Mastitis - symptoms, treatment, folk remedies for mastitis, prevention of mastitis. How to treat mastitis at home? What is and how to treat purulent mastitis Symptoms of incipient mastitis

Breastfeeding coincides with the weakening of the immune system of a young mother, which is still recovering after childbirth. Her mammary glands are also especially vulnerable now, because many new processes are happening in them. Sometimes mastitis occurs suddenly, you just need to freeze, and it can also begin after any event that lowers a woman’s immunity.

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Most breast problems can be avoided if you feed your baby frequently and correctly.

Signs of mastitis are chest pain, fever, redness of the skin of the mammary glands. Mastitis, uncomplicated by infection, often begins after rough and painful “pumping” at the moment when milk comes in sharply after childbirth.

If a woman expresses milk once before feeding and then breastfeeds the baby frequently, uncomplicated mastitis will go away in 1-2 days. If the situation does not improve, the mother is prescribed antibiotics that are compatible with breastfeeding.

What is mastitis?

Mastitis is an inflammation of the mammary gland that occurs even in non-lactating women with decreased immunity. But we will now talk about lactation mastitis, that is, about the problems of nursing mothers.

Mastitis must be distinguished from lactostasis, which is what stagnation of milk in the breast is called. Lactostasis always begins with compaction in the milk lobule, and only after 2 days, during which relief does not occur, mastitis can develop.

Sometimes mastitis occurs suddenly, you just need to freeze, and it can also begin after a sleepless night, moving, severe stress or any other event that lowers a woman’s immunity. In this case, the temperature does not rise above 38 degrees C, but pain in the mammary glands occurs even when moving the arms or changing position, first one and then the other breast swells, the general condition resembles a cold: headache, muscle aches, no appetite.

What to do if you suspect you have mastitis?

1. Contact a gynecologist or lactation consultant (it is better to call him at home).

2. Before visiting the doctor, measure the temperature in three points: under the armpit on the side of the painful, healthy breast and in the elbow, and write down the results.

3. You need to get rid of milk stagnation. If the baby is actively sucking, apply it as often as possible (preferably every hour and a half). It is important that feedings alleviate the condition and not add pain. If your nipples are cracked, be sure to call a consultant to learn how to feed and express without discomfort.

4. In order for milk to be released better, it is important to relax, eliminate spasm of the milk ducts and reduce breast swelling.

To relieve spasm of the ducts before feeding or pumping, the following help:

Very warm, wet compresses on the chest (the gauze should be soaked in hot water and squeezed out);
compress with magnesium solution (apply 5-10 ampoules to gauze and hold for 15 minutes);
dry heat on the neck and shoulders;
simultaneous stimulation of both nipples with twisting movements;
pumping an overfilled breast until it softens before feeding, or full pumping if the baby refuses to latch on or breastfeeding is too painful;
The doctor may advise taking 2 tablets of no-shpa (no more than 3 times a day) or dissolving a tablet of deaminoxytocin (no more than 4 per day) 20-30 minutes before feeding or pumping.

5. During feeding, make sure that the baby's head is slightly tilted back, his chin is directed towards the source of mastitis - the seal, and sit or lie down in a relaxed and comfortable manner.

6. Help relieve swelling:

Cold dry compresses on the chest after feeding (for 5-7 minutes);

Temperature and pain in mastitis uncomplicated by infection are relieved with ibuprofen. If the drug does not help, be sure to inform your doctor about this - perhaps mastitis is still caused by pathogenic microbes, and the young mother urgently needs the help of antibiotics.

7. If after 48 hours there is no improvement, you need to do an ultrasound of the mammary glands, donate milk for culture of microflora and its sensitivity to antibiotics, and continue treatment under the supervision of a doctor.

8. Even if the mother feels well, bed rest is important until recovery. All tasks, except feeding the baby, should be temporarily delegated to assistants.

What not to do if you have mastitis

In no case should you “break stones in the chest” - there are no stones in it, but there are delicate tissues that, when handled roughly, swell, small vessels in them are damaged, which will only aggravate the problem. Experienced mothers and competent obstetricians express the mammary gland gradually, carefully and without pain.

Do not pump after every feeding, because this will increase the amount of milk, and with mastitis, its excess worsens the condition. If the baby does not refuse to suck, it is enough to express completely once or twice a day, and apply it to the breast every hour.

Do not make compresses with camphor oil or alcohol solutions. Camphor in milk is dangerous for the baby, and alcohol increases lactostasis. All cases of “magical healing” with the help of these remedies can be explained by the normal and uncomplicated course of lactostasis, which would have passed without treatment.

Do not wean your baby unless your doctor insists on it. The doctor may require this in case of frequent severe mastitis, when treatment does not help, and also, but only temporarily, in case of purulent mastitis or the identification of many dangerous microorganisms in milk. At the same time, you can continue to feed from a healthy breast.

For uncomplicated mastitis, frequent breastfeeding helps recovery much better than pumping or suppressing lactation. For a child, a sudden transfer to artificial nutrition can be much more dangerous than the milk of a mother suffering from mastitis.

Do not limit yourself to liquids, drink rosehip decoction, dried fruit compote or warm non-mineral water. Milk with mastitis can be salty, and if there is a lack of water in the mother’s body, the child may refuse such food, and the milk itself will become even more viscous and will have difficulty leaving the mammary gland.

Mastitis, or breastfeeding, is an inflammation of the breast tissue caused by the penetration of infectious agents. Due to the spread of pathology, purulent destruction of the gland and surrounding tissues is formed; in severe cases, sepsis (blood poisoning) occurs.

The main category of patients suffering from mastitis are primiparous women. Their glandular tissue of the mammary gland is not as well developed as that of experienced nursing mothers, the ducts have not yet developed, and sometimes the nipple is problematic (retracted, flattened). In addition, primiparous women do not have experience in breastfeeding and expressing milk.

The disease develops in 3-7% of the total number of women giving birth, and this number, according to medical statistics, remains unchanged for decades. Approximately 80-85% of mastitis cases occur in the first month after childbirth. Mastitis can be either lactational or non-lactational. There are manifestations of this disease in newborn girls under the influence of the mother’s hormonal levels. Non-lactation mastitis can develop in girls and women from 15 to 60 years old, accounting for 5% of all cases of the disease. It does not proceed as rapidly as lactation, with a minimum of complications, but more often it becomes chronic.

The main causative agents of lactation mastitis:

Decreased appetite;

Sleep disturbance;

Increase in the size of the mammary glands;

Redness of the skin of the chest, expansion of the saphenous veins;

Swelling of regional lymph nodes.

The following types of purulent mastitis are distinguished:

Abscess mastitis - forms inside or behind the gland, filled with pus;

Infiltrative-abscessing mastitis - a dense infiltrate of many small abscesses forms in the tissues of the gland, occupying at least 2 quadrants of the chest;

Phlegmonous mastitis - the breast is significantly enlarged and swollen, the skin acquires a bluish-red tint, the nipple is retracted, at least 3 quadrants of the gland are affected, the hemoglobin level is reduced, blood and urine tests are abnormal;

Gangrenous mastitis - due to the formation of blood clots in the blood vessels, the blood supply to the gland is disrupted, which causes tissue, the breast is enlarged, there are areas of necrosis on its surface - blisters filled with ichor, the skin becomes bluish-purple, all quadrants of the gland are affected by gangrene.

With gangrenous mastitis, confusion, a sharp, rapid pulse, and changes in laboratory test parameters are noted.

Depending on the clinical picture of the disease and laboratory test results, the following conditions are distinguished:

General urine analysis;

Bacteriological culture of milk samples from both mammary glands - the concentration of pathogenic bacteria per 1 ml 3 is determined;

Milk examination for cytology (determining the concentration of leukocytes as indicators of inflammation);

Measuring the acid balance of milk, normally the pH of breast milk is 6.8, with inflammation this number increases.

Informative instrumental research methods:

Ultrasound of the mammary gland - the localization of purulent tissue melting is analyzed;

Puncture of the infiltrate in phlegmonous and abscessive forms to examine its contents;

Mammography of the mammary glands is rarely performed when diagnosing a chronic process;

Biopsy and histological examination for differential diagnosis of suspected breast cancer.

Treatment methods for mastitis

There are indications for the use of conservative therapy. To analyze the situation, milk is expressed from the affected breast, and after 3-4 hours it is examined again. If the pain subsides, the temperature approaches normal values, and the compaction becomes smaller, most likely, normal lactostasis occurs.

If the condition does not improve, the temperature remains high, and the woman still feels unwell, milk stagnation is combined with mastitis.

Indications for conservative treatment:

The disease lasts no more than 3 days;

The temperature does not exceed subfebrile values;

Blood tests are normal;

General condition is satisfactory;

There are no symptoms of a purulent process.

In the absence of positive dynamics after several days of conservative treatment and the transition of mastitis to a purulent or, especially, gangrenous form, the woman is indicated for surgical intervention.

The surgery is performed under general anesthesia in a surgical hospital. The doctor tries to preserve the aesthetic appearance and functionality of the mammary gland as much as possible.

After removing the affected tissue, the wound is washed for 5-12 days and antibiotics are administered intravenously or intramuscularly. Breastfeeding after surgery is stopped artificially, with medications, since expressing milk from the operated breast is impossible

For conservative treatment and prevention of complications after surgery, antibacterial drugs of various groups are used. Staphylococcus aureus is most sensitive to drugs from the group of penicillins and cephalosporins. These are Oxacillin, Dicloxacillin, Cefazolin, Cephalexin.

How antibacterial agents pass into breast milk:

Penicillins - penetrate into milk in a minimal dose;

Cephalosporins - a limited amount passes into milk, somewhat larger than that of penicillins;

Macrolides - almost half of the drug appears in milk, but it does not pose a danger to the child;

Aminoglycosides - a minimal amount is found in milk, but even this dose is toxic to the baby’s kidneys;

Fluoroquinolones are highly toxic drugs and are not recommended during breastfeeding.

Additionally, antihistamines, vitamin complexes, and physiotherapy (ultrasound, UHF therapy) are used.

What ointment to use for mastitis?

At the beginning of the disease, a good therapeutic effect can be recorded when applying Vishnevsky ointment:

The infiltrate resolves;

Pain is reduced;

Milk secretion improves.

There is a different opinion among practicing surgeons regarding the use of this ointment - the increased temperature that occurs at the site of application provokes the proliferation of bacteria and only stimulates the further development of mastitis.

To avoid the symptoms of mastitis, you need to take precautions and prepare in advance for breastfeeding.

Prevention measures:

Master the correct way to attach the baby to the breast so that the baby grasps the nipple and part of the areola around it;

Feed the baby on demand, avoiding breast overfilling - if the baby completely empties the breast, there is no need for excessive pumping;

Choose a comfortable bra;

Follow hygienic rules for caring for your breasts, wash them with cool water, avoiding constant hydration;

If lactostasis occurs, immediately consult a doctor or lactation consultant.

Even if the alarm is false, it is better to play it safe and not expose yourself to serious complications.

Which doctor treats mastitis?

It is most advisable to contact a surgeon for treatment of mastitis. If the symptoms of the disease are not so severe, you can get advice from.

Education: Diploma in Obstetrics and Gynecology received from the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at NIMU named after. N.I. Pirogova.

Mastitis is one of the most common breast diseases, which is characterized by infectious and inflammatory processes in the breast tissue. This inflammation has a high rate of spread. The effect of inflammation is expressed in purulent destruction of the glands and breast tissue, which can lead to blood poisoning. First of all, girls who are just preparing to become a mother should become familiar with the symptoms and types of mastitis.

Inflammation is caused by an infection, which in the vast majority of cases is caused by Staphylococcus aureus. This bacterium causes non-critical skin lesions in the form of acne, etc. But it can also lead to dangerous phenomena (meningitis, pneumonia, mastitis, etc.). It is the penetration of staphylococcus into the breast tissue that causes breastfeeding (the old name for mastitis).

Nowadays, doctors are increasingly faced with cases of mastitis, which are caused by a whole complex of bacteria that have entered the mammary gland and caused infectious inflammation with suppuration. Most often, these are gram-positive staphylococci and gram-negative Escherichia coli.

Mastitis in women can be lactation or non-lactation. Lactation mastitis occurs during lactation (especially in girls giving birth for the first time). Non-lactation mastitis appears even in non-breastfeeding women aged 15 to 60 years. It is logical to assume that the causes of mastitis for each form are different, but there are also common factors among them:

• Decreased immune capabilities of the body, which cannot suppress inflammation.
• Stagnation of milk in the breast (lactostasis) is a common cause of mastitis.
• The presence of direct pathways for bacteria to penetrate into the mammary gland (wounds, nipple cracks).
• Mastopathy and other breast diseases. Their complications lead to infectious inflammation (mastitis).

Risk factors for developing mastitis

The entry of Staphylococcus aureus and other pathogens into human breast tissue will not necessarily lead to inflammation and suppuration. Inflammation of the mammary gland in women is caused by anatomical and systemic factors that reduce the body’s ability to suppress infection in the mammary glands, or make it easier for bacteria to work:

• Hormonal imbalances leading to mastopathy.
• Microcracks and other damage to the nipple and areola (especially during feeding).
• Surgical interventions, scar formations in the mammary glands.
• Anomalies in the shape of the nipples - flat, lobed and others.
• Difficult pregnancy, late toxicosis.
• Low patency of the mammary gland ducts, too much milk produced.
• Diseases that reduce immunity.
• Stressful conditions, insomnia and other psychological complications.

The disease “mastitis” manifests itself due to imperfection of the milk ducts, insufficient development of the nipple, impaired feeding technique and expressing milk.

Symptoms of mastitis

The symptoms of mastitis vary depending on the form of inflammation, as well as the current stage of mastitis. In general, we can identify common signs of mastitis that are observed in patients:

• The appearance of discomfort in the chest area. With the development of mastitis and the growth of inflammation, discomfort develops into pain.
• The breasts increase in size, swelling of the mammary gland is observed. With bilateral infection, both mammary glands are susceptible to these changes.
• Redness of the skin over the site of inflammatory processes is observed, which is accompanied by local swelling of the chest tissue. Pain is felt when touched and palpated.
• Enlargement and occurrence of pain in the lymph nodes. In particular - in the armpits.
• Weakness of the body as a whole. The patient feels unwell and constantly lethargic, and loses his appetite.
• Body temperature rises. In the initial stages of the disease up to 37-38°C. At the finals, up to 39-40°C.
• The stage of development of an abscess (late forms of mastitis) is accompanied by nausea and vomiting, and headache. All this develops into convulsions and loss of consciousness, the patient is often in infectious-toxic shock. With timely treatment, this group of symptoms can be avoided.

Clinical forms of mastitis

The clinical picture of mastitis refers to the development of inflammation in a woman 1-4 weeks after the birth of a child (the most common cases of mastitis). The classification of mastitis allows us to identify two main forms of inflammation: chronic and acute. Chronic mastitis does not cause significant harm to human health; the disease occurs locally and does not spread throughout the tissues.

There are two ambiguous forms of mastitis:

• Plasmacytic mastitis, also called periductal mastitis. It is not inflammation in the truest sense of the word. There is an expansion of the mammary gland ducts, in which creamy contents (plasma, lymphocytes, histiocytes) are present. At times, purulent discharge occurs from the mammary gland through the nipple. Often confused with mastopathy or cancer. Mostly occurs in older women.
• Fibrocystic mastitis, its development is associated with disturbances in hormone levels and pathologies of the thyroid gland. Presents as painful lumps inside the mammary glands. It most often manifests itself in girls during puberty and in women during menopause.

The types of mastitis are associated with the stage of development of the disease.

Serous

The initial stage of mastitis development. It is very easy to confuse it with banal lactostasis. Mastitis begins to develop on days 2-5 of breast milk stagnation. In the section of the mammary gland, where stable lactostasis is observed, the tissues are saturated with serum (serum). Local inflammation of the breast tissue occurs, even without exposure to harmful microorganisms. A timely visit to a doctor (mammologist, gynecologist, therapist) will prevent the development of inflammation and quickly recover from mastitis.

There is a thickening of the chest area at the site of stagnation, the temperature of the affected area increases locally, swelling and pain are observed (typical accompaniments of inflammation). Expressing milk causes pain and does not bring relief. If the disease is ignored, mastitis develops into more severe purulent inflammation.

Infiltrative

Infiltrative mastitis is characterized by the accumulation of a mixture of lymph, blood and cellular particles in the breast tissue (which is called infiltrate), and can occur chronically. The reason for the development of the infiltrative form of the disease is damage by pathogenic bacteria. The duration of the stage is influenced by the body’s immune reserves and the aggressiveness (quantity) of staphylococcus, or its alliance with other bacteria. This type of mastitis can quickly move to the next stage of the disease. In the acute form or relapse of the chronic form of mastitis, patients experience leukocytosis.

Abscessing

This type is associated with the formation of abscesses. Purulent mastitis begins 4-6 days after the appearance of infiltration in the chest tissues. The painful sensations intensify, the breast tissue looks like a spongy material soaked in pus. On palpation, there is a sensation of fluid movement. Persistent intoxication is observed (weakness, headaches, etc.). If there is no surgical intervention at this stage, mastitis goes into terminal (destructive) stages.

Phlegmonous

Further development of purulent inflammation. An abscess causes complete swelling of the affected part of the body, redness of the chest adjacent to the bluish color of the surface tissues. Touching the chest causes sharp pain. The nipple is pulled inward. Body temperature ranges from 38-39°C (febrile). Purulent mastitis in some cases is accompanied by convulsions and loss of consciousness. Hospitalization for phlegmonous mastitis is strictly required.

Gangrenous

The last type of mastitis is gangrenous mastitis. The affected breast is much larger than the healthy one. Areas affected by necrosis are visible. Necrosis of breast tissue causes infectious-toxic shock. The destructive stage of mastitis is fatal. But there is a chance of a cure for gangrenous mastitis.

Forms, depending on location

Mastitis is also classified according to the place of occurrence:

• Intramammary localization of mastitis - inflammation occurs deep in the mammary glands and affects the glandular tissue. Occurs most often.
• Subcutaneous and subareolar mastitis is a superficial area of ​​suppuration of the breast tissue. With subcutaneous localization, inflammation is located in any area under the skin of the chest. With subareolar localization, the breast tissue under the areola of the nipple is affected. The cause is small ulcers, infected wounds and other injuries to the breasts and nipples.
• Retromammary mastitis is a breakthrough of purulent inflammation that occurs inside the breast tissue (retromammary area).

Manifestation of the disease in children and men

In the vast majority of cases, mastitis in newborns is confused with physiological mastopathy, which is also characterized by inflammation. Mastopathy refers to signs of normal adaptation of an infant to life outside the womb. It is associated with excess estrogen, which came from the mother during pregnancy. Ridding the baby's body of excess hormones causes engorgement of the breast tissue in children. Inflammation is observed in children of both sexes, but more often in girls.

Purulent mastitis appears very rarely in newborns. It is associated with improper baby hygiene, ignoring prickly heat and microdamage to the nipples. Often, parents’ attempts to cure “mastitis” in a newborn (which is actually mastopathy) lead to infection with the real disease.

Mastitis in men is also extremely rare. Reasons include diabetes, gynecomastia, tumors in the genital area, consumption of anabolic steroids and low-quality beer (estrogens). It is hormonal causes that in most cases are the causative agents of male mastitis. Treatment is similar to that for women.

Diagnostics

If pain and inflammation occur in the chest area, a person should immediately consult a doctor: mammologist, pediatrician or gynecologist. The surgeon also treats mastitis.

The process of diagnosing mastitis does not cause any difficulties. The basis is the patient’s complaints, the results of palpation and laboratory tests.

The following tests are carried out:

• Urine and blood analysis (general).
• Study of breast milk for bacteriological composition. The indicators of both mammary glands are compared. 1 ml of liquid is enough.
• Study of the number of red blood cells in milk. They play the role of markers of inflammation.
• Acid-base balance and reductase are calculated.

In severe forms of mastitis (abscess, phlegmonous mastitis), the patient undergoes a breast examination using ultrasound. The infiltrate of the affected mammary gland is also examined (puncture).

If diagnosis is difficult (usually in chronic mastitis), mammography is prescribed. Chronic mastitis requires a biopsy to diagnose cancer.

Conservative treatment

Treatment of mastitis with medications is allowed in the initial stages. In this case, the patient should feel satisfactory: the temperature does not exceed 38°C, there is no purulent inflammation. Blood tests should show no changes.

If drug therapy does not show effectiveness, preparations for surgery begin.

Antibiotics

Antibiotics and antibacterial medications for mastitis are taken for 10-14 days. The infectious cause of mastitis is eliminated with drugs that contain amoxicillin. It suppresses Staphylococcus aureus, streptococcus and other infections that cause purulent inflammation.

At the initial stages of inflammation of the mammary glands, treatment with penicillin antibiotics is allowed.

Analgesics

Analgesics are designed to reduce the level of inflammation and swelling, as well as relieve the pain of mastitis. Medicines can be supplemented with antispasmodics. Prescribed Ibuprofen, Paracetamol, No-shpa, etc. The type of medication depends largely on whether the woman is breastfeeding.

Antihistamines

Blockade of histamine receptors is important for large swelling of the mammary glands. This is especially true for people with low blood pressure, as well as patients predisposed to septic shock. If there is purulent discharge in the milk, lactation is suppressed with drugs.

Immunomodulators

One of the reasons for the penetration of infections is a decrease in immunity. Drugs such as Polyglobulin, Methyluracil, Antistaphylococcal gamma globulin and other immune modulators are prescribed taking into account tests and medical history.

Vitamin complexes

Vitamins have a beneficial effect on the entire body and also increase a person’s ability to resist pathogens. In addition to fruits and vegetables, useful elements are obtained from vitamin complexes such as Complivit, Undevit, etc.

Creams and ointments

Drugs with a local anti-edematous and anti-inflammatory effect for the mammary glands are prescribed in conjunction with the above-mentioned drugs against mastitis. The ointment heals damaged breast tissue and eliminates the feeling of discomfort in the affected breast. Traumgel, Heliomycin, Progestogel and others are prescribed.

Under no circumstances should you self-prescribe medications. This can cause allergic reactions and mastitis complications.

Surgical treatment

Starting with abscess mastitis, effective treatment is surgery. A small focus of purulent inflammation is treated by inserting a needle into the mammary glands and pumping out the pus. Antibiotics are then pumped into the devastated area to eliminate the inflammation.

A large abscess and multiple foci of inflammation imply mastitis. During the operation, the source of inflammation is opened, and the pus is removed along with the affected tissue. A drainage is installed into the resulting cavity to pump out pus. After 3-4 days, the drainage is removed and a suture is made (if mastitis does not recur).

After surgical measures to eliminate mastitis, the patient undergoes therapy with infusion solutions. This is followed by taking antibiotics, non-steroidal anti-inflammatory drugs and immunomodulators.

Traditional treatment at home

Treatment at home is allowed only for serous mastitis or lactostasis. The doctor must agree to home therapy.

Compresses

It is allowed to use cold compresses on the chest:

• Pumpkin pulp boiled in milk.
• Honey cakes (flower honey and wheat flour).
• Tea mushroom.
• Grated carrots.

Cabbage wraps

Cabbage leaf is used for redness of the mammary glands. The cabbage is cooled and applied to the chest for an hour or two. The procedure must be repeated at least 6 times a day.

Water massage

Rubbing with alcohol

Treatment of mastitis with folk remedies should not include exposure to high temperatures. Alcohol compress and rubbing have a warming effect. Bacteria multiply quickly in warm conditions. This will speed up the transition of mastitis to the abscess stage.

Ice

When mastitis begins, applying ice will slow the spread of infection and reduce discomfort. The ice pack should be wrapped in a towel to prevent frostbite. The duration of sessions is no more than 3 minutes.

Honey

Honey has a disinfectant and antibacterial effect. Promotes wound healing. You can apply cold honey compresses to your chest no more than 2 times a day.

Essential oils

Essential oils are added to chest compresses. Mint helps reduce fever, fir kills bacteria and reduces inflammatory processes. Camphor oil acts as a pain reliever. Essential oils are prohibited during breastfeeding (lactostasis).

Medicinal herbs

Decoctions are made from herbs and used in compresses against mastitis. Oral administration is allowed with the consent of the doctor.

• Sage - suppresses lactation function, weak antibiotic.
• Alder reduces inflammatory processes.
• Chamomile is a native antiseptic, the effect is noticeable in infectious mastitis.
• Sweet clover works as an antispasmodic.

Complications of mastitis

Any infection accompanied by inflammation, especially with the participation of Staphylococcus aureus, can cause complications in the form of septic syndromes:

• Pericarditis.
• Meningitis.
• Infectious-toxic shock condition.
• The appearance of several purulent inflammations - pneumonia, osteomyelitis, etc.
• DIC syndrome.

When taking medications in a timely manner, complications of mastitis are not observed.

Prevention of mastitis

Prevention of mastitis is a set of measures that minimize the risk of occurrence and development of purulent inflammation:

• Speedy elimination of milk stagnation in the mammary glands.
• Breast hygiene, especially during feeding.
• Timely healing of breast injuries.
• Normalization of hormone levels.
• Restoration of immune functions.
• Regular examination of the mammary glands by a mammologist.

Since the absence of damage to breast tissue helps to avoid mastitis, you should pay special attention to the choice of bra. It must be the right size, comfortable in shape and made from natural fabrics.

You shouldn’t start even minor breast inflammation and hope that it will go away on its own. If you suspect mastitis, you should consult a doctor as soon as possible.

Purulent mastitis is a nonspecific inflammatory disease that affects interstitial (connective) tissue and milk ducts. Infectious processes in the chest are caused by pyogenic microbes, and non-infectious processes are caused by injuries and hormonal imbalance. In 80% of cases, the pathology is diagnosed in primiparous women, but it also occurs in childless patients, teenage girls, newborns and men. Advanced mastitis is life-threatening, so the disease must be treated promptly.

Forms and types

Doctors distinguish two main forms of pathology:

• lactation – occurs during breastfeeding;
• non-lactational (fibrocystic) – not associated with breastfeeding, occurs in women and men.

Lactation mastitis that occurs in the first 2–3 days after birth is called epidemic. Endemic mastitis is diagnosed 2–3 weeks after discharge from the hospital.

Mastitis can also be acute or chronic. The acute form occurs immediately after infection with pyogenic microbes and is divided into five stages:

• serous - in the tissues of the mammary glands the concentration of leukocytes increases and serous fluid accumulates;
• infiltrative – small capsules filled with purulent fluid form in the chest;
• abscess – multiple cysts with purulent contents form in the mammary gland, which can merge into one large abscess;
• phlegmonous - inflammation spreads to surrounding tissues;
• gangrenous - subcutaneous tissue, skin, glandular and connective tissue die, blood clots form in the vessels, blood circulation is disrupted, and necrosis starts.

Chronic infiltrative mastitis may be the result of improper treatment of the acute form of the disease. A dense, mobile cyst filled with purulent contents forms in the mammary gland, which periodically becomes inflamed and causes discomfort.

The disease is also divided into types depending on location:

• subcutaneous - the abscess is located in the subcutaneous tissue;
• galactophoritis - the formation clogs the milk duct;
• subareolar – the cyst is located behind the nipple;
• intramammary - an extensive abscess involving parenchyma or connective tissue;
• retromammary - inflammation spreads to the tissue behind the mammary glands;
• total – necrosis of the breast and surrounding tissues.

Abscesses can also be superficial or deep. The former tend to break out, while the contents of the latter melt the pectoral fascia and spread to the pleura. Both forms of purulent mastitis are accompanied by regional lymphadenitis.

Causes

Depending on the cause, mastitis can be infectious or non-infectious. Infectious diseases are caused by pyogenic microbes:

• Staphylococcus aureus;
• streptococcus;
• fungi such as Candida;
• Pseudomonas aeruginosa;
• staphylococcus and E. coli;
• Proteus.

Bacteria enter the breast tissue through cracks and wounds in the nipples, which are formed due to improper feeding and pumping, tight underwear and lack of care for the areolas. Favorable conditions for the proliferation of microbes are created by lactostasis - blockage of the milk ducts and stagnation of breast milk.

The infection can penetrate the mammary glands through the blood if a woman has chronic tonsillitis, pyelonephritis and other inflammatory diseases of internal organs. The risk of mastitis increases with weakened immunity due to difficult labor and postpartum complications.

A non-infectious disease occurs due to hormonal imbalance, mechanical injuries to the mammary glands, diabetes mellitus, impaired metabolism and sudden changes in climatic zones.

Symptoms

The primary symptoms of lactational, non-lactational and chronic infiltrative mastitis are the same:

• breast engorgement and swelling;
• severe pain in the mammary glands;
• a sharp increase in body temperature to 39–40 degrees;
• headache;
• fever alternating with chills;
• severe weakness.

Despite similar symptoms, all three forms of mastitis have their own clinical characteristics.

Lactational

Lactation-type disease is always associated with breastfeeding. The inflammatory process in the mammary glands begins 3–4 weeks after discharge from the maternity ward and occurs in a severe form with mild symptoms.

One or more small cysts filled with pus form in the breast. Sometimes the structure of the connective tissue surrounding the tumor changes. Small capsules appear inside it, similar to grains of wheat or peas.

At the initial stage, the breast practically does not increase, its contour remains clear and correct. The woman complains only of breast tenderness and fever. The disease progresses sharply after stopping feeding and pumping: the skin turns red, the breasts swell and become deformed. The patient complains of insomnia, headaches, loss of appetite and general weakness.

Non-lactational

Non-lactation mastitis often occurs against the background of fibrocystic mastopathy, fibroadenoma, as well as hormonal imbalance caused by menopause and adolescence.

Patients with non-lactation mastitis have a sharp rise in temperature, headaches, weakness, nausea, insomnia and chills. The infected mammary gland swells and becomes firmer to the touch, the skin turns red, and an unhealthy shine appears. A painful cyst forms inside the breast, and lymph nodes enlarge in the armpits.

Chronic

In patients with chronic mastitis, the body temperature does not rise above 37.5 degrees, and a slight increase in leukocytes is detected in the blood. Breasts are of normal size, without swelling or deformation. The skin is normal in color or has slight redness.

A painless lump can be felt inside the mammary gland. The neoplasm is mobile and dense. Breast pain only occurs during lactation and breastfeeding. The nodes in the armpit may become enlarged.

What purulent mastitis looks like

With purulent mastitis, the breasts are swollen and painful. The skin is shiny, covered with vague red spots. The nipples stretch and become flat, and sometimes seem to “sink” into the mammary gland.

In nursing women, lactation is disrupted. The milk becomes thick and curdled, with white flakes and small granules of coagulated protein appearing in it. It becomes difficult for the baby to suckle, so he becomes capricious and refuses to take the nipple.

Treatment

The initial stage of purulent mastitis can be treated with conservative and traditional methods. Advanced infiltrative and abscess forms require surgical intervention.

Conservative methods

Patients with serous lactation mastitis are recommended:

• limit physical activity and stay in bed;
• express milk every 3 hours;
• take laxatives based on sodium sulfate to dehydrate the body and suppress lactation;
• administer antispasmodics intramuscularly twice a day: no-shpa, pituitrin, papaverine hydrochloride solution in combination with oxytocin;
• take antibacterial drugs.

Patients with the first symptoms of mastitis are prescribed broad-spectrum antibacterial agents and milk culture for bacteria. After receiving the tests, the doctor selects medications taking into account the sensitivity of the microflora. Antibacterial agents can be supplemented with antihistamines to relieve swelling. The drugs are best administered intramuscularly or intravenously.

Conservative methods of treating mastitis include early radiotherapy and electrophoresis of novocaine or ethyl alcohol. Ultrasound exposure, irradiation with a Sollux lamp, applications with ozokerite and other thermal physiotherapeutic procedures are prescribed after normalization of body temperature and reduction of breast swelling.

In the early stages of purulent mastitis, an ice pack wrapped in a fabric bag is applied to the mammary gland. Cold suppresses lactation in the milk ducts and reduces discomfort. Ice treatment is recommended in the first 4–5 days of acute mastitis.

Traditional methods

Home remedies for mastitis should only be used after consulting a doctor. The most popular methods include:

1. Herbal tea made from lemon balm, thyme and chamomile. Infusions are taken orally to strengthen the immune system and reduce inflammation.
2. Honey rubbing. Diluted honey has antiseptic properties and heals cracked nipples.
3. Cabbage compresses. Cabbage leaves draw out water and relieve swelling, relieve pain and help with extreme heat.

Rubbing and compresses are used only cold. Heat increases the growth of bacteria and can cause mastitis to worsen.

Operation

The doctor opens and cleans the ulcers, installs a drainage system for washing the inflamed cavities with antiseptic solutions. In advanced cases, purulent abscesses are resected along with surrounding tissues.

After the operation, the woman is additionally prescribed a low-dose UHF electric field, laser therapy and intravascular ultraviolet irradiation.

Possible complications

Purulent mastitis destroys the glandular tissue of the mammary glands and causes infectious diseases. The most serious complications include:

• lymphadenitis;
• lymphangitis;
• milk fistulas;
• erysipelas;
• mediastinitis;
• sepsis;
• gangrene;
• septic endocarditis;
• infectious-toxic shock.

Purulent mastitis leads to deformation and loss of glandular tissue, so a woman may have problems with breastfeeding. The disease also increases the risk of lactostasis during repeated pregnancy and breastfeeding.

FAQ

In 95 out of 100 cases, purulent mastitis is diagnosed in the postpartum period. The disease lasts no longer than 1–2 weeks and, with proper treatment, does not require surgical intervention. Unfortunately, not all women know how to detect mastitis at an early stage, which doctor to contact with this problem, and what means to use to fight the infection.

Which doctor treats mastitis

Diagnosis and conservative treatment of serous mastitis can be prescribed by an obstetrician-gynecologist. Patients with infiltrative forms are referred to a surgeon who performs an MRI or CT scan, prescribes a general blood test, ultrasound of the mammary glands, and, if necessary, a biopsy. Depending on the results, the surgeon may refer the patient for additional examination by a mammologist or oncologist.

Mastitis and breastfeeding

Women with serous and initial stages of infiltrative mastitis are advised not to give up breastfeeding. On the contrary, frequent application of the baby to the inflamed mammary gland can speed up recovery.

If purulent mastitis worsens and pus is discharged from the nipples, feeding is stopped, but the woman should express herself every 1.5–2 hours. Milk from a diseased mammary gland should not be given to a baby. Milk from healthy breasts is given only after pasteurization.

Antibiotics for mastitis

Purulent mastitis is treated with semisynthetic penicillins:

• ampicillin;
• cephobid;
• Zyvox;
• amoxicillin;
• dalacin C;
• sulperazone.

Antibiotics are prescribed intramuscularly, intravenously, or as an oral solution. The drugs can be combined with novocaine or clavulanic acid to increase their effectiveness, as well as with antihistamines.

Are compresses necessary for mastitis?

Early stages of mastitis can be treated with cold compresses and antibacterial and anti-inflammatory ointments. Warm compresses can be prescribed after opening the abscess, but only with the permission of the surgeon and mammologist.

What ointments to use for mastitis

Symptoms of lactostasis and serous mastitis are reduced by a single application of Progestogel to the mammary glands. The early stage of infiltrative mastitis is treated with Traumeel, Levomekol, ichthyol and heparin ointment. “Balsamic liniment” (Vishnevsky ointment) is prescribed in the postoperative period and for superficial ulcers located in the subcutaneous tissue.

Preparations for external use must be combined with antibacterial treatment, antibiotics, vitamins and other means recommended by the doctor.

Among complex and dangerous female diseases, a special place is occupied by inflammation of the mammary gland - mastitis, to which absolutely all women are susceptible. But, despite this, there are many excellent ways to cure such an illness without consequences and complications.

Mastitis, or as it is also called, breastfeeding, is an insidious disease, the development of which can be triggered either by an infection, mainly Staphylococcus aureus, or by stagnation of milk in the mammary gland. As a rule, this disease occurs in a unilateral form, that is, in one breast. However, there are rare cases of bilateral mastitis.

To a greater extent, only women who have given birth suffer from breastfeeding, and not only those who safely feed their children, but also non-breastfeeding new mothers. This is due to hormonal changes in the female body after pregnancy and childbirth, as well as the beginning of lactation (the process of producing breast milk). However, it is worth noting that not only women in labor can be susceptible to the disease, but also those representatives of the fair sex who have any of the following health problems:

We will separately highlight other reasons why mastitis may occur. One of them is more concerned with young girls who have had their nipple pierced. During this procedure, if you carry it out independently and without observing hygienic and sanitary standards, you can introduce an infection into the body, which will become the causative agent of inflammation of the mammary gland.

Another reason is a woman wearing tight underwear, which leads to compression of the breasts and mammary gland tissue, which in turn can lead to their deformation and improper development.

What mastitis looks like: photo

Forms of mastitis

Inflammation of the mammary gland can occur in several forms, depending on which the woman will experience symptoms of varying severity:

• Serous form of mastitis– the initial form of the disease, in which a woman’s breasts greatly increase in volume and she feels pain upon palpation. In addition, a high temperature may rise. This form of breastfeeding is mainly characteristic of nursing mothers who have had milk stagnation (lactostasis), which has caused inflammation, because, as you know, breast milk contains a lot of different nutrients, and this is the most favorable environment for bacteria to live. As a rule, the serous form of mastitis is quickly and easily treated at home with folk remedies.

• Infiltrative form of the breast - a more complex stage of development of the disease, which occurs if a woman does not begin timely treatment for the serous form of mastitis. In addition to the characteristic symptoms of serous inflammation of the mammary gland, the woman also experiences a fever, and hard lumps appear in her breasts, which cause cutting pain. Seals will also make themselves felt externally. Redness will appear in the places where they are located on the skin of the chest. This form of breastfeeding cannot be cured on your own. During the visit to the doctor, the woman will be prescribed special antibiotics.

• Purulent form of mastitis– untreated infiltrative mastitis, that is, the lump begins to fester, resulting in an abscess that requires surgical intervention.

Types of mastitis

As we mentioned above, mastitis can occur both in women giving birth and in other women at risk. In view of this, inflammation of the mammary gland is divided into the following types:

• Lactation mastitis, which 7-16% of new breastfeeding mothers face.

Unfortunately, with such a diagnosis, a woman is strictly prohibited from feeding her baby in the future, since the milk is infected and poses a danger to the child’s health. It is necessary to suppress the process of milk production using drugs specially designed for this and do everything possible to get rid of the infection.

Some people confuse mastitis with lactostasis, which has similar symptoms of mastitis in a nursing mother women. However, in fact, lactostasis is one of the main and first causes of breastfeeding. Therefore, a woman in labor first of all needs to take all necessary measures to prevent stagnation of milk. To do this, you need to pump in a timely manner and feed the baby on demand at any time of the day.

The second cause of mastitis in nursing mothers is failure to comply with personal hygiene rules. Before and after each feeding, nipples should be washed well and treated with special products that moisturize and nourish the skin. Indeed, during feeding, cracks often form on the nipples, through which infection can easily enter the body and cause mastitis.

We cannot fail to mention another important reason for the occurrence mastitis during breastfeeding– the presence of an inflammatory process of an infectious nature in any other organ of the woman. This could be the throat, tonsils, nose, ear and even teeth. Immunity drops so much during pregnancy that a similar health problem can occur after childbirth.

• Non-lactation mastitis(extremely rare), occurring in women whose bodies have hormonal disorders and other abnormalities.

It should be noted that at an early stage mastitis in non-breastfeeding patients according to symptoms very different from women who breastfeed. The main signs that they have the disease include:

• Increased sweating
• The appearance of swelling in the chest
• No pain
• No temperature or nipple changes
• General health is quite satisfactory

Consequently, it is impossible to recognize mastitis in a non-breastfeeding woman at the very first stage unless she undergoes a regular medical examination by a gynecologist, mammologist and endocrinologist.

Treatment of mastitis

Depending on the type and form of inflammation of the mammary gland, the process of diagnosis and treatment of this disease will depend. We'll consider, how to treat mastitis lactational and non-lactational.

Treatment of mastitis in nursing mothers women will begin with a comprehensive diagnosis in order to identify the cause of the disease. To do this, the patient will need to donate blood, breast milk or other nipple discharge for laboratory testing. Their results should identify an infection that needs to be treated with antibiotics.

If no infection is detected (this is possible with a serous form of the infant), then mastitis can be treated at home. A woman can continue to breastfeed her baby and independently carry out the following manipulations:

• Do breast massage using different techniques. Water massage, when the mammary glands are massaged with a stream of water, helps and relieves pain very well.
• Exercise - perform at least two basic exercises - push-ups and squeezing your palms in front of you. During these exercises, the pectoral muscles are trained, which prevents congestion in the mammary glands.
• Apply cold compresses three times a day. It turns out that with this procedure you can relieve pain and inflammation. However, breastfeeding mothers will need to exercise extreme caution in this process to ensure that the cold does not affect breast milk production.
• Make cabbage wraps (preferably at night). To do this, you need to beat one cabbage leaf with a kitchen hammer so that the juice stands out. With the side of the sheet from which it comes out, apply it to your chest and wrap it loosely with a bandage or cloth. You can grind the cabbage in a meat grinder, and then mix it with yogurt, and make compresses from this mixture.

An alternative to cabbage could be:

• Vishnevsky ointment
• Vaseline ointment
• camphor oil
• camomile tea
• burdock leaves
• pumpkin pulp
• sea ​​buckthorn oil
• vodka
• cottage cheese cakes
• baked onion
• herbal decoctions from currant leaves, sage, St. John's wort, calendula

Important note! In no case should hot compresses be applied to lactation mastitis, because this can only create a favorable environment for the proliferation of bacteria in the mammary gland that provoked the disease.

If the tests reveal the presence of infection, then it will be impossible to do without a course of ten-day antibacterial therapy, but in this case breastfeeding will definitely be stopped.

What medications are usually prescribed for women with lactation mastitis:

• Ampicillin – taken in tablets;
• Amoxicillin - also taken in tablets, but can cause side effects in the form of allergic reactions;
• Cefazolin - injected intravenously and intramuscularly.

If the pain is very severe, which is especially typical for the last stages of mastitis, then women are also given painkilling injections (Novocaine).

In addition to antibiotics, the patient will also be injected with hormonal drugs that promote rapid emptying of milk from the breast. These include Oxytocin and Parlodel. To maintain the normal state of the female body, patients are also given IVs and a course of vitamins is prescribed.

If the case of lactation mastitis is too advanced, then doctors resort to surgery.

How to cure mastitis in a non-breastfeeding woman women? Essentially, the course of treatment will be the same. The biggest difficulty in the treatment process will be to establish the cause of breastfeeding. Therefore, the diagnosis of the disease is broader.

It includes the following procedures:

• Ultrasound diagnostics of the breast (at the site of inflammation)
• Tomography to detect tumors in the mammary gland
• Complete gynecological examination (examination and tests)
• Tests for hormone levels to detect endocrine disorders

If the root cause of mastitis in a non-breastfeeding woman is an infection, she will be prescribed the above course of antibiotics. If the disease occurs against a background of weakened immunity, the patient will be prescribed vitamin complexes and herbal preparations. If mastitis occurs after a chest injury, treatment will consist of physiotherapeutic procedures.

Complications and consequences of mastitis

Mastitis is a disease that, if treated incorrectly or untimely, can be fatal.

We will name 4 main complications that may arise:

1. Breast abscess, when large cavities filled with pus form in the mammary glands;
2. Cellulitis, which is characterized by the spread of pus throughout the chest, accompanied by extensive inflammation, swelling, bluish skin and high fever;
3. Gangrene – the skin of the breast becomes black, blistered and dead. With this complication, doctors often resort to amputation of the breast;
4. Sepsis - pus from the mammary gland enters the blood, resulting in blood poisoning and death of the patient.

Prevention of mastitis

If we are talking about a nursing woman, then the best prevention of mastitis is to frequently put the baby to the breast. In addition, new mothers during lactation need to wear special high-quality underwear that does not compress the breasts and allows her skin to breathe. Of course, it is important to follow the rules of personal hygiene - wash your nipples with baby soap after each feeding.

Women who do not breastfeed, first of all, need to be examined regularly. Under no circumstances should you overcool and cause infectious diseases, even if they are not related to the mammary gland.

Video: Mastitis: safety precautions for nursing mothers

In this excerpt from the TV show “Live Healthy!” experts talk with Elena Malysheva, what to do for mastitis lactating women.