Update: December 2018
Mastitis is an inflammatory process in the area of the parenchyma and in the area of lactating breast tissue. The disease develops only in 2 - 5% of lactating women. Despite the fact that acute mastitis can occur in women at any time, it most often occurs 2 to 3 weeks after childbirth (82-87% of cases), but it can also occur later.
This is explained by the anatomical and physiological changes that occur in the breast when the secretion of colostrum and milk begins. In 90-92% of patients, only one mammary gland is affected, and the left-sided one is more likely to have right-sided mastitis (it is easier for a right-handed person to express with the right hand, so the left breast is better emptied than the right).
The main condition for the development of mastitis is congestion in the chest (see), which may or may not be accompanied by an infection (usually hospital-acquired) - non-infectious mastitis.
Primipara women are at risk for mastitis because they:
- there is a physiological imperfection of the ducts of the mammary glands
- poorly developed glandular tissue that produces milk
- underdeveloped nipple
- besides, there is still no experience
- No ().
About the lactation period
The shape, size and position of the breast are very individual, vary widely within normal limits and depend on:
- age
- phases of the menstrual cycle
- general physique
- lifestyle
- state reproductive system women.
Anatomy of the mammary glands
A woman’s breasts have a lobed structure, large lobes are separated by intervals of connective tissue into 20–40 segments, each of which consists of alveoli. The alveolus itself is lined with a single-layer glandular epithelium with an excretory duct, which are connected to each other into large ducts in which breast milk accumulates. Lobar ducts, merging with each other, excretory ducts open at the tip of the nipple of the breast.
In the area of the border of the halos, the ducts have extensions called lacteal sinuses. Around the glandular structures, the breast space is filled with adipose tissue, which determines its size and also shape, along with the development of the glandular lobules themselves. A woman’s breast is surrounded by a whole complex of lymph nodes, so when the breasts become inflamed, they increase in size and are painful. Lymph nodes into which lymph flows from the mammary gland:
- axillary (97% outflow)
- supraclavicular
- subclavian
- parasternal
- mediastinal and bronchopulmonary
What happens to the breasts during pregnancy and immediately after the birth of the baby
Synthesis and isolation breast milk for feeding the baby starting from the second trimester of pregnancy, when the production of colostrum is gradually activated.
- Colostrum - more like whey than regular milk, with a high content of proteins and fats, is secreted until the first 2-3 days after the birth of the child, and then is replaced by transitional and mature milk.
- Maximum amount of milk matures by 6–12 days of the postpartum period.
- Stabilization period- when the optimal amount of milk secreted for the baby’s nutrition occurs, this period lasts during the first 3 to 6 months of breastfeeding.
- Average duration of lactation ranges from 5 to 24 months.
Why does mastitis occur?
Pathogens of mastitis
There are 3 main causative agents of lactation mastitis, primarily:
- 70% of breastfeeding women with mastitis have Staphylococcus aureus
- staphylococcus albus
- streptococcus
As a rule, these infectious agents are resistant to penicillins. Less commonly sown are β-hemolytic streptococcus, fecal enterococcus, Escherichia coli, Klebsiella pneumonia, and up to 1% Mycobacterium tuberculosis. Most often, anaerobes are detected, which are mainly represented by staphylococci. Also, epidermal staphylococcus can be sown in cultures, but it is not pathogenic, gets into the milk from nipples that are not treated before the culture, and does not cause any purulent process in the breast.
Infection
Infection can be either community-acquired or nosocomial - it occurs through contact with infected linen, care items, etc. Prognosis for nosocomial infection will be more severe than with community-acquired infection.
Adult bacteria carriers- with classic mastitis after childbirth, the source of infection can be hidden bacteria carriers (usually from medical staff, roommates, their relatives), who become ill with mild, erased manifestations of purulent or infectious inflammatory pathologies. It is believed that 20-30% of people are carriers of Staphylococcus aureus.
Newborn - a source of infection can also be a baby, who can be both a carrier of the bacilli and a patient with inflammatory diseases nasopharynx, oral cavity, pharynx or pyoderma (pustular skin disease).
One contact of Staphylococcus aureus on the skin of the chest is not enough to cause mastitis; for its development, the presence of provoking factors is necessary:
Local anatomical factors provoking mastitis:
- nipple defects - lobed nipple, inverted flat nipple, etc.
- mastopathy
- rough scars after surgery ( severe forms mastitis in the past, removal benign neoplasms etc.).
Systemic functional factors:
- pathological course of pregnancy- late toxicosis, threats of miscarriage, premature birth
- pathology of childbirth - blood loss during childbirth, trauma of the birth canal, manual separation of the placenta, first birth of a large fetus
- postpartum complications- bleeding, postpartum fever, exacerbation of concomitant diseases.
A decrease in tissue resistance to the pathogenic influence of microorganisms against the background of a decrease in the functioning of local and general immunity after childbirth, hypovitaminosis, concomitant pathologies, pathologies of childbirth and pregnancy create favorable conditions for the development of mastitis.
The mechanism of mastitis
Milk stagnation
When milk stagnates, a small amount of bacteria is found in it, which accumulate in the ducts of the gland. Over time, milk curdles and undergoes fermentation processes, which provokes the destruction of epithelial cells lining the milk ducts and alveoli.
Curdled milk, together with particles of desquamated epithelium, blocks the milk ducts, causing lactostasis. When stagnation occurs, bacteria multiply intensively and cause infectious inflammation. Increased pressure in the chest disrupts blood circulation processes - venous stagnation. Edema helps to reduce the overall reactivity of the tissue, which creates excellent conditions for the proliferation of bacteria.
Inflammation leads to significant breast soreness, which naturally complicates expressing milk, creating a vicious circle: lactostasis increases inflammation, inflammation aggravates lactostasis.
Cracked nipples
The infection, as a rule, penetrates through cracks in the nipples; infection is possible during expressing milk or breastfeeding; less often, the infection spreads through the blood and lymph flow. In 25–31% of cases of all mastitis, cracked nipples are also recorded at the same time, which makes it possible to trace the relationship. And although cracks in the nipples are found in 23–65% of all breastfeeding women, when mastitis develops only in 3–6%, nevertheless, preventing the occurrence of cracks serves as a simultaneous prevention of the development of mastitis.
The main reason for the development of cracked nipples is improper attachment of the child - incomplete latching on to the breast by the child. Improper breast care can also worsen cracks (see).
Often, it is the appearance of cracks in the nipples, forced pumping (and insufficient emptying of the breast at the same time) that causes lactostasis and, as a result, mastitis.
Diagnostics
If symptoms of mastitis occur, a nursing woman should contact a gynecologist, mammologist or surgeon. After examining the breast and assessing the patient’s complaints, the doctor may order the following tests:
- urine test and general analysis blood
- bacteriological (number of bacteria in 1 ml) and cytological (number of leukocytes) examination of milk from both glands
- except clinical symptoms, in the diagnosis of initial forms of mastitis, laboratory studies of the secretion of the female breast will be significant. Normally, it has a slightly acidic reaction (pH - 6.8). Inflammation provokes a change in the acidity of milk towards an increase in pH, which can be explained by an increase in the activity of alkaline phosphatase.
To diagnose erased forms of lactation mastitis, use:
- Ultrasound (for destructive forms of mastitis) to determine the exact location of the purulent area
- thermal imaging, thermography
- in rare cases, mammography is used for serious indications
- puncture of the infiltrate (for phlegmonous and abscess forms) followed by bacteriological examination of the pus.
Classification of mastitis
Depending on the clinical signs, the number of leukocytes and bacteria in the analysis of breast milk, the following are distinguished:
- lactostasis
- non-infectious mastitis
- infectious mastitis
Using only clinical signs and symptoms of mastitis, it is impossible to determine the absence or presence of infection. In the absence of effective evacuation of breast milk, non-infectious mastitis will develop into infectious mastitis, and this, in turn, can lead to the formation of an abscess. In clinical practice, the following classification of mastitis is used:
According to the course of the inflammatory process:
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According to functional status:
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According to the location and depth of the lesion:
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According to the nature of inflammation:
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According to the prevalence of the process:
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In addition, with some breast diseases, similar symptoms occur as the symptoms of mastitis in nursing, so it must be distinguished from:
- boils, carbuncles
- abscesses, phlegmon
- erysipelas, which are combined into one concept - paramastitis
- in case of chronic mastitis, differential diagnosis is required (biopsy of suspicious material and its histological examination).
Symptoms
What is the difference between breast engorgement and full breasts? When the breasts swell, both lymphatic and venous drainage are difficult, pressure in the milk ducts increases, and both breasts swell and swell. The picture is similar with breasts filled with milk, but there are differences:
- breasts full of milk- hard to the touch, heavy, warm, but there is no swelling or redness, and there is no visible shiny surface, milk spontaneously leaks from the nipple, it is easy for the baby to suck and the milk flows easily.
- engorged breasts- painful, enlarged, swollen, looks swollen and may be shiny, with blurry areas of reddened skin, the nipple sometimes stretches to a flat state, the baby has difficulty attaching to the breast and also sucking because milk does not flow easily from the breast.
Serous form of mastitis, unlike milk stagnation
Acute inflammation must be distinguished from simple stagnation of milk, the causes of which may be: abnormal nipple structure, short frenulum in a child, improper attachment, underdevelopment of the milk ducts in first-time mothers, untimely pumping, intense milk production.
| LACTOSTASIS | SEROUS MASTITIS | |
| Beginning of state | Acute lactostasis is a bilateral process, and most often develops between 3–5 days after birth, i.e. on milk flow days. | Stagnation of milk with the addition of pyogenic microflora for 2 - 4 days, and sometimes even a day, turns into a serous form of mastitis. It usually begins acutely:
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| Condition of the gland, skin | With stagnation, the tumor-like formation corresponds to the contours of the lobules of the mammary gland, is mobile, with clear boundaries and a bumpy surface, and most importantly, painless and without redness. | Due to the presence of infiltrate, the breast increases in size, palpation becomes sharply painful, and the infiltrate itself is not clearly defined. |
| Pumping | When pressed, the milk is released freely - expressing is painless and relief is sure to be felt after it. | Expressing is extremely painful and does not bring relief. |
| General state | The general condition of a woman with acute stagnation worsened slightly. Body temperature, lab tests blood and milk - within normal limits. When milk stagnation occurs, two main clinical sign inflammation: redness and fever. | Persistent subfibrility 37-38C or in an acute process immediately 38-39C. Clinical analysis blood shows signs of inflammation - an increase in the number of leukocytes, an increase in ESR. |
For non-infectious mastitis early stage Spontaneous recovery is possible - the seal resolves, the pain subsides, the temperature returns to normal. In case of infection, as a rule, without treatment, the process enters the infiltrative phase. Doctors advise that any severe engorgement of the mammary glands with an increase in body temperature should be considered the initial stage of mastitis in order to promptly begin diagnosis and adequate treatment.
There are cases when banal lactostasis occurs with severe breast tenderness and a disturbance in the general condition of the woman, then after careful expression of milk after 3-4 hours, the infiltrate is palpated again and examined:
- With lactostasis, the temperature decreases, the pain subsides and the condition returns to normal.
- With a combination of mastitis and lactostasis after 3-4 hours the painful infiltrate is palpated, the condition does not improve, the temperature remains high.
Infiltrative stage
In the absence of adequate treatment, after 2–6 days the process may enter the infiltrative phase, which is characterized by greater severity of clinical symptoms and deterioration of the woman’s condition.
- An infiltrate without clear contours forms in the affected breast
- The affected breast is enlarged, the skin over the infiltrate is not yet red and there is no swelling yet, the affected gland is extremely painful.
- In 80% of patients, body temperature rises to 38.0 - 41.0, with treatment it can be reduced to 37-37.5C.
- Signs of intoxication: weakness, headache, lack of appetite.
In the absence of therapy, the infiltrative form of the disease passes into a destructive stage after 4-5 days, the serous inflammation becomes purulent and the breast tissue resembles a honeycomb with pus or a sponge soaked in pus.
Destructive - purulent and gangrenous mastitis
Strengthening general and local symptoms inflammation will indicate the transition of the initial forms of mastitis to purulent stage, while signs of purulent intoxication are clearly expressed, since toxins enter the blood from the source of inflammation:
- The body temperature constantly remains at high levels; temperature changes of several degrees are typical during the day. The temperature of the mammary gland itself also increases.
- Intoxication: appetite decreases, headache, weakness appear, sleep deteriorates.
- The chest is tense, enlarged, the infiltrate itself increases in size, has clear contours, the skin of the chest turns red, and every day it is more and more pronounced.
- Symptoms of fluctuation (fluid/pus movement) appear in one area of the gland.
- In some cases, regional lymphadenitis occurs (enlargement of nearby lymph nodes).
- Abscesses can form on the surface or in the deep parts of the gland with subsequent spread.
There are the following forms of destructive mastitis:
- Abscessing - with the formation of abscess cavities (cavities filled with pus), while softening and a symptom of fluctuation (irridescent liquid when palpated) are felt in the infiltrate zone.
- Phlegmonous - significant swelling of the breast and its massive enlargement, sharply painful, the skin is bright red, perhaps even bluish-red, there is often retraction of the nipple. The woman's hemoglobin is reduced and urine analysis worsens.
- Infiltrative-abscessing- the presence of a dense infiltrate, which includes small abscesses of various sizes. It is more severe than an abscess. The symptom of fluctuation is rare due to the fact that ulcers do not large sizes and the compaction may appear uniform.
- Gangrenous is an extremely serious condition of a woman, characterized by a fever of 40 - 41º, an increase in pulse to 120 - 130 beats/min, the breasts sharply increase in volume, skin swelling is noted, blisters with hemorrhagic contents are identified on its surface, and areas of necrosis are identified. Gradually the swelling spreads to the surrounding tissues.
Should I continue or stop breastfeeding if I have mastitis?
As for maintaining breastfeeding during mastitis, several decades ago the recommendations of pediatricians and gynecologists were categorical: During the period of mastitis treatment, interrupt breastfeeding.
Today, the situation has turned 180 degrees and all breastfeeding specialists are demanding that babies be breastfed, no matter what. It seems that the truth, as usual, is still closer to the middle or, at a minimum, should be based on a set of arguments for and against. It is worth making a distinction between feeding the baby this milk and maintaining lactation as such:
Maintaining lactation
Lactation should be maintained in all cases where possible, since regular milk flow is very important; according to some data, only 4% of cases of acute mastitis, while maintaining lactation and feeding the child, progresses to an abscess or purulent mastitis.
Feeding a baby with breast milk with mastitis
And when it comes to feeding a baby with breast milk, it is worth weighing the risks and benefits for the baby of not breastfeeding and the impact of the mother's treatment. In each clinical case, the issue is resolved individually:
- For non-infectious mastitis, which is not so different from lactostasis, breastfeeding cannot be stopped. Of course, in conjunction with rational pumping (not to the last drop, but as necessary to avoid hyperlactation), gentle therapeutic massage and anti-inflammatory therapy (Ibuprofen, Traumeel, ultrasound).
- If we are talking about an infectious process. Here we will have to proceed from how severely the person suffers general state mothers (it is difficult to feed with a temperature of 40, wild pain and axillary lymphadenitis).
The second point becomes purulent discharge from the nipples. Breastfeeding instructors persistently argue that pus is just dead bacteria and white blood cells and that feeding a baby with it is not contraindicated. But excuse me, we object, why is purulent discharge still sown in bacteriological laboratories, obtaining good bacterial growth and determining the sensitivity of pathogens to antibiotics? Purulent discharge from the nipples should:
- or express very carefully before feeding
- or become an obstacle to continuing breastfeeding during the period of treatment for purulent mastitis.
You can maintain lactation during the treatment period with the help of regular pumping until the problem is resolved, but during this period, feeding the child and then treating intestinal disorders against the background of staphylococci acquired during feeding, as well as from the influence of antibiotic therapy, is an extremely unfavorable matter for the baby, long-term and costly.
Almost all antibacterial drugs administered to a nursing woman enter breast milk and the baby’s body, causing adverse effects - toxic and allergic reactions, suffers normal microflora Gastrointestinal tract.
Depending on different pharmaceutical groups, some antibiotics easily penetrate milk and create high concentrations of active substances, others pass in small quantities, which does not represent real threat for the baby and therefore approved for use when breastfeeding.
Conservative treatment
Depending on the patient’s condition, treatment can be carried out both in a hospital setting and on an outpatient basis. In the initial stages, complex conservative therapy is carried out when:
- the disease lasts no more than 3 days
- the woman's general condition is relatively satisfactory
- no obvious symptoms purulent inflammation
- temperature less than 37.5 C
- moderate breast tenderness
- General blood test is normal.
Since the main cause and aggravating factor is lactostasis, it is important to effectively empty the mammary glands, so milk should be expressed every 3 hours, first from the healthy breast, then from the affected one. Treatment of mastitis:
- Feeding or expressing regularly to resolve lactostasis in combination with massage.
- Broad-spectrum antibiotics for infectious mastitis
- Symptomatic therapy - non-steroidal anti-inflammatory drugs (), antispasmodics ()
- Traumeel gel for non-infectious mastitis.
Every other day, if the dynamics are positive, physiotherapy is prescribed - UHF therapy, ultrasound, they promote the resorption of the inflammatory infiltrate and normalize the functions of the mammary gland. Treatment at home involves examining the woman every 24 to 48 hours; if there is no positive dynamics and response to antibiotic therapy, the woman should be hospitalized.
Antibiotics for the treatment of mastitis
Once a diagnosis of lactation mastitis is made:
- in a woman heat, severe general condition
- there are cracked nipples and signs of mastitis
- the condition does not improve a day after milk flow normalizes.
Antibiotic treatment must be started to ensure optimal results. Even the slightest delay in prescribing therapy will increase the likelihood of abscess formation. The duration of the course of treatment is determined individually, the average course is 7 days. Groups of antibiotics:
- Penicillins
Penetrates into women's milk in limited quantities. The concentration of benzylpenicillins in milk is tens of times less than the concentration in serum. The same rule is typical for semisynthetic penicillins. During inflammatory processes, the transfer of these components into milk decreases. A relatively low degree of diffusion into milk is characteristic of broad-spectrum penicillins. The index for penicillins is significantly less than 1.
- Cephalosporins
Data suggest limited transfer into milk. Maximum concentration at healthy women, one hour after administration is 2.6% of the maximum concentration in the blood serum. With inflammation, there is an increase in the transfer of antibiotics into breast milk. There is evidence of poor excretion of second and third generation cephalosporins in breast milk. Despite the fact that the index is also less than one, its value exceeds that of penicillins.
- Macrolides
They penetrate in relatively high concentrations, reaching an average of 50% of the level in blood serum. But at the same time, there is no negative effect on the penetration of macrolides into the child’s body.
- Aminoglycosides
Most representatives pass poorly into breast milk, and in low concentrations. But still, no official studies have been conducted, since the drugs are prohibited for use during pregnancy and breastfeeding due to nephrotoxicity. The concentration in breast milk is 30% of the concentration in the blood, but there may be an effect on the intestinal microflora of newborns.
- Fluoroquinolones
All representatives of this pharmaceutical group pass into breast milk, but strictly controlled studies have not been conducted. The use of drugs in this group during pregnancy and breastfeeding is not recommended due to high risk toxicity.
Drugs of choice without stopping breastfeeding: amoxicillin, augmentin (amoxiclav with caution if the benefit to the mother outweighs the harm to the baby), cephalosporins - cephalexin. Inadmissible when feeding a child: sulfonamides, lincosamines, tetracyclines, fluoroquinolones.
Is it possible to make compresses for mastitis or use ointments?
When the first signs of lactostasis or mastitis appear, you should consult a doctor, establish a diagnosis, determine the stage of the disease and discuss treatment methods.
Non-infectious mastitis- warming compresses can only be used for lactostasis and non-infectious mastitis in complex treatment. It is possible to use semi-alcohol dressings on the affected area at night, cabbage leaves with honey, burdock leaves, etc. After the compress, rinse the chest with warm water. You can also use homeopathic gel Traumeel.
For purulent mastitis Warming compresses and the use of ointments can aggravate the course of the disease and are therefore not recommended.
Surgery
Often, despite active conservative treatment with antimicrobial drugs, about 4-10% of developing mastitis may progress to purulent or destructive stages. Such complications require immediate and active surgical treatment, which will be carried out only during hospitalization.
The abscess area is opened to remove pus from the tissues and the wound is actively washed with antiseptics, followed by drainage. The procedure is carried out under general anesthesia. Also, as an additional study, in order to conduct differential diagnosis, a small fragment of the walls in the area of the abscess is sent for histological examination, because the process can be combined with a malignant neoplasm.
Prevention
Early consultation with a doctor at the slightest suspicion minimizes the risks of developing purulent mastitis. In the postpartum period, a nursing woman should be carefully monitored for the purpose of early diagnosis of lactostasis and mastitis. Basic prevention:
- Use only comfortable nursing underwear
- It is better to establish breastfeeding on demand
- If hyperlactation occurs, you should express some milk before feeding.
- Attach your baby correctly, make sure your baby is latching onto the breast correctly
- Do not shorten feeding time
- It's better to sleep on your side or back
- Feed at night, avoid long gaps at night
- Do not overcool your chest and protect it from injury
- Prevent the occurrence of cracked nipples and treat them promptly.
IN mandatory sanitary and hygienic conditions must be observed. Timely identify and sanitize foci of infection in the mother’s body (carious teeth, tonsils, sinuses).
The term "mastitis" comes from two words: mastos, meaning breast, and the ending -itis, meaning inflammation. Thus, mastitis is an inflammation of the mammary gland.
In most cases, accounting for 80-85%, the disease develops in women after childbirth. It occurs less frequently in non-lactating women. In some cases, the infection affects pregnant women and newborns.
Causes and mechanisms of disease development
In 9 out of 10 cases of mastitis, it is caused by Staphylococcus aureus. The pathogen enters the mammary gland through cracks in the nipples that occur in a nursing mother. In more rare cases, microbes penetrate first into the ducts of the gland, and then into its tissue when feeding a child or expressing milk (intracanalicular route). There are very rare cases when the infection is brought from other purulent foci through the blood or lymphatic vessels(hematogenous and lymphogenous routes).
Lactostasis – stagnation of milk, accompanied by engorgement of the mammary glands – increases the risk of mastitis.
Lactation mastitis most often affects women who do not have breastfeeding experience. It develops in approximately every twentieth postpartum woman, of whom more than 77% are primigravidas.
The infection can affect the glandular tissue itself, or the parenchyma, or spread mainly through the connective tissue layers, forming interstitial inflammation. In response to the pathogen entering the gland, the body responds with a reaction aimed at removing it.
At the site of microbial penetration, blood vessels dilate and blood flow increases. Brought with blood immune cells– lymphocytes. One group of lymphocytes directly captures and destroys microbial agents, while simultaneously helping another subgroup “recognize” their antigens. Another group of lymphocytes, based on information about the antigenic structure, begins to produce antibodies. Antibodies attach to the surface of microbes, then such complexes are also destroyed. As a result of the breakdown of microbial cells and lymphocytes themselves, pus is formed.
Increased blood flow to the gland causes swelling and redness of the skin, its function is disrupted, pain occurs, and the temperature at the site of the disease rises. During intense inflammation, the released active substances affect the entire body, including the thermoregulation center in the brain, changing its settings. Appears general reaction in the form of fever and intoxication (poisoning).
The mammary gland has structural features. After childbirth, its function is significantly enhanced. During this period of a woman’s life, physiological immunodeficiency is also observed. All these factors determine the difference between the course of mastitis and other acute infectious processes.
The lobulated structure of the mammary gland, a large number of fat cells, the presence of cavities and ducts cause poor limitation of the inflammatory process and its rapid spread. Serous and infiltrative forms quickly turn into purulent forms, which tend to be protracted and often complicated by sepsis.
Classification
Types of mastitis are usually determined by the stage of its development, sometimes the nature of the disease (specific forms) comes to the fore:
Spicy:
A) serous;
B) infiltrative;
B) purulent:
- abscess;
- phlegmonous;
- gangrenous.
Chronic:
A) purulent;
B) non-purulent.
Specific (rare forms):
A) tuberculosis;
B) syphilitic.
Symptoms of mastitis
Symptoms of mastitis in nursing women usually develop in the second or third weeks after childbirth. Most patients initially experience acute stagnation of milk, which has not yet been complicated by microbes entering the gland. This condition is manifested by a feeling of heaviness in the mammary gland, tension in it. Small compactions can be felt in individual lobules. They have clear boundaries, are quite mobile and painless. Externally, the skin is not changed, there are no general manifestations. However, during lactostasis, various microorganisms accumulate in the ducts of the gland, including staphylococci. It is necessary to cure lactostasis within 2-3 days. Otherwise it will turn into mastitis.
If pyogenic microorganisms penetrate the gland tissue, serous mastitis develops after 3-4 days. It begins with an increase in body temperature to 38-39˚C, accompanied by chills. The woman’s general condition worsens, weakness, sweating, and headache appear. Pain in the mammary gland gradually increases, becoming very severe, especially during feeding or pumping. The gland itself enlarges, the skin over it turns a little red. When palpated, small painful lumps are detected. Signs of inflammation are detected in the blood: leukocytosis, an increase in the erythrocyte sedimentation rate to 30 mm/h.
If treatment is delayed, infiltrative mastitis develops after 2-3 days. Manifestations of general intoxication intensify - fever with chills and heavy sweat persists. A woman complains of severe weakness and weakness, strong headache. In the mammary gland, upon palpation, an infiltrate is determined - a painful area is more thick fabric, which does not have strictly defined boundaries. It can be located around the nipples (subareolar), deep in the tissue (intramammary), under the skin (subcutaneous) or between the gland and chest(retromammary).
At the same time, you can detect enlarged, painful axillary The lymph nodes, which become a barrier to the spread of microorganisms through the lymphatic tract.
This stage of the disease lasts from 5 to 10 days. After this, the infiltrate can resolve on its own, but more often it suppurates.
Purulent mastitis
Purulent mastitis occurs with high fever (39˚C or more). Sleep is disturbed and appetite is lost. Local signs of the disease intensify. In one of the areas of the gland, fluctuation or softening appears - a sign of the appearance of pus in the area. Depending on the degree of damage to the mammary gland, several forms of the disease are distinguished.
With phlegmonous mastitis, the body temperature reaches 40˚C. The mammary gland increases significantly in size, the skin over it is shiny, reddened, and swollen. There is enlargement and tenderness of the axillary lymph nodes.
At gangrenous form The patient's condition is very serious. High fever is combined with an increase in heart rate to 120 per minute or higher, and a decrease in blood pressure. Acute pain may occur vascular insufficiency- collapse. The skin over the enlarged mammary gland is swollen, blisters and areas of dead tissue—necrosis—appear on it. In the blood, pronounced leukocytosis is determined, an increase in the erythrocyte sedimentation rate, a shift leukocyte formula to the left, toxic granularity of leukocytes. Protein appears in the urine.
Subclinical purulent mastitis occurs, in which the symptoms are mild. The erased signs of mastitis are also determined during its chronic course.
Acute mastitis can cause severe consequences:
- lymphangitis and lymphadenitis (inflammation of lymph drainage vessels and lymph nodes);
- milk fistula (usually after spontaneous opening of an abscess, less often after surgical treatment, it can close on its own, but within long term);
- sepsis (penetration of microbes into the blood with damage to various internal organs).
Certain forms of mastitis
Some types of inflammation of the mammary glands have their own characteristics. These forms are less common and therefore less easily diagnosed.
Non-lactation mastitis
The causes of inflammation of the mammary gland outside of feeding are associated with general changes in the body:
- hormonal changes during puberty or;
- immunodeficiency states, diabetes, chronic infections, malignant tumors;
- Iatrogenic mastitis – after operations on the mammary glands, for example, for cosmetic purposes.
With non-lactation mastitis, moderate pain and swelling of the mammary gland and enlarged axillary lymph nodes are usually detected. If the process becomes purulent, the body temperature rises, the pain intensifies, and the general condition worsens. The formed abscess can open onto the surface of the skin or into the lumen of the gland canal, forming a long-term non-healing fistula.
Treatment of non-lactation mastitis is based on the same principles as mastitis in nursing mothers.
Neonatal mastitis
During the newborn period, a child experiences a sexual crisis - a condition accompanied by engorgement of the mammary glands. If at this time a pathogen enters the gland tissue, it will cause inflammation. Most often, staphylococcus enters the child’s mammary gland by contact, especially if he has a purulent process on the skin (pyoderma) and mechanical irritation of the glands.
At the onset of the disease, unilateral enlargement of the mammary gland occurs. The skin over it is initially unchanged, but then turns red and becomes sore. Soon hyperemia (redness) of the skin becomes pronounced. If the gland tissue undergoes purulent melting, fluctuation is determined. The child eats poorly, worries, cries constantly, and his body temperature rises. Often the purulent process spreads to the chest wall with the formation of phlegmon.
Treatment of the disease is carried out in a hospital. Antibiotics and detoxification therapy are prescribed. For infiltration, local methods and physiotherapy are used. The formation of abscesses is an indication for surgical treatment.
At timely treatment The prognosis for neonatal mastitis is favorable. If a large part of a girl’s gland disintegrates, then in the future this may create problems with breast formation and lactation.
Prevention of this condition involves careful care of the child’s skin. During a sexual crisis, it is necessary to protect his mammary glands from mechanical irritation by clothing. If the engorgement is significant, you can cover them with a sterile, dry cloth.
Diagnostics
If signs of inflammation are pronounced, diagnosing mastitis is not particularly difficult. Assess the patient’s complaints, ask her about the duration of the illness and the connection with feeding the child, clarify concomitant pathology, examine and palpate the mammary glands.
Blood tests determine an increase in the number of leukocytes and erythrocyte sedimentation rate. In severe cases, anemia develops and protein appears in the urine.
Important information can give bacteriological examination milk, and with the development of sepsis - blood.
Ultrasound examination of the mammary glands is often used to evaluate the process over time.
However, diagnostic difficulties also occur. If the patient does not have fluctuations and redness of the skin, then purulent mastitis often remains unrecognized and she is treated conservatively. In many cases, this is caused by self-medication with antibiotics, when the patient “smears” the clinical picture with them, and the doctor sees an already changed course of the disease.
The erased form of the disease is characterized by normal or slightly elevated body temperature, there is no swelling or redness of the skin. However, the gland remains painful for a long time, and when palpated, an infiltrate is detected. In this case, puncture of a purulent focus can help in diagnosis, especially in the abscess form.
Treatment
What to do if you have mastitis?
It is necessary to urgently contact a surgeon at your place of residence. Therapy should be started as early as possible, before a purulent form of the disease develops.
Is it possible to breastfeed if you have mastitis?
In mild cases, feeding the baby can be continued. With purulent mastitis, breastfeeding should be stopped, because this can introduce both microbes and antibiotics and other drugs into the child’s body.
How to treat mastitis?
For this purpose, conservative and surgical methods are used.
If the patient’s condition is satisfactory, the temperature does not exceed 37.5˚C, the duration of the disease is less than 3 days, infiltration is only in one quadrant of the gland and there are no local signs of inflammation (edema, hyperemia), conservative therapy is prescribed. If it does not bring effect within two to three days, surgery is necessary.
Therapy is carried out in a hospital. Treatment of mastitis at home is possible in exceptional cases only with mild forms of the disease. The treatment regimen includes the following directions:
- Express milk every 3 hours, first from a healthy gland, then from a diseased gland.
- No-shpa is administered intramuscularly three times a day for three days, half an hour before the next pumping.
- Retromammary novocaine blockades with the addition of antibiotics daily.
- Treatment with broad-spectrum antibiotics intramuscularly (penicillins, aminoglycosides, cephalosporins).
- Desensitizing therapy, vitamins B and C.
- Semi-alcohol compresses on the gland once a day.
- Traumeel S ointment, which relieves signs of local inflammation.
- If the condition improves, UHF or ultrasound physiotherapy is prescribed within a day.
It should be especially noted that cold or warming agents (including the popular folk remedy - camphor oil) should not be used for the conservative treatment of acute mastitis. These methods can mask the course of the purulent process or, on the contrary, cause it rapid spread.
If the body temperature is high and there is an infiltrate in the gland tissue, surgical intervention is required. In case of severe lactostasis, which is also accompanied by similar symptoms, you must first free the gland from milk. For this purpose, retromammary novocaine blockade, No-shpa and Oxytocin are administered, then the woman expresses milk. If the fever and infiltration were caused by lactostasis, after pumping the pain goes away, the infiltration is not detected, and the body temperature decreases. With purulent mastitis, after complete pumping, a painful compaction remains in the tissues of the gland, the fever persists, and the state of health does not improve. In this case, surgical intervention is prescribed.
Surgery for mastitis
The operation is performed under general anesthesia. When choosing access to the lesion, its location and depth are taken into account. If the abscess is located subareolar or in the center of the gland, a semi-oval incision is made along the edge of the areola. In other cases, external lateral incisions are made or they are carried out along the fold under the mammary gland. Radial incisions are not used now, since they leave rough scars that are poorly hidden under underwear.
After making an incision, the surgeon removes all purulent-necrotic tissue of the gland. The resulting cavity is washed antiseptics, install a drainage-washing system to drain fluid and wash the wound with antibiotics and antiseptics after surgery. The wound is closed with a primary suture. This allows the formation of a closed cavity, which is gradually filled with granulations. As a result, the volume and shape of the mammary gland is preserved.
In some cases, such an operation is impossible, for example, with anaerobic microflora or a large skin defect.
Immediately after the operation, they begin to rinse the cavity with a solution of chlorhexidine in a volume of 2-2.5 liters per day. Washing is stopped approximately on the fifth day, provided that inflammation has stopped, there is no pus in the cavity, and its volume has decreased. The sutures are removed 8-9 days after surgery.
IN postoperative period carry out conservative therapy, which includes antibiotics, desensitizing drugs, vitamins.
Prevention
For a woman after childbirth, mastitis prevention is very important. Following some simple recommendations from your doctor will help avoid stagnation of milk and the development of inflammation.
A woman should know the rules of breastfeeding:
- apply the baby alternately to each breast, changing breasts during the next feeding;
- Before feeding, wash your hands, preferably wash your areolas;
- feed the child no longer than 20 minutes, not allowing him to fall asleep;
- express remaining milk after feeding.
It is necessary to prevent the appearance of cracked nipples:
- wash the areolas and nipples with warm, then cool water without soap;
- periodically rub your nipples with a towel;
- Change bras and pads that absorb milk regularly.
When lactostasis occurs, the following tips will help:
- before feeding, apply a warm compress or breast massage;
- feed the baby from the sore breast twice as often as from the healthy one;
- apply cold compresses to the breasts after feeding;
- drink more fluids;
- Consult your doctor for advice on breastfeeding.
If it is not possible to cope with the symptoms of lactostasis within two days, an urgent visit to a doctor is necessary, since there is a high probability of developing mastitis.
How does mastitis occur? What are its symptoms? Is it possible to treat mastitis during breastfeeding at home using folk remedies? When should you take antibiotics, and which ones? Do I need to wean? All about mastitis during breastfeeding in the recommendations of lactation consultants.
Mastitis is an inflammatory process in the tissues of the mammary gland. IN medical practice The disease occurs not only in breastfeeding women. It can affect both men and children, including newborns. But it is young mothers who are more susceptible to the disease than others, because their breasts are in the “risk zone.”
Causes
Contrary to popular belief that mastitis occurs as soon as the chest gets cold, the causes of the disease are found in something completely different. The only way to get cold breasts, lactation consultants joke, is by exposing them naked to the cold. Your mammary glands are inextricably linked with the processes in your body. And if you freeze in cold weather or, for example, get your feet wet, your immunity will weaken and the disease will actually have a chance. However, this is typical for so-called recurrent or untreated mastitis, which recurs regularly.
The causes of the primary disease lie in improper organization of breastfeeding and the addition of infection.
- Complicated lactostasis. In ninety-five percent of cases, lactostasis (stagnation of milk in the duct) goes away within one to two days with the correct treatment technique. Active resorption of the breast is required, for which the baby is placed in it hourly. If it is not possible to cope with stagnation within four days, the tissue swelling becomes inflamed. A complication arises due to the fact that the body sees the “enemy” in the stagnant protein of breast milk and directs forces there immune defense. Redness forms, the inflamed lobe becomes painful.
- Infection. It can “sit” quietly in the body until it gets a chance to “break out” out. Foci of infection are chronically inflamed tonsils (tonsillitis), carious cavities in the teeth. Bacteria can enter the thoracic ducts during a mother's sore throat. But the shortest way for them is through the cracks in the nipples.
Depending on how mastitis occurred during breastfeeding, there are two forms.
Uninfected mastitis
It is untreated lactostasis, which is complicated due to excessive swelling of the tissues.
Symptoms:
- deterioration of health against the background of an existing lump in the chest;
- temperature rise to 38 and above;
- soreness of the affected mammary lobe, swelling, redness.
To diagnose uninfected mastitis, lactation consultants recommend measuring body temperature in three areas: under the armpit, in the elbow, and in the groin. If it is higher in the armpit, it means that you have developed complicated lactostasis. It is the “simplest” form of mastitis, the treatment of which does not require antibiotics.
Infected mastitis
Develops as a result of associated infection. It can become a “continuation” of non-infectious mastitis if treatment is not started on time.
Symptoms:
- progressive deterioration of the woman’s condition;
- acute pain in the affected lobe, pain when touched and walking, redness, the chest becomes hot;
- an increase in body temperature, maintaining it for more than two days when using treatment tactics for uninfected mastitis.
The danger of infected mastitis is that without treatment with antibiotics it can develop into an abscess: the formation of purulent cavities in the thoracic lobes. The abscess must be removed surgically or by suctioning pus during medical manipulations. Lack of timely treatment poses a threat to a woman’s life.
Treatment of mastitis
If you notice signs of mastitis while breastfeeding, you must begin treatment immediately. The sooner measures are taken, the faster your health will improve, and the less likely it is to develop complications. Be sure to consult a doctor, especially if several days have passed since the onset of the illness. But you can do a lot at home, too.
When to take antibiotics
Uninfected mastitis during breastfeeding resolves without the use of antibiotics, with the help folk remedies and proper organization of the baby’s attachments. But there are situations when without antibacterial drugs not enough. Treatment tactics are suggested by the famous Canadian pediatrician Jack Newman, founder of the first clinic to help nursing mothers, and a UNICEF expert.
According to Jack Newman, it is necessary to take antibiotics if:
- symptoms of the disease do not go away within twenty-four hours: temperature, redness, painful swelling persist;
- the disease proceeds without changes, the woman does not get better or worse within twenty-four hours;
- within twelve hours there is a sharp deterioration in the condition: increased pain, enlargement of the affected area or its hardening.
You do not need to take antibiotics if:
- there is reason to diagnose a woman with mastitis, but less than twenty-four hours have passed since its onset, and the correct treatment tactics are being used;
- Without taking antibacterial agents, the patient's condition began to improve.
Taking antibiotics must be discussed with your doctor. But many specialists do not risk working with nursing mothers, requiring them to temporarily stop breastfeeding. Be sure to tell your doctor about your intention to continue breastfeeding and ask for antibiotics that are compatible with lactation.
For the treatment of mastitis choose antibacterial agents, affecting Staphylococcus aureus. Traditional penicillin-based drugs and its modern synthetic analogue Amoxicillin are often ineffective against these bacteria. Combined antibacterial drugs are more productive:
- "Amoxiclav";
- "Clindomycin";
- "Ciprofloxacin";
- "Flucloxacillin";
- "Cephalexin";
- "Cloxacillin."
Jack Newman draws attention to the possibility of using these remedies without the need to interrupt breastfeeding. “There is no danger for the child,” he writes in the article “Milk Stagnation and Mastitis.” “The disease goes away faster if you continue to breastfeed.”
Prevention
As you know, preventing a disease is easier than fighting it. Recommendations for the prevention of mastitis during breastfeeding are the same as for the prevention of lactostasis.
- Feed often, regularly. Breastfeeding consultants insist on organizing a feeding regime “on demand”, as natural and physiological. Regular consumption of milk by a child without many hours of breaks is the best prevention of congestion.
- Change your positions.
- Place the baby in the classic “cradle” position, from under your arm, with the jack’s legs towards your head. Different positions during feeding allow you to release different lobes of the breast. Make sure you suck properly.
- The baby's lips should cover almost the entire areola of the nipple, and not just its tip, and the tongue should be located under the nipple. With this application, sucking does not cause discomfort to the mother, and the milk ducts work fully. Don't pump in vain.
- With the correct feeding regimen, pumping is not necessary. Otherwise, you risk getting hyperlactation - increased milk production, which often becomes the cause of regular mastitis. Choose your underwear wisely.
- The bra should not squeeze the breasts, interfering with the outflow of milk. Only wear one that is specifically designed for nursing mothers. Protect your chest from injury.
- Blockage of blood vessels can be caused by blows and bruises. If cracks appear, do not rush to wash them regularly with soap. This will strip away the skin's natural oily protective layer and open the way for bacteria. For breast hygiene, a daily warm shower is enough. Wean gradually.
A large percentage of mastitis occurs with the sudden introduction of complementary foods or weaning “in one day,” when the usual mode of breast release is disrupted. Breastfeeding should “leave” from the life of mother and child gradually. Then weaning and the transition to an “adult” diet will take place without negative consequences for the mother. And finally, have fun breastfeeding! Get enough sleep, rest more often, feel, first of all, like a woman, a beloved mother. In everyday life, be sure to attract helpers, do not carry heavy things. Not only yours depends on this emotional condition
, but also health. Mastitis - dangerous disease the right tactics actions at its first manifestations.
It has long been believed that there is nothing better and more beneficial for an infant than mother's milk.
However, the development of such pathological process Like mastitis, it confuses a woman; against the backdrop of a painful condition and fatigue, she does not know whether it is possible to have a child with mastitis, and what actions should be performed first in order to quickly restore her health.
Mastitis is characterized by the development of an inflammatory process in the mammary gland. It occurs as a result of the penetration of microbes into skin(in most cases through cracks in the nipples).
Microorganisms entering the breast contribute to the souring and thickening of milk, which leads to clogging of the milk ducts. Swelling forms, which compresses neighboring ducts, also causing stagnation of milk there and the development of infection. Ultimately, an extensive inflammatory process matures and an abscess may form.
The main causative agents of mastitis are staphylococcus and streptococcus. Moreover, this disease develops to a greater extent due to the penetration of staphylococcal infection.
Causes of mastitis:
- , characterized by prolonged stagnation of milk in the breast;
- improper attachment to the breast, which leads to poor emptying of the mammary gland;
- various nipple injuries;
- low immunity contributes to the weakening of the body's defenses.
Symptoms of mastitis:
- the appearance of lumps in the mammary gland;
- the breasts increase significantly;
- the area of skin in the area of the lump is hot and red;
- feeding and pumping is painful;
- there may be blood or pus in the milk;
- fever, chills.
There are several forms of mastitis development:
- Serous– this stage is characterized by high body temperature, general weakness, and fatigue. The glands are inflamed and hardened. Pumping and breastfeeding are accompanied by painful sensations. However, there is no relief.
- Infiltrative– an increased content of leukocytes is detected in the blood. Dizziness appears and the body temperature is constantly high. Lumps measuring 2-3 cm in size can be felt in the chest.
- Purulent– body temperature rises to 40 degrees. The infiltrate in the mammary gland becomes purulent, while the breasts swell, significantly increase in size, and acquire a pinkish tint. The temperature is constantly fluctuating. When it falls, it appears severe chills and sweating.
In turn, purulent mastitis (which should be classified as destructive forms) is divided into several stages of development:
- Infiltrative-purulent.
- Abscessing.
- Phlegmonous.
- Gangrenous.
At these stages, the infiltrate in the chest is completely replaced by pus. Urgent surgical intervention is required.
If at least one symptom appears, you should urgently consult a mammologist in order to exclude the onset of mastitis or begin its treatment in a timely manner. The earlier therapy is started, the easier its consequences will be.
Should I continue breastfeeding if I have mastitis?
As a rule, with the development of mastitis, many women begin to worry about the possibility of further breastfeeding.
However, in such a situation, the mammary gland especially needs regular and high-quality emptying.
It follows from this that when of this disease Under no circumstances should you stop breastfeeding.
Contraindications to lactation:
- Development of purulent mastitis. In this case, it is impossible to breastfeed the patient, as the risk of infection entering the child’s body increases. An alternative option is to continue feeding with the healthy breast, while simply expressing the milk from the other breast and discarding it.
- Mastitis therapy medicines, which require temporary cessation of feeding the child. Pumping should continue as well.
The baby should be placed on the sore breast as often as possible. In addition, after completing feeding, it is recommended to additionally use a breast pump for final emptying of the mammary gland.
Rules for breastfeeding during mastitis
When breastfeeding with mastitis, you should adhere to the following basic rules:
- It is necessary to ensure correct attachment to the breast – this measure has special significance, since often the cause of lactostasis, and as a consequence, the development of mastitis, is ineffective breastfeeding by the child. At the same time, proper attachment protects the woman from damage to the nipples, and also promotes sufficient emptying of the breast.
- During feeding, the breasts should be squeezed and lightly massaged so that the milk comes out more easily.
- The baby should be put to the breast as often as possible.
- It is better to wash your breasts once a day plain water no soap. With too frequent hygiene, especially with cosmetics(soap, shower gel), a special protective lubricant is washed away from the skin of the nipples, which helps soften them and also protects them from the penetration of microbes.
- After each feeding, it is recommended to additionally express your breasts with a breast pump.
Massaging the breasts should be done with extreme caution, as rough pressure can lead to the penetration of excess milk into the soft tissue of the mammary gland, which will only aggravate the existing problem.
Likely consequences
Depending on the form of mastitis suffered, its consequences can be divided into 2 groups:
- Serous mastitis is easily treatable and does not have any serious consequences. In addition, about 80% of women continue to breastfeed. The only negative point is the occurrence of some psychological discomfort during breastfeeding, accompanied by fear of this process. However, with the right psychological assistance, the woman quickly rehabilitates and during her next pregnancy breastfeeds without problems.
- Destructive forms require surgical intervention in 99% of cases. The resulting breast abscess is opened, the pus is removed, and the cavity is washed with an antiseptic. As a rule, during such operations, secondary sutures are applied, which promotes rapid healing.
If mastitis has already reached the gangrenous stage, amputation of the mammary gland is performed.
The main consequences of surgery:
- long recovery after surgery;
- restriction of physical activity;
- severe psychological condition;
- inability to continue breastfeeding.
With timely detection of incipient mastitis, as well as the implementation of its high-quality treatment, the consequences of this disease are practically not felt.
Prevention of mastitis
In order to prevent the occurrence of mastitis, a woman should take the following preventive measures:
- it is necessary to strictly observe the rules of personal hygiene;
- The baby should be fed on demand, not on a schedule;
- carefully ensure that the baby latches onto the breast correctly;
- prevent injury to the nipples, and if this does happen, it is necessary to speed up their healing;
- Make sure your baby sucks completely on each breast;
- during feeding, a woman should periodically change her body position;
- use underwear for nursing mothers.
To summarize, it should be noted that mastitis is a serious disease, the advanced form of which has very negative consequences.
In this regard, it is extremely important to prevent mastitis, and if suspicion arises, urgently seek help from a doctor. However, in some cases, you can safely continue breastfeeding.
Young mothers know firsthand what mastitis is, since they have experienced this unpleasant disease themselves. You can often hear that mastitis is called a “runny nose” of the chest, but the symptoms and pain that accompany it cause great fear in women. During this period, they are concerned with only one question: is it possible to breastfeed the child and is this dangerous for the baby’s health?
Mastitis is bacterial infection and occurs mainly in women during breastfeeding, but can also be observed in non-breastfeeding mothers. Experts have not yet fully clarified all the circumstances under which infection occurs, since the disease can occur both in women with damaged nipples (cracks in the nipples) and in those whose breasts are in perfect order. With this disease, breast compaction is observed, which may prevent the detection of another phenomenon - lactostasis or stagnation of milk in the ducts. The resulting compaction occurs in combination with severe swelling and significant pain, while the skin becomes red and the chest feels hot to the touch. Most often, this situation is mistaken for blockage of the milk ducts, but in fact the cause of mastitis is the penetration of milk into the soft tissues.
Typically, women in such a situation begin to worry about continuing breastfeeding, fearing that this could harm the baby. But you should not be afraid of this, moreover, under no circumstances should you stop breastfeeding. With mastitis, the breasts need constant and thorough emptying so that milk does not stagnate in the affected breast. At the same time, it is important to squeeze the breast and lightly massage it while feeding the baby so that the milk is more easily squeezed out of it. When massaging the breasts, you should be extremely careful, since rough pressure can cause excess milk to penetrate into the soft tissue of the breast, which will significantly worsen the condition. Since milk stagnation in the affected breast should not be allowed during this period, it is necessary to put the baby to the breast as often as possible, and it is also recommended to use a breast pump to completely empty it after feeding. According to some mothers, breast pumps empty the breasts much better than when the baby sucks. It is worth noting that this occurs when the mother’s nipples become inflamed. If putting your baby to the breast causes unbearable pain, it is better to use a breast pump and feed the baby from a bottle or cup.
During the period of illness, a woman simply needs a calm environment and proper rest, no overexertion. Therefore, in order not to get out of bed at night in order to feed the baby, it is recommended to put him in bed with you in advance. All this will prevent the development of mastitis into more serious forms, including suppuration.
Warmth will help you cope with mastitis on your own. Between feedings, it is recommended to warm the breasts with a heating pad or a hot water bottle. You can also use hot compresses, take hot showers and baths, or apply a well-ironed diaper to the affected breast. By the way, some mothers, on the contrary, find relief from cold compresses. In this case, you should choose what brings relief to you.
Very often, with mastitis, a woman experiences an increase in temperature. There is no need to be afraid of this, since the body is fighting inflammatory processes. It is necessary to reduce the temperature only in cases where its value is too high. If necessary, you can take painkillers. They will not cause any harm to the baby’s body, but they will bring significant relief to the mother. For example, you can use Ibuprofen, it is approved for use during lactation, eliminates pain and relieves inflammation. In this case, before taking any drug, it is important to consult a specialist.
In general, at the first symptoms of mastitis, you should immediately consult a doctor. To facilitate breastfeeding and relieve pain, it is recommended to apply a dry hot compress to the sore breast for a few minutes immediately before feeding. Only after a complete breast examination will the doctor prescribe a treatment for mastitis. In addition, the specialist will instruct the woman on measures to prevent this disease.
Depending on the form of mastitis, as well as the duration of the condition in which the woman remains, the doctor may prescribe antibiotics. Typically, a specialist prescribes drugs that can be used during breastfeeding and that do not have any effect. negative influence on the quantity and quality of milk, as well as the health of the baby. In this case, when prescribing antibiotics, it is necessary to warn the doctor that you intend to maintain lactation and the ability to breastfeed.
About a day after starting to take antibiotics, the woman feels a significant improvement in her condition. Even if mastitis is caused non-infectious causes, the drug will eliminate inflammation. It is worth remembering that if mastitis is caused by improper attachment of the baby to the breast, then treatment in this case will have a positive effect for a while. To prevent relapse of the disease it is important proper organization feeding the baby. You need to make sure that the baby is attached to the breast correctly, for which you need to remember step by step instructions on breastfeeding. During feeding, it is necessary to change the position, looking for the optimal one, in which the baby will be comfortable and comfortable to suck.
Many women are afraid to take antibiotics, leaving them as a last resort. But in any case, medications of this kind must be on hand. Coping with mastitis initial stage on your own is possible, but if improvements from self-treatment no, there is a risk of developing purulent inflammation, which requires medical and often surgical intervention.
It is necessary to clearly understand that mastitis is not a death sentence, and that in this case, you can and should continue to breastfeed your baby. With proper, and most importantly, timely treatment, the disease is successfully and fairly quickly eliminated. The most important thing is that even if the mother is feeling terrible, feeding from an inflamed breast is safe for the baby. Even if in case infectious origin mastitis, along with milk, pathogenic bacteria will enter the baby’s digestive tract, and his gastric juice will cope with them without much difficulty.
