Mastitis - symptoms, causes, complications and treatment of breast mastitis. How to recognize mastitis: clinical picture of the disease

Happy is the woman who did not know what mastitis is. But unfortunately, this disease occurs quite often. Up to five percent of breastfeeding mothers suffer from mastitis and, as a rule, this disease most often affects first-time mothers. Therefore, it is very important to strictly follow the rules of breastfeeding and basic sanitary standards. However, mastitis is an insidious disease. It affects not only nursing mothers, but also women over thirty, newborns and even adult men...

The fact is that breast mastitis is an inflammatory disease of the mammary glands, which is caused by various microorganisms. The trigger for the development of mastitis can be a cold or the penetration of infection through microcracks in the nipples. There are two types of mastitis - lactation, which occurs in nursing women, and fibrocystic.

The trouble of nursing mothers

As a rule, mastitis in nursing women develops in the first three months after the birth of a child. Mastitis during breastfeeding can be caused by a violation of milk flow through the ducts. As a rule, this is due to both simple inexperience and improper feeding of the baby, and inept actions when pumping. This is why lactation mastitis most often affects women giving birth for the first time.

If pumping and feeding are improper, microcracks appear on the nipples, which become entry points for infection. Staphylococcus aureus and other types of microorganisms penetrate through cracks into the breast and cause inflammation. Sometimes mastitis in nursing is a consequence of postpartum infection. But this happens extremely rarely.

Signs of mastitis

Once mastitis has begun to develop, it is impossible to recognize its symptoms. The disease manifests itself acutely: the temperature suddenly rises to 38-39°C; The breasts increase in size and become dense and sensitive. At the same time, a woman may have chills, nausea, weakness, and weakness, which resemble flu symptoms. Further, the signs of mastitis increase rapidly. After a while, it is simply impossible to touch the breast, it is so painful to the touch. After 2-3 days, a lump appears in the breast, the skin turns red, and a burning sensation and pain are felt when feeding.

Most often, mastitis in a nursing mother develops in one breast. It almost never appears after 6 months - most often it affects a young mother in the period 2-3 weeks -3 months after the birth of the child. Unfortunately, if mastitis appears, the woman is at risk - the incidence of recurrent mastitis is quite high. If treatment is not started on time, trying on yourself “tested” grandmother’s recipes, retold by friends, then the disease will quickly develop into purulent mastitis. In this case, drug treatment may no longer be effective and surgical intervention will be required.

Other types of mastitis

Women after thirty years of age may develop non-lactation mastitis. It affects weakened women who have problems with the immune system and sluggish pathological processes in the body. In this case, the signs of mastitis may not be so obvious and overlap with the symptoms of other diseases, which makes diagnosis difficult.

After forty to sixty years, symptoms may resemble mastitis-like breast cancer. For diagnosis, tissue is excised in the area of ​​the lump to rule out cancer.

Non-lactation mastitis in women can be caused by injury to the mammary gland, sudden climate change - non-lactation mastitis is a very common occurrence after a holiday in warm countries in winter.

Mastitis in men is very rare, but still occurs. First of all, this is a sign hormonal imbalance in organism; Mastitis often appears in those who suffer from diabetes. Sometimes men who have undergone gender reassignment surgery and breast implants also develop mastitis, but such cases are rare. As a rule, treatment of male mastitis is done without surgery, using medications.

Mastitis occurs in children. Mastitis most often occurs in newborns, which develops in the first weeks of life due to infection. Microorganisms penetrate through the blood from another source of infection or from the outside, through skin lesions. We must remember that childhood mastitis develops very quickly and has a rapid course. After a day or two, the disease enters a purulent stage. You should not think that if the newborn is a boy, then he cannot get mastitis - childhood mastitis equally often affects both boys and girls.

Mastitis manifests itself as a common inflammatory disease - the temperature rises, the child becomes apathetic or, conversely, excitable, and refuses to eat. One mammary gland is enlarged. On the first day of illness there is no redness, then swelling, redness, and soreness appear. Breast mastitis in a child requires prompt medical attention at the first suspicion. Babies are treated in the hospital with antibiotics and vitamins.

Mastitis affects girls in adolescence– as a rule, hormonal changes in the body are to blame for this, leading to a temporary weakening of the defenses. Treatment of mastitis in adolescents is similar to the treatment of non-lactation mastitis in adult women.

Treatment of mastitis

Despite the severity of the symptoms, mastitis in women is treated successfully and quickly enough. Conservative and surgical treatment methods are used. If mastitis is diagnosed quickly and is not advanced, then antibiotic therapy is prescribed for two weeks. The disappearance of painful sensations is not a reason to discontinue medications. If treatment is interrupted, mastitis may return.

At the same time, to alleviate the condition, applying ice to the chest is prescribed, drinking plenty of fluids, warm shower. No matter how painful it may be, you should not stop breastfeeding or pumping. If purulent mastitis has developed, it is better to express milk. Otherwise, milk will accumulate in the breasts and mastitis will worsen.

If antibiotic therapy does not produce results and mastitis has entered the purulent stage, then surgical intervention: the abscess is opened in the hospital.

Prevention of mastitis

Lactation mastitis is better prevented than treated! From the very beginning of feeding, follow simple rules that will help avoid breast infection. Before and after each feeding you need to wash mammary glands, wipe weak disinfectant solution. Be sure to change the baby's position, placing him on each breast in turn, but only after he has completely emptied the first breast. Express the remaining milk.

There is no need to allow the baby to play with the breast - if he is already full and is just playing around, then stop feeding. Due to the constant presence of the nipple in the child's mouth and biting, microcracks may appear on them, through which the infection can easily penetrate into the mammary gland.

Any cracks in the chest that appear should be immediately lubricated with a solution of brilliant green.

It is especially necessary to carefully monitor the health of teenage girls, not allowing them to overcool the mammary glands or engage in sports that can lead to breast injury.

The main thing to remember is that at the first signs of the disease there is no need to self-medicate, look for forgotten recipes in books, follow the advice of neighbors and good relatives. Mastitis can be cured quite quickly and without any complications if you consult a doctor in time.

Mastitis is a fairly common disease; its symptoms can be extremely unpleasant. And if it is not diagnosed on time, then untimely or incorrect treatment can lead to serious consequences. Find out the first signs of illness so you can be fully prepared.

Mastitis is a disease characterized by inflammation of the mammary gland. More often inflammatory process begins to develop due to activity pathogenic microorganisms, such as streptococci, staphylococci and some others. These bacteria can invade breast tissue in different ways, but most often they come from the outside, namely through damage to the skin, including microscopic ones.

In most cases (90-96%), mastitis develops during breastfeeding, but it can also be found in non-breastfeeding women and girls. Female representatives are more susceptible to this disease during puberty, which occurs at 13-15 years of age, as well as during menopause and menopause, and this is primarily due to hormonal changes. But sometimes mastitis is diagnosed in newborn girls or even in men, although such cases are medical practice are rare.

As for the reasons, as a rule, they are associated with improperly organized breastfeeding. Negative factors during lactation may include stagnation of milk (lactostasis), improper attachment of the baby to the breast, clogged feeding (milk) duct, failure to comply with personal hygiene rules (touching the mammary glands with dirty hands, wearing dirty underwear), damage to the nipples, which contributes to penetration of pathogenic microorganisms into tissues.

In non-breastfeeding women, mastitis develops due to various damage to the tissue of the mammary glands and damage to the integrity of the skin in this area. Bacteria can enter through cracks, scratches, abrasions, wounds, unsuccessfully removed pimples or moles. Towards development pathogenic microflora may lead to certain accompanying illnesses, for example, mastopathy or dermatological diseases (subject to violation of the integrity of the lesions). But sometimes the infection spreads inside the body from nearby organs. Also, infection in non-breastfeeding females can be caused by something in the breast. foreign bodies, such as piercing earrings, implants.

Manifestations of the disease

If mastitis develops, its signs will not go unnoticed, but they may be confused with symptoms of other breast diseases. And yet it is possible to distinguish the disease. Thus, one of its features is its one-sided nature: inflammation is usually observed only in one breast (although it also happens differently). And the specific manifestations of mastitis in women depend on its form and stage. Several stand out, and each is worth considering in detail.

Serous mastitis

Most mild form and the first stage of development is considered to be serous, in which serous fluid, spreading through the tissues of the mammary glands. In this case, the signs of mastitis are mild and similar to lactostasis in nursing mothers. Thus, the mammary gland may become engorged and swollen, somewhat enlarged in size. Sometimes hyperemia is observed, the skin in the area of ​​inflammation becomes hot. In some cases, serous mastitis occurs without temperature, but it can also increase to insignificant levels (37.5 - 38 ° C). Expressing becomes painful, does not bring the expected relief, and the woman experiences discomfort.

If inflammation of the mammary gland continues to develop further, then the serous fluid provokes further changes in the tissues, as a result of which mastitis passes into the next stage and a more complex form.

Infiltrative mastitis

The next stage is infiltrative. How to determine such mastitis? With this form, an infiltrate forms in the breast tissue, which is an accumulation of cells, as well as admixtures of lymphatic fluid and blood. He is subsequently exposed to pathogenic microflora.

Symptoms of infiltrative mastitis:

• The infiltrate, which looks like a compaction, does not have clear boundaries and has a heterogeneous structure, is easily palpable.
• The pain intensifies; it is observed not only upon palpation, but also with minimal mechanical stress. Gradually the pain becomes constant.
• The temperature rises to more critical levels - about 38.5-39 °C.
• Swelling of the mammary gland increases, the affected breast may increase in size, which becomes clearly visible even to the naked eye.
• The skin in the area of ​​inflammation is hot and may turn red.
• On at this stage Signs of general intoxication of the body may appear, such as fever, body aches, weakness, headaches, and malaise.

The duration of the stage depends on the woman’s health, as well as treatment. If therapy is incorrect, then mastitis progresses to the next form.

Purulent mastitis

The infiltrate that appeared at the previous stage, if untreated, can become inflamed, and this will lead to the formation of pus. In this case we will talk about the purulent form.

How does mastitis manifest if it is in purulent form? You should pay attention to the following warning signs:

• A certain rather extensive area of ​​compaction, the tissues of which seem to roll or shimmer upon palpation and resemble a honeycomb. This manifestation indicates the presence of purulent contents. In some cases, there are several zones, which signals the spread of the process.
• The pain increases and can become cutting.
• The affected mammary gland looks very swollen, the redness intensifies.
• Hyperemia persists and intensifies, the skin remains very hot to the touch.
• Superficial veins and small capillaries dilate.
• Extremely preserved heat bodies.
• Signs of intoxication are increasing, manifested in the form of a decrease and complete absence appetite, severe weakness, dizziness or headaches, drowsiness, muscle pain, as well as nausea or even vomiting.
• Regional located in close proximity to the chest The lymph nodes increase in size and thicken, they are easily palpable and can stand out above the surface of the body.

At this stage, only surgical treatment is possible. And if it is not timely, then mastitis can develop into the next form.

Phlegmous mastitis

Purulent inflammation at this stage extends to soft fabrics and can even melt them. Cellulitis does not have clear boundaries, so it is often not possible to detect the compaction during palpation. But the symptoms continue to become more and more pronounced, and the woman’s condition steadily worsens and becomes extremely serious.

The swelling becomes even more obvious and becomes total, the skin of the mammary gland may have a burgundy or bluish tint, the nipple is often deformed and retracted, and the breast is extremely painful. All signs of intoxication intensify, and may be accompanied by fainting and convulsions. The patient requires immediate and professional medical care, in the absence of which it will develop last stage mastitis.

Gangrenous mastitis

In the gangrenous form, the inflammatory process involves blood vessels and lymphatic vessels, tissue death begins. The affected mammary gland significantly increases in size, darkens, and black areas appear on its surface, indicating necrosis, that is, tissue death. In some cases, blood clots form and the skin may become blistered.

If there is no help at this stage, then extremely difficult problems will arise. severe consequences, even death.

Mastitis can develop in both nursing mothers and non-breastfeeding women. In any case, it is important to detect it in time in order to be able to start competent treatment and avoid complications.

The value of breastfeeding for both the health of the child and the young mother is undeniable. However, quite often the process is in danger of being interrupted due to the development of inflammatory processes in the mammary glands of a nursing woman.

Specifics of development and general symptoms of the disease

Mastitis is often complicated by lactostasis developing in the mammary gland. It is characterized by an active inflammatory process that occurs for various reasons, most often it is infectious processes. If the disease occurs during breastfeeding, the cause may also be excess milk, which is retained in the mammary glands and forms lumps.

It is breastfeeding mothers who constitute a risk group. Mastitis can also develop when a crack or other wound appears on the areola of the nipple, through which infection penetrates. The period of menopause, when it occurs, is also considered a negative factor. hormonal disbalance. In prenatal women, mastitis develops extremely rarely.

Based on the causes of the disease, mastitis is divided into two main types: lactation (occurring during breastfeeding) and non-lactation (developing at other times, independent of childbirth). The pathological process proceeds almost the same, regardless of its type.

Highlight the following types mastitis:

Each type of pathology has characteristic features mastitis, which distinguishes them from other inflammatory processes in the mammary gland. You can determine inflammation yourself at the initial stage, however, accurate diagnosis Only a doctor can.

The first signs of the disease usually appear almost immediately after the onset of the inflammatory process. The very first symptom that helps determine the presence of abnormalities is a lump in the chest.

The following visual symptoms of mastitis are also noted:

• redness skin mammary gland;
• temperature up to 40 degrees;

With absence timely diagnosis and therapy for the patient:

At breastfeeding Milk mixed with blood or pus may be released. The cause of such discharge is an abscess, which indicates the development of an acute form of the disease.

Symptoms of the disease depending on its form

Mastitis is an inflammatory process that can occur in different shapes, depending on the reasons that prompted it and the factors contributing to its progression.

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In medicine, there are six stages of the disease:

Determine the form of pathology without the help of a doctor and special examination very difficult. Each type of disease manifests itself special features, characteristic of him. In this case, the patient also experiences the above listed general symptoms mastitis.

Serous stage

It is very difficult to diagnose the pathology of the serous form without medical help, since the symptoms are similar to lactostasis. Only a specialist can make an accurate diagnosis. However, the signs of serous stage mastitis are clearly expressed.

Symptoms include:

The serous form develops within two to three days. If the pathology is not diagnosed at this stage, the disease quickly progresses to the next form.

Infiltrative form

The most commonly diagnosed type of mastitis. When therapy is started in a timely manner, it does not progress to other stages. The infiltrative form is characterized by the formation of a purulent focus of inflammation, which in most cases forms on the surface of the skin of the breast (mainly on its upper area).

Signs of the infiltrative form are:

When pathology develops during lactation, milk production does not stop, but it flows out with difficulty. In this regard, there is additional negative impact on the chest, which aggravates the situation.

Purulent form

The development of the purulent form most often occurs gradually. IN in rare cases mastitis progresses acutely. The symptoms of the disease are characterized gradual increase intensity of signs. The purulent type of the disease is preceded by the rapid development of the first two forms.

Purulent inflammation is accompanied by:

Upon palpation, a mobile neoplasm with a dense consistency can be detected. Palpation is accompanied by pain. At the purulent stage, the infiltrate no longer has clear outlines.

Abscess stage

An abscess form of the disease develops in the absence of treatment for purulent inflammation. All symptoms of the previous stages become significantly worse and are complemented by other symptoms.

The abscess stage is characterized by:

The infiltrate of an abscess is strictly localized. Its boundaries are clear. In the absence of medical therapy or other methods of influence, the pus begins to spread.

Phlegmonous mastitis

Exacerbation of an abscess is a phlegmonous stage. At this stage, mastitis affects the entire mammary gland. The woman's general condition deteriorates sharply and severely. Symptoms are of high intensity, leading to severe painful sensations and other signs of the inflammatory process.

The signs of mastitis at the phlegmonous stage are as follows:

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During diagnosis, changes are also noted in laboratory tests: very low hemoglobin, an increase in the number of leukocytes in the blood and the appearance of protein in the urine.

Gangrenous mastitis

Lack of treatment for phlegmonous form or violation immune system lead to the development of the most dangerous type of mastitis – the gangrenous stage. At this stage, breast tissue can become necrotic. Gangrenous mastitis is nothing more than the formation of gangrene, which is characterized by complete decomposition tissues, accompanied by purulent processes.

Symptoms of gangrenous mastitis are acute:

In advanced cases, the skin of the mammary glands has open gangrene, which gradually increases the affected area. In this case, treatment can only be carried out surgical method through partial or complete removal mammary gland. Breastfeeding in case of gangrene is impossible.

Diagnostics

Self-diagnosis for mastitis can be dangerous. You should examine your breasts yourself very carefully. At the first stage, you can only determine the presence of abnormalities; it is impossible to make a diagnosis yourself.

It is impossible to identify pathology without the help of a specialist, even if acute forms disease, however, palpation of the chest and assessment of symptoms can suggest a diagnosis. It is possible to accurately determine the type of disease only after visiting a doctor (surgeon or mammologist) and undergoing a full examination.

The specialist examines the breast tissue and palpates to identify foci of inflammation. The woman will also need to pass lab tests and get a mammogram. The specialist may prescribe an ultrasound to accurately identify the location of the tumors. At the acute purulent stage, a puncture is performed.

To prevent progression dangerous species Mastitis should be contacted by specialists when the first signs are detected pathological process. We should not forget that the initial stages of the disease occur very quickly.

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• nipple discharge...
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Mastitis is infectious inflammation mammary glands, which most often develops in women after childbirth and is associated with breastfeeding.

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

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

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

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

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

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

Symptoms of mastitis

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

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

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

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

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

Causes of mastitis

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

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

Lactostasis

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

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

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

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

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

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

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

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

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

Chronic mastitis

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

Risk factors for developing mastitis

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

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

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

Causes of non-lactation mastitis

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

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

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

Neonatal mastitis

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

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

Diagnosis of mastitis

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

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

Additional examination

As additional examination assigned:

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

Treatment of mastitis

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

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

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

Is it possible to breastfeed during mastitis?

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

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

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

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

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

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

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

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

Treatment of non-purulent mastitis

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

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

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

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

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

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

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

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

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

Treatment of purulent mastitis

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

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

Prevention of mastitis

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

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

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

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

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

Basic rules of breastfeeding:

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

2. You should take a comfortable position: sitting or lying down, so that your muscles do not feel tired and you do not need to change your body position by interrupting feeding.

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

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

5. Most important point- correct latching on the breast during feeding. The baby should latch on wide open mouth, not only the nipple, but also most of the areola - the areola. Underlip The baby's breast should be turned outward while sucking.

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

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

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

How to express milk correctly

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

• To facilitate the release of milk before expressing, you can do a gentle massage of the breast.
• When expressing, place your fingers on the periphery of the areola (at the border of the skin and the nipple circle), do not pull the breast directly by the nipple.
• Alternate pumping with stroking movements from the periphery of the breast to the areola of the nipple.

Breast care

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

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

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

Breastfeeding is an important and responsible period in a woman’s life. Many people experience breast problems while breastfeeding. Lactostasis and mastitis can often occur. Inexperienced mothers may confuse these diseases. In order to start treatment in a timely manner, you need to know their differences.

Lactostasis and mastitis have similar symptoms

Lactostasis

This is stagnation of milk in the milk duct. The gland in which stagnation has formed undergoes swelling and becomes painful on palpation. It is difficult to express milk from the affected breast; this is often difficult to do due to severe pain.

Lactostasis does not affect general state women, it is expressed only by local manifestations.

There is a feeling of discomfort when feeding and nagging pain.

1. Self-palpation of the breast reveals a lumpy painful lump. During pumping, milk release is difficult.

All signs may vary in intensity depending on the severity of the condition. With prolonged stagnation, pathogenic flora may attach, which subsequently leads to infection.

Lactostasis is expressed by discomfort during breastfeeding

Mastitis

Represents an infectious inflammatory process in the mammary gland. The breasts increase in size, redness of the skin occurs at the site of inflammation. Deterioration in general well-being, manifested in symptoms of general intoxication. The disease begins abruptly, with a rise in temperature to 38 degrees, headache and lethargy. The chest increases significantly in size, a feeling of fullness and pain appears. The skin is swollen, with a characteristic reddish tint in the affected area, hot to the touch.

At initial stages mastitis, the patient's condition is satisfactory. Advanced disease may lead to joining bacterial infection, which, against the backdrop of a favorable nutrient environment, quickly develops into purulent mastitis.

Mastitis may be accompanied by fever

Reasons for the development of lactostasis and mastitis

Lactostasis in most cases develops due to non-compliance with the feeding regime and hygiene procedures. Abrupt termination of breastfeeding also leads to stagnation of milk.

Insufficient breast pumping is the main factor for the development of congestive processes.

Mastitis develops against the background of prolonged lactostasis. Improper attachment and breast care leads to cracked nipples, one of the ways for pathological flora to penetrate. The presence of chronic foci of infection and decreased immunity increase the risk of mastitis.

Comparisons of the differences between these two diseases are given in the table.

signs	lactostasis	mastitis
General toxic symptoms	With lactostasis, the woman’s general well-being is not affected, body temperature remains normal	Deterioration in health, headache, drowsiness, lethargy, often fever up to 38 degrees or higher
Local symptoms	Swelling of the gland, pain, redness	The breast increases in size, the skin becomes rich red, shiny, pain not only during palpation, but also at rest, hot to the touch.
Milk separation	It is difficult; when expressing, you will see how it drips from one duct, while from others it flows like a stream	Hardly
Onset of relief from pumping	Yes	No
Enlarged lymph nodes	No	Yes
Duration	1-2 days	When after 1-2 days the body temperature begins to rise, the swelling increases - serous mastitis can be assumed.

What not to do when lactostasis begins

1. Apply warming agents or alcohol compresses, this will only worsen the situation and create an environment for the development of pathological flora.
2. Do not give the baby the affected breast - of course, feeding will be painful. But it is the baby who will cope with stagnation better than any pumping.
3. Reducing the amount of liquid you drink leads to thickening of the milk, which further aggravates the situation.
4. You should not let your husband help you overcome lactostasis. The sucking behavior of an adult and an infant differs significantly, and such manipulations can lead to injury to the nipple.

If you have lactostasis, you need to drink a lot of fluids

Treatment

If signs of lactostasis are detected, measures must be taken immediately. If you delay the process for several days, there is a high risk of developing mastitis.

1. To improve milk flow, apply more often to the baby’s “sick” breast. Use different feeding positions, preferably so that the baby's chin rests on the swollen area.
2. You need to massage your breasts with gentle movements in a circle. Under no circumstances should you “break” it, as this will only damage the delicate breast tissue.
3. You need to express not after feeding, but before it. Doing this after feeding will only increase milk production. Carry out these procedures after a warm shower or bath.
4. Physiotherapy using ultrasound gives a good effect in treatment. After just a couple of sessions, relief comes.

Treatment folk remedies cannot be replaced with anything prescribed by a doctor. Only as auxiliary manipulations. By being carried away by self-medication, you can worsen the situation and lead to purulent inflammation– and subsequently, to surgical treatment.

Physiotherapy with ultrasound gives good effect for mastitis

If non-infectious mastitis occurs, treatment is prescribed by a doctor. Drug treatment in such cases is not required. To identify pathological flora, bacterial culture of milk is done. If detected, antibacterial drugs are prescribed. In such cases, stop feeding from the affected breast. But you don’t have to stop breastfeeding completely - you can feed the baby from a healthy breast and express the other one.

After treatment, with the permission of the doctor, you can begin to breastfeed.

Prevent the development of lactostasis in a timely manner by following the recommendations. Consult a lactation specialist to help resolve issues with proper attachment. Do not delay contacting a specialist - the sooner treatment begins, the lower the risk of complications and the spread of infection.