of the initial forms of mastitis to purulent stage, while signs of purulent intoxication are well expressed, since toxins come from the focus of inflammation into the blood:

Body temperature is constantly kept at high numbers, temperature drops of several degrees during the day are characteristic. The temperature of the mammary gland itself also rises.
Intoxication: appetite decreases, headache, weakness appear, sleep worsens.
The chest is tense, enlarged, the infiltrate itself increases in size, has clear contours, the skin of the chest turns red, and every day this is more and more pronounced.
In one of the areas of the gland, symptoms of fluctuation appear (movement of fluid / pus).
In some cases, there is an attachment of regional lymphadenitis (an increase in the nearest lymph nodes).
Abscesses can form on the surface or in the deep sections of the gland with subsequent spread.

Distinguish the following forms destructive mastitis:

Abscessing - with the formation of cavities of abscesses (cavities filled with pus), while softening and a symptom of fluctuations are felt in the infiltrate zone (overflowing fluid when palpated).
Phlegmonous - significant swelling of the breast and its massive increase, sharply painful, the skin is bright red, perhaps even bluish-red, there is often a retraction of the nipple. The woman's hemoglobin is reduced and the urinalysis worsens.
Infiltrative-abscessing- the presence of a dense infiltrate, which includes small abscesses of various sizes. It flows harder than abscessing. The fluctuation symptom is rare due to the fact that the abscesses do not large sizes and compaction may appear uniform.
Gangrenous - an extremely serious condition of a woman, characterized by a fever of 40 - 41º, an increase in heart rate to 120 - 130 beats / min, the breast increases sharply in volume, skin edema is noted, blisters with hemorrhagic contents are determined on its surface, areas of necrosis are determined. Gradually, the edema spreads to the surrounding tissues.

Should you continue or stop breastfeeding if you have mastitis?

As for the preservation of breastfeeding with mastitis, a few decades ago, the recommendations of pediatricians and gynecologists were categorical: interrupt breastfeeding for the period of treatment of mastitis.

Today, the situation has turned 180 degrees and without exception, all breastfeeding specialists demand to breastfeed babies, no matter what. It seems that the truth, as usual, is still closer to the middle, or at least should be based on a set of arguments for and against. It is worth making a distinction between feeding the baby with this milk and maintaining lactation as such:

Preservation of lactation

Lactation should be maintained whenever possible, since a regular outflow of milk is very important, according to some reports, only in 4% of cases, acute mastitis progresses to an abscess or purulent mastitis while maintaining lactation and feeding the child.

Breastfeeding a baby with mastitis

As for breastfeeding the baby, it is worth weighing the risks and benefits for the baby of not breastfeeding against the impact of the mother's treatment. In every clinical case the issue is resolved individually:

For non-infectious mastitis, which is not so different from lactostasis, breastfeeding cannot be stopped. Of course, in conjunction with rational pumping (not to the last drop, but if necessary to avoid hyperlactation), mild therapeutic massage and anti-inflammatory therapy (Ibuprofen, Traumeel, ultrasound).
If we are talking about the infectious process. Here it is necessary to proceed from how pronounced the general condition of the mother suffers (it is difficult to feed with a temperature of 40, wild pains and axillary lymphadenitis).

The second moment becomes purulent discharge from the nipples. Breastfeeding instructors stubbornly prove that pus is just dead bacteria and white blood cells and it is not contraindicated to feed a child with it. But let us object, why is purulent discharge still sown in bacteriological laboratories, getting a good bacterial growth and determining the sensitivity of pathogens to antibiotics? Purulent discharge from the nipples should:

or pump very thoroughly before feeding
or become an obstacle to the continuation of breastfeeding for the period of treatment of purulent mastitis.

It is also possible to maintain lactation during the treatment period with the help of regular pumping until the problem is resolved, but during this period to feed the child and then treat for intestinal disorders against the background of staphylococci obtained during feeding, as well as from the effect of antibiotic therapy - this is extremely unfavorable for the baby, for a long time and costly.

Almost all antibacterial drugs administered to a nursing woman enter breast milk and into the body of a child, having an adverse effect - toxic and allergic reactions, suffer normal microflora GIT.

Depending on the different pharmaceutical groups, some antibiotics easily pass into milk and create high concentrations. active substances, others pass in small quantities, which does not pose a real threat to the baby and therefore are approved for use during breastfeeding.

Conservative treatment

Depending on the condition of the patient, treatment can be carried out both in a hospital and on an outpatient basis. At the initial stages, complex conservative therapy is carried out, when:

the disease lasts no more than 3 days
the general condition of the woman is relatively satisfactory
No obvious symptoms purulent inflammation
temperature less than 37.5 C
moderate breast tenderness
general blood test is normal.

Since lactostasis is the main cause and aggravating factor, it is important to effectively empty the mammary glands, so milk should be expressed every 3 hours, first with healthy breast, then with the affected one. Mastitis treatment:

Regular feeding or pumping to resolve lactostasis in combination with massage.
Broad-spectrum antibiotics for infectious mastitis
Symptomatic therapy - non-steroidal anti-inflammatory drugs (), antispasmodics ()
Traumeel gel for non-infectious mastitis.

A day later, with positive dynamics, physiotherapy is prescribed - UHF therapy, ultrasound, they promote resorption inflammatory infiltrate and normalizes the functions of the mammary gland. Home treatment involves examining a woman every 24 to 48 hours, in the absence of positive dynamics and response to antibiotic therapy, the woman should be hospitalized.

Antibiotics to treat mastitis

Once lactational mastitis is diagnosed:

the woman has a high temperature, severe general condition
there are cracked nipples and signs of mastitis
the condition does not improve a day after the normalization of the outflow of milk.

antibiotic treatment should be started to ensure optimal results. Even the slightest delay in prescribing therapy will increase the likelihood of abscess formation. The duration of the course of treatment is determined on an individual basis, the average course is 7 days. Groups of antibiotics:

Penicillins

Penetrate into the milk of a woman in limited quantities. The concentration of benzylpenicillins in milk, compared with the concentration in serum, is ten times less. The same rule is typical for semi-synthetic penicillins. In inflammatory processes, the transition of these components into milk is reduced. Relatively low degree diffusion into milk is characteristic of broad-spectrum penicillins. The index for penicillins is significantly less than 1.

Cephalosporins

Data suggest limited passage into milk. The maximum concentration at healthy women, an hour after administration is 2.6% of the maximum concentration in blood serum. With inflammation, there is an increase in the passage of the antibiotic into breast milk. There are data on poor excretion second and third generation cephalosporins in breast milk. Despite the fact that the index is also less than one, but its value exceeds that of penicillins.

Macrolides

Penetrate into relatively high concentrations reaching an average of 50% of the serum level. But at the same time, it is not noted negative influence on the penetration of macrolides into the child's body.

Aminoglycosides

Most of the representatives do not penetrate well into breast milk, and in low concentrations. But still, no official studies have been conducted, since the drugs are prohibited during pregnancy and lactation due to nephrotoxicity. Concentration in breast milk is 30% of the concentration in the blood, but it is possible to affect the intestinal microflora of newborns.

Fluoroquinolones

All representatives of this pharmaceutical group pass into breast milk, but strictly controlled studies have not been conducted. The use of drugs in this group during pregnancy and breastfeeding is not recommended, due to the high risk of toxicity.

Drugs of choice without stopping breastfeeding: amoxicillin, augmentin (amoxiclav with caution if the benefit to the mother predominates over the harm to the baby), from cephalosporins - cephalexin. Inadmissible when feeding a child: sulfonamides, lincosamines, tetracyclines, fluoroquinolones.

Is it possible to make compresses for mastitis, use ointments?

When the first signs of lactostasis or mastitis appear, you should consult a doctor, establish a diagnosis, determine the stage of the disease and discuss treatment options.

Noninfectious mastitis- warming compresses can only be used for lactostasis and non-infectious mastitis in complex treatment. It is possible to use half-alcohol dressings on the affected area at night, cabbage leaves with honey, burdock leaves, etc. After the compress, the chest is rinsed with warm water. You can also use homeopathic Traumeel gel.

With purulent mastitis warm compresses and the use of ointments may exacerbate the course of the disease and are therefore not recommended.

Surgery

Often, despite active implementation conservative treatment antimicrobials, there may be a transition to purulent or destructive stages of about 4-10% of developing mastitis. Such complications require immediate and active surgical treatment, which will be carried out only during hospitalization.

The abscess zone is opened to remove pus from the tissues and the wound is actively washed with antiseptics, followed by drainage. The procedure is performed under general anesthesia. Also as additional research, in order to conduct a differential diagnosis, a small fragment of the walls in the abscess area is sent for histological examination, because process can be combined with a malignant neoplasm.

Prevention

Seeing a doctor earlier at the slightest suspicion minimizes the risk of developing purulent mastitis. During the postpartum period, breastfeeding women should be carefully monitored to early diagnosis lactostasis and mastitis. Basic prevention:

Use only comfortable nursing underwear
Better to breastfeed on demand
If hyperlactation occurs, express a little milk before feeding
Attach the baby correctly, monitor the correct grip of the breast by the baby
Don't shorten your feeding time
Better to sleep on your side or back
Feed at night, avoid big night breaks
Do not overcool the chest and protect it from injury
Prevent the occurrence of cracked nipples and treat them in a timely manner.

IN without fail it is necessary to observe the sanitary and hygienic regime. Timely identify and sanitize foci of infection in the mother's body (carious teeth, tonsils, sinuses).

We welcome our regular readers and newcomers who have looked at our site in search of an answer to the burning question: what is mastitis and how to treat it. The main topic of today's article is the treatment of mastitis at home. We will also touch on the types of this disease, the factors contributing to its development and standard therapy.

This is easy to judge by the name of the disease alone, it speaks of an inflammatory process affecting the mammary gland. In the history of medicine, this disease is called - infants, which is also very significant. Think breastfeeding is only for breastfeeding mothers? It turns out that this is not so. This disease can be:

In newborns, regardless of gender. A baby at the age of a newborn is associated with the ingestion of mother's lactogenic hormones into the baby's blood. In this case, the baby's nipple becomes rough and slight discharge of a translucent liquid may be observed. With mild symptoms, treatment is not required.
Girls and women of all ages. Usually proceeds sharply.
In men, because they also have a mammary gland, although it is greatly reduced. And its tissues may well become inflamed under adverse conditions.

Mastitis can be:

purulent;
serous;
and fibrocystic.

The most common is lactation (postpartum), caused by stagnation of milk in the breast. The second place in the frequency of occurrence is occupied by the breast of newborns and plasma cell mastitis.

Signs of the disease

At a nursing mother acute inflammation breast tissue may occur against the background of prolonged lactostasis or develop very quickly without signs of milk stagnation. The main signs of pathology:

pain in the affected gland of a bursting nature;
swelling, the appearance of well-palpable seals;
swelling and hyperemia of tissues;
an increase in local temperature;
difficulty and severe pain when pumping.

With purulent mastitis with abscess formation, signs of general intoxication are added to local symptoms, body temperature reaches febrile numbers, lymph nodes in the armpit on the side of the lesion increase, tachycardia, weakness, and headache are noted. In milk, an admixture of pus and streaks of blood is noticeable.

Inflammation of the mammary gland in women after 50 years of age, against the background of hormonal changes in the body, or in men, can be acute and chronic. The main symptoms, with the exception of lactostasis: swelling, redness, temperature (the area of the affected gland is hot to the touch) will be the same as in lactating women.

Factors contributing to the development of the disease

Lactational mastitis usually develops against the background of poor outflow of milk, in the presence of nipple cracks or other microdamages of the areolar zone. Conditionally pathogenic microflora (staphylo-, streptococcus, rarely E. coli) under such conditions easily penetrates into the tissues of the mammary gland and actively multiplies there. Contributes to the development of pathology and early weaning of the child from the breast.

Non-lactation mastitis is provoked by:

piercing of the areolar zone;
injuries in the chest and nipple complex, severe hypothermia in this area;
degeneration of breast tissue (age-related, associated with mastopathy);
infectious processes in the area of sweat and sebaceous glands,;
fungal infections (actinomycosis);
STD (syphilis);
side effect some antihypertensive drugs.

With the development of breast discomfort, it is worth seeing a mammologist. by the most serious illness with which to differentiate mastitis is cancer. Mastitis itself is prone to progression, suppuration and abscess formation. In the latter case, the treatment will be exclusively operational.

Directions in the treatment of the disease

Standard medical therapy involves taking antibiotics. With non-lactational mastitis, physiotherapy may be prescribed. In the case of fibrocystic changes, treatment of the underlying disease is required ().

You ask whether it is possible to heal with folk remedies at home? It is better, of course, to visit a mammologist. But healers offer a variety of methods for treating this disease:

mechanical impact(massage: manual and water, suction of milk at);
use in the form of decoctions, infusions, lotions;
essential oils for rubbing the affected area and compresses;
apitherapy;
applications from the leaves of white cabbage, beets, carrots;
camphor oil / alcohol, linseed and olive oils;
salt heating.

In the case of lactostasis in former time husbands literally sucked milk from their wives to alleviate their condition. Today, any woman can use a breast pump. Maximum pumping is an excellent preventive measure and required action with postpartum stagnation of milk and the onset of inflammation.

Simple and popular methods of folk therapy

Those methods that helped are good. simple, affordable and effective measures are considered:

honey cakes;
compresses from cabbage leaves;
rubbing with camphor alcohol;
wraps with camphor oil;
dry heat(salt heating or using semolina pads).
compresses with aloe leaf or Kalanchoe;
poultices from sweet clover and sophora decoction.

A honey cake is made from honey and flour and applied overnight. Honey has excellent absorbable and regenerative properties. In such a cake for a warming effect, you can drop 2-3 drops of juniper or fir essential oil, if a woman does not feed a child during this period, it is better for nursing mothers not to use essential oils. Enhances the effect of aloe juice.

cabbage leaf and camphor alcohol is applicable for serous mastitis both postpartum and non-lactostasis related. A white cabbage leaf is quite effective when used alone (cabbage must be beaten off with a chef's hammer so that it releases juice) and in combination with honey or sour cream / kefir. It has excellent absorbable properties, relieves swelling.

Camphor alcohol and oil are the first assistant to young mothers. Alcohol can rub the affected area. It is better not to put compresses on the chest area. The skin is delicate and can be easily burned. For a compress or wrap, it is better to use comfort oil. It has excellent warming-absorbing properties, fights inflammation and does not burn tissue.

A mixture of juices (aloe and kalanchoe) in equal parts with the addition of olive or linseed oil in the same amount and honey has a good anti-inflammatory effect, accelerates tissue regeneration.

Lotions and washing of the chest with decoctions medicinal plants with an antiseptic effect accelerate the process of restoration of affected tissues. An effective remedy in the fight against inflammation, a decoction of sophora and a decoction of sweet clover are considered.

Salt can be used in the form of dry heat, as well as semolina. To do this, bags filled with coarse salt or semolina are heated in the oven, in a frying pan or the lid of a boiling pot and applied to the affected area (carefully, do not burn yourself!).

Salt, preferably sea salt, can be used as a poultice. To do this, it is dissolved in water heated to 50 ° C, a towel is moistened in this water and applied to a sore spot. The procedure is effective in the initial stages of inflammation.

Other methods of folk therapy

Animal fats are often used to treat inflammatory processes. The bearish and badger fat. With their help, you can prevent mastitis by treating the nipples when the first cracks appear. Treatment of the disease is carried out by applying warm compresses with these fats.

Recipes traditional medicine for patients with non-lactational mastitis are more diverse. On the inflamed area of \u200b\u200bthe chest, they suggest applying a compress of grated beets or carrots. Well proven essential oils (mint, lemon balm, juniper, fir) mixed with olive or linseed oil, bear fat.

A rich selection of decoctions and teas. You can prepare drinks in equal parts:

with mint, lemon balm, sweet clover;
hypericum, sage;
a leaf of strawberry, blackcurrant and raspberry.
calendula, red-fruited mountain ash, linden blossom.

Infusions can be drunk, mixing them with tea, or separately. Usually 1 tablespoon of collection per 200 ml of water is required.

Remember that all these recipes are relevant at the beginning of inflammation. If purulent mastitis has begun, it is better to contact a mammologist in order to avoid the development of an abscess and an operation to open it or sepsis.

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

The course of mastitis passes in several periods. If there was no necessary treatment, the disease can go into a purulent form, fraught with dangerous complications. If mastitis is detected in the early stages and treatment is started in a timely manner, it is possible to prevent the progression of purulent inflammation of the breast.

Causes of mastitis

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

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

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

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

Risk Factors for Mastitis

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

There are a number of factors that increase the risk of mastitis:
large mammary glands,
the presence of cracks in the nipples,
nipples of an “irregular” shape (inverted or flat nipples) make it difficult for the baby to suckle the breast, as a result of which the mammary glands are not emptied enough during feeding, which leads to the appearance of lactostasis,
lactostasis - with insufficient decantation of milk, it stagnates in the ducts of the mammary glands. Usually, with lactostasis, the outflow of milk from one lobe of the mammary gland is disturbed due to clogging of it with a “plug” of thickened milk.

Signs of lactostasis are:
pain in the breast,
nodules (seals) in the chest that disappear after massage,
uneven leakage of milk from the affected area of the breast.

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

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

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

Stages of development of mastitis

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

Signs and symptoms of mastitis

Usually mastitis is distinguished by acute development - this indicates that symptoms appear quickly (within a few hours - a couple of days).

There are such main signs and symptoms of mastitis:
body temperature rises to 38 degrees, which is evidence of the presence of an inflammatory process in the body. As a result of an increase in temperature, chills, pain in the head, weakness appear;
constant pain in the chest of a aching nature, which intensifies during breastfeeding;
an increase in the volume of the mammary gland, redness of the skin in the area of inflammation, the skin becomes hot.

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

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

Diagnosis of mastitis

If you have any of the symptoms listed above, you should urgently seek medical help. The diagnosis of mastitis is to identify characteristic features diseases that are detected during the doctor's palpation and examination of the mammary gland.

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

Mastitis and breastfeeding

With mastitis forbidden lactation, regardless of the form of the disease. This is due to the fact that breast milk, both from diseased and healthy breasts, can contain many bacteria that are dangerous for the baby. In addition, in the treatment of mastitis mandatory use of antibiotics which also pass into breast milk and may harm the baby. Even with a temporary suspension of breastfeeding during mastitis, it is necessary to express milk regularly and carefully. This procedure will not only speed up the recovery process, but will also help maintain lactation in the future so that the woman has the opportunity to continue breastfeeding.

Mastitis treatment

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

In the treatment of mastitis, the following basic principles are guided:
stopping the growth of bacteria
removal of inflammation
anesthesia.

Purulent mastitis treated only with surgical intervention. It is strictly forbidden to treat mastitis on your own!

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

Treatment infiltrative and serous, i.e. Not purulent forms mastitis carried out by conservative methods surgical intervention. It is necessary to express milk every three hours to avoid stagnation, which contributes to the growth of bacteria. To get rid of soreness in the chest, use anesthetic drugs local action, such as, for example, novocaine blockades.

Antibiotics are the main drugs for the treatment of mastitis. After determining the sensitivity of bacteria, a specific antibiotic is prescribed. As a rule, for the treatment of mastitis are used following groups antibiotics:
cephalosporins ( cephradil, cefazolin and so on.),
penicillins ( Amoxiclav, Oxacillin and so on.),
aminoglycosides ( Gentamicin) and so on.

Antibiotics are taken both inside and intravenously and intramuscularly.

Treatment of purulent mastitis is based on surgical intervention. The operation is done using general anesthesia. After the operation, antibiotics are prescribed without fail.

When antibiotics are stopped and bacteriological tests show that the milk does not contain bacteria, it is allowed to resume breastfeeding.

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

Prevention of mastitis

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