Angina

Mastitis during breastfeeding: signs, treatment and prevention. Mastitis and breast infections, how to treat, how to prevent, is it possible to feed a child with mastitis, purulent mastitis, pathological lactostasis, stagnation of milk in the breast Mastitis is it possible to feed a child

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 from the 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 the neighboring ducts, also causing stagnation of milk there and the development of infection. Eventually a vast inflammatory process 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 injuries to the nipples;
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- detected in blood increased content leukocytes. 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, severe chills and sweating appear.

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 if this disease occurs, breastfeeding should under no circumstances be stopped.

Contraindications to lactation:

Development of purulent mastitis. In this case, you cannot breastfeed the sick breast, as the risk of infection entering the child’s body increases. Alternative option is to continue feeding with a healthy breast, while the second one should simply express the milk and pour it out.
Treatment of mastitis with medications that 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 finishing 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 is of particular importance, 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 with plain water without 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 breast, 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 there are no serious consequences does not carry. In addition, about 80% of women continue to breastfeed. The only negative point is the occurrence of some psychological discomfort when breastfeeding, accompanied by fear of this process. However, with the right psychological help, a woman will quickly rehabilitate herself and breastfeed without problems during her next pregnancy.
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;
impossibility of continuation 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.

Video on the topic

Mastitis in the old days they called it a baby. This pathology is an infectious-inflammatory process in tissues mammary gland, as a rule, having a tendency to spread, which can lead to purulent destruction of the gland body and surrounding tissues, as well as generalization of the infection with the development of sepsis (blood poisoning).

There are lactation (that is, associated with the production of milk by the gland) and non-lactation mastitis.
According to statistics, 90-95% of mastitis cases occur in the postpartum period. Moreover, 80-85% develops in the first month after birth.

Mastitis is the most common purulent-inflammatory complication of the postpartum period. Frequency of development lactation mastitis constitutes about 3 to 7% (according to some sources up to 20%) of all births and has not had a downward trend over the past few decades.

Mastitis most often develops in nursing women after the birth of their first child. Usually the infectious-inflammatory process affects one gland, usually the right one. Predominance of defeat right breast This is due to the fact that for right-handed people it is more convenient to express the left breast, so milk stagnation more often develops in the right.

Recently, there has been a tendency towards an increase in the number of cases of bilateral mastitis. Today, a bilateral process develops in 10% of mastitis cases.

About 7-9% of lactation mastitis are cases of inflammation of the mammary gland in women who refuse to breastfeed; this disease is relatively rare in pregnant women (up to 1%).

Cases of the development of lactation mastitis in newborn girls are described, during the period when increased level hormones received from the mother’s blood cause physiological swelling of the mammary glands.

About 5% of mastitis in women is not associated with pregnancy and childbirth. As a rule, non-lactational mastitis develops in women aged 15 to 60 years. In such cases, the disease proceeds less violently, complications in the form of generalization of the process are extremely rare, but there is a tendency to transition to a chronically relapsing form.

Causes of mastitis

Inflammation with mastitis is caused by a purulent infection, predominantly Staphylococcus aureus. This microorganism causes various suppurative processes in humans, from local skin lesions (acne, boils, carbuncles, etc.) to fatal injuries internal organs(osteomyelitis, pneumonia, meningitis, etc.).

Any suppurative process caused by Staphylococcus aureus can be complicated by generalization with the development of septic endocarditis, sepsis or infectious-toxic shock.

Recently, cases of mastitis caused by association of microorganisms have become more frequent. The most common combination of Staphylococcus aureus with gram-negative Escherichia coli (common in environment microorganism that normally inhabits the human intestine).
Lactation mastitis
In cases where we are talking about classic postpartum lactation mastitis, the source of infection most often becomes hidden bacteria carriers from medical personnel, relatives or roommates (according to some data, about 20-40% of people are carriers of Staphylococcus aureus). Infection occurs through contaminated care items, linen, etc.

In addition, a newborn infected with staphylococcus can become a source of infection during mastitis, for example, with pyoderma (pustular skin lesions) or in the case of umbilical sepsis.

However, it should be noted that contact with Staphylococcus aureus on the skin of the mammary gland does not always lead to the development of mastitis. For the occurrence of an infectious-inflammatory process, it is necessary to have favorable conditions - local anatomical and systemic functional ones.

Thus, local anatomical predisposing factors include:

rude scar changes in the gland, remaining after severe forms of mastitis, operations for benign neoplasms etc.;
congenital anatomical defects (retracted flat or lobulated nipple, etc.).

Regarding system functional factors, contributing to the development of purulent mastitis, the following conditions should be noted first:

pregnancy pathology (late pregnancy, premature birth, threatened miscarriage, severe late toxicosis);
birth pathology (trauma birth canal, first birth with a large fetus, manual separation of the placenta, severe blood loss during childbirth);
puerperal fever;
exacerbation of concomitant diseases;
insomnia and others psychological disorders after childbirth.

Primiparas are at risk of developing mastitis due to the fact that their milk-producing glandular tissue is poorly developed, there is a physiological imperfection of the gland ducts, and the nipple is underdeveloped. In addition, it is important that such mothers have no experience of feeding a child and have not developed the skills to express milk.
Non-lactation mastitis
As a rule, it develops against the background of a decrease in general immunity(transferred viral infections, heavy concomitant diseases, sudden hypothermia, physical and mental stress, etc.), often after microtrauma of the mammary gland.

The causative agent of non-lactation mastitis, as well as mastitis associated with pregnancy and lactation, in most cases is Staphylococcus aureus.

To understand the features of the mechanism of development of lactational and non-lactational mastitis, it is necessary to have a general understanding of the anatomy and physiology of the mammary glands.

Anatomy and physiology of the mammary glands

The mammary (mammary) gland is an organ of the reproductive system designed to produce human milk during the postpartum period. This secretory organ is located inside a formation called the breast.

The mammary gland contains a glandular body surrounded by well-developed subcutaneous fatty tissue. It is the development of the fat capsule that determines the shape and size of the breast.

At the most protruding place of the breast there is no fat layer - here is the nipple, which, as a rule, has a cone-shaped, less often cylindrical or pear-shaped.

The pigmented areola makes up the base of the nipple. In medicine, it is customary to divide the mammary gland into four areas - quadrants, bounded by conditional mutually perpendicular lines.

This division is widely used in surgery to indicate the localization of the pathological process in the mammary gland.

The glandular body consists of 15-20 radially located lobes, separated from each other by fibrous tissue. connective tissue and loose fatty tissue. The bulk of the glandular tissue itself, which produces milk, is located in posterior regions glands, while ducts predominate in the central regions.

From the anterior surface of the gland body through the superficial fascia, which borders the fatty capsule of the gland, to deep layers Dense connective tissue cords are sent to the skin and to the collarbone, representing a continuation of the interlobar connective tissue stroma - the so-called Cooper ligaments.

The main structural unit of the mammary gland is the acinus, consisting of tiny formations of vesicles - alveoli, which open into the alveolar ducts. The inner epithelial lining of the acinus produces milk during lactation.

The acini are united into lobules, from which the milk ducts depart, merging radially towards the nipple, so that the individual lobules unite into one lobe with a common collecting duct. The collecting ducts open at the top of the nipple, forming an expansion - the milk sinus.

Lactation mastitis proceeds less favorably than any other purulent surgical infection, this is due to the following features of the anatomical and functional structure of the gland during lactation:

lobular structure;
a large number of natural cavities (alveoli and sinuses);
developed network of milk and lymphatic ducts;
abundance of loose fatty tissue.

The infectious-inflammatory process during mastitis is characterized by rapid development with a tendency to rapid spread of infection to neighboring areas of the gland, involvement of surrounding tissues in the process and a pronounced risk of generalization of the process.

So, without adequate treatment, the purulent process quickly engulfs the entire gland and often takes a protracted, chronically relapsing course. In severe cases, purulent melting of large areas of the gland and the development of septic complications (infectious-toxic shock, blood poisoning, septic endocarditis, etc.) are possible.

Mechanism of development of the infectious-inflammatory process

The mechanism of development of lactational and non-lactational mastitis has some differences. In 85% of cases lactation mastitis the disease develops against the background of milk stagnation. In this case, lactostasis, as a rule, does not exceed 3-4 days.

Acute lactation mastitis

With regular and complete expression of milk, bacteria that inevitably fall on the surface of the mammary gland are washed away and are not capable of causing inflammation.

In cases where adequate pumping does not occur, a large number of microorganisms accumulate in the ducts, which cause lactic fermentation and milk coagulation, as well as damage to the epithelium of the excretory ducts.

Curdled milk together with particles of desquamated epithelium clog the milk ducts, resulting in the development of lactostasis. Quite quickly, the amount of microflora that intensively multiplies in a confined space reaches a critical level, and infectious inflammation develops. At this stage, secondary stagnation of lymph and venous blood occurs, which further aggravates the condition.

The inflammatory process is accompanied by severe pain, which in turn makes it difficult to express milk and aggravates the state of lactostasis, so that a vicious circle is formed: lactostasis increases inflammation, inflammation increases lactostasis.

In 15% of women, purulent mastitis develops against the background of cracked nipples. Such damage occurs due to the inadequacy of a sufficiently strong negative pressure in oral cavity baby and poor elasticity of the nipple tissue. Purely hygienic factors can play a significant role in the formation of cracks, such as, for example, prolonged contact of the nipple with the damp fabric of the bra. In such cases, irritation and weeping of the skin often develops.

The occurrence of cracks often forces a woman to give up breastfeeding and careful pumping, which causes lactostasis and the development of purulent mastitis.

To avoid nipple damage when breastfeeding, it is very important to latch your baby to the breast at the same time every day. In such cases, the correct biorhythm of milk production is established, so that the mammary glands are, as it were, prepared for feeding in advance: milk production increases, the milk ducts expand, the lobules of the gland contract - all this contributes to the easy release of milk during feeding.

With irregular feeding, the functional activity of the glands increases already during the feeding process; as a result, individual lobules of the gland will not be completely emptied and lactostasis will occur in certain areas. In addition, with an “unready” breast, the baby has to expend more effort while sucking, which contributes to the formation of nipple cracks.

Non-lactation mastitis

At non-lactation mastitis infection, as a rule, penetrates the gland through damaged skin due to accidental injury, thermal damage(heating pad, tissue burn in an accident) or mastitis develops as a complication of local pustular skin lesions. In such cases, the infection spreads through the subcutaneous fatty tissue and fatty capsule of the gland, and the glandular tissue itself is damaged again.

(Non-lactation mastitis, which arose as a complication of a breast boil).

Symptoms and signs of mastitis

Serous stage (form) of mastitis

The initial or serous stage of mastitis is often difficult to distinguish from banal lactostasis. When milk stagnation occurs, women complain of heaviness and tension in the affected breast; a mobile, moderately painful lump with clear segmental boundaries is palpated in one or more lobes.

Expressing with lactostasis is painful, but the milk comes out freely. The woman's general condition is not affected and her body temperature remains within normal limits.

As a rule, lactostasis is a temporary phenomenon, so if within 1-2 days the compaction does not decrease in volume and persistent low-grade fever appears (increase in body temperature to 37-38 degrees Celsius), then serous mastitis should be suspected.

In some cases, serous mastitis develops rapidly: the temperature suddenly rises to 38-39 degrees Celsius, and complaints of general weakness and pain in the affected part of the gland appear. Expressing milk is extremely painful and does not bring relief.

At this stage, the tissue of the affected part of the gland is saturated with serous fluid(hence the name of the form of inflammation), which a little later receives leukocytes (cells that fight foreign agents) from the bloodstream.

At the stage of serous inflammation, spontaneous recovery is still possible, when the pain in the gland gradually subsides and the compaction completely resolves. However, much more often the process moves into the next - infiltrative phase.

Considering the seriousness of the disease, doctors advise any significant engorgement of the mammary glands, accompanied by an increase in body temperature, to be considered the initial stage of mastitis.

Infiltrative stage (form) of mastitis

The infiltrative stage of mastitis is characterized by the formation of a painful compaction in the affected gland - an infiltrate that has no clear boundaries. The affected mammary gland is enlarged, but the skin above the infiltrate at this stage remains unchanged (redness, local increase in temperature and swelling are absent).

Elevated temperature during the serous and infiltrative stages of mastitis is associated with the entry of human milk from foci of lactostasis into the blood through damaged milk ducts. Therefore, when effective treatment lactostasis and desensitizing therapy, the temperature can be reduced to 37-37.5 degrees Celsius.

In the absence of adequate treatment, the infiltrative stage of mastitis passes into the destructive phase after 4-5 days. In this case, serous inflammation is replaced by purulent inflammation, so that the gland tissue resembles a sponge soaked in pus or a honeycomb.

Destructive forms of mastitis or purulent mastitis

Clinically, the onset of the destructive stage of mastitis manifests itself sharp deterioration general condition of the patient, which is associated with the intake of toxins from the lesion purulent inflammation into the blood.

Body temperature rises significantly (38-40 degrees Celsius and above), weakness, headache appear, sleep worsens, and appetite decreases.

The affected breast is enlarged and tense. In this case, the skin over the affected area turns red, the skin veins dilate, and the regional (axillary) lymph nodes often become enlarged and painful.

Abscess mastitis characterized by the formation of cavities filled with pus (abscesses) in the affected gland. In such cases, softening is felt in the area of infiltration; in 99% of patients, the symptom of fluctuation is positive (a feeling of iridescent liquid when palpating the affected area).

(Localization of ulcers in abscess mastitis:
1. - subalveolar (near the nipple);
2. - intramammary (inside the gland);
3. - subcutaneous;
4. - retromammary (behind the gland)

Infiltrative abscess mastitis, as a rule, is more severe than an abscess. This form is characterized by the presence of a dense infiltrate consisting of many small abscesses various shapes and magnitude. Since the ulcers inside the infiltrate do not reach large sizes, the painful compaction in the affected gland may appear homogeneous (the symptom of fluctuation is positive in only 5% of patients).

In approximately half of the patients, the infiltrate occupies at least two quadrants of the gland and is located intramammary.

Phlegmonous mastitis characterized by total enlargement and severe swelling of the mammary gland. In this case, the skin of the affected breast is tense, intensely red, in places with a cyanotic tint (bluish-red), the nipple is often retracted.

Palpation of the gland is sharply painful; most patients have a pronounced symptom of fluctuation. In 60% of cases, at least 3 quadrants of the gland are involved in the process.

As a rule, disturbances in laboratory blood parameters are more pronounced: in addition to an increase in the number of leukocytes, there is a significant decrease in hemoglobin levels. Indicators are significantly violated general analysis urine.

Gangrenous mastitis develops, as a rule, due to the involvement of blood vessels in the process and the formation of blood clots in them. In such cases, as a result of a gross disruption of the blood supply, necrosis of large areas of the mammary gland occurs.

Clinically, gangrenous mastitis is manifested by an enlargement of the gland and the appearance on its surface of areas of tissue necrosis and blisters filled with hemorrhagic fluid (ichor). All quadrants of the mammary gland are involved in the inflammatory process; the skin of the breast takes on a bluish-purple appearance.

The general condition of patients in such cases is severe; confusion is often observed, the pulse quickens, and blood pressure drops. Many laboratory parameters of blood and urine tests are disrupted.

Diagnosis of mastitis

If you suspect inflammation of the mammary gland, you should seek help from a surgeon. In relatively mild cases, nursing mothers can consult their attending physician at the antenatal clinic.

As a rule, making a diagnosis of mastitis does not cause any particular difficulties. The diagnosis is determined based on the patient’s characteristic complaints and examination of the affected mammary gland.
From laboratory research, as a rule, carry out:

bacteriological examination of milk from both glands (qualitative and quantification microbial bodies in 1 ml of milk);
cytological examination of milk (counting the number of red blood cells in milk as markers of the inflammatory process);
determination of milk pH, reductase activity, etc.

In destructive forms of mastitis, an ultrasound examination of the mammary gland is indicated, which makes it possible to determine the exact localization of areas of purulent melting of the gland and the condition of the surrounding tissues.
In abscess and phlegmonous forms of mastitis, puncture of the infiltrate is performed with a wide-lumen needle, followed by bacteriological examination of the pus.

In controversial cases, which often arise in the case of a chronic process, an x-ray examination of the breast gland (mammography) is prescribed.

In addition, in case of chronic mastitis, you should mandatory conduct differential diagnosis with breast cancer, for this purpose a biopsy (sampling of suspicious material) and histological examination are performed.

Treatment of mastitis

Indications for surgery are destructive forms of infectious and inflammatory process in the mammary gland (abscessing, infiltrative-abscessing, phlegmonous and gangrenous mastitis).

The diagnosis of a destructive process can be unambiguously made in the presence of foci of softening in the mammary gland and/or a positive symptom of fluctuation. These signs are usually combined with a violation of the patient’s general condition.

However, erased forms of destructive processes in the mammary gland are often encountered, and, for example, with infiltrative abscess mastitis, it is difficult to detect the presence of foci of softening.

Diagnosis is complicated by the fact that banal lactostasis often occurs with a disturbance in the general condition of the patient and severe pain in the affected breast. Meanwhile, as practice shows, the question of the need surgical treatment should be resolved as soon as possible.

In controversial cases, to determine medical tactics, first of all, carefully express milk from the affected breast, and then after 3-4 hours, re-examine and palpate the infiltrate.

In cases where it was only a question of lactostasis, after expressing the pain subsides, the temperature decreases and improves general condition patients. Fine-grained, painless lobules begin to be palpated in the affected area.

If lactostasis was combined with mastitis, then even 4 hours after pumping, a dense painful infiltrate continues to be palpated, the body temperature remains high, and the condition does not improve.

Conservative treatment of mastitis is acceptable in cases where:

the patient's general condition is relatively satisfactory;
the duration of the disease does not exceed three days;
body temperature below 37.5 degrees Celsius;
none local symptoms purulent inflammation;
pain in the area of infiltration is moderate, palpable infiltrate occupies no more than one quadrant of the gland;
General blood test results are normal.

If conservative treatment does not produce visible results for two days, then this indicates the purulent nature of the inflammation and serves as an indication for surgical intervention.

Surgery for mastitis

Operations for mastitis are performed exclusively in a hospital setting, under general anesthesia (usually intravenous). At the same time, there are basic principles for the treatment of purulent lactation mastitis, such as:

when choosing an surgical approach (incision site), the need to preserve function and aesthetics is taken into account appearance mammary gland;
radical debridement(thorough cleansing of the opened abscess, excision and removal of non-viable tissue);
postoperative drainage, including the use of a drainage-washing system (long-term drip irrigation of the wound in postoperative period).

(Incisions for operations for purulent mastitis. 1. - radial incisions, 2. - incision for lesions of the lower quadrants of the mammary gland, as well as for retromammary abscess, 3 - incision for subalveolar abscess)
Typically, incisions for purulent mastitis are made in a radial direction from the nipple through the area of fluctuation or greatest pain to the base of the gland.

In case of extensive destructive processes in the lower quadrants of the gland, as well as in case of retromammary abscess, the incision is made under the breast.

For subalveolar abscesses located under the nipple, the incision is made parallel to the edge of the nipple.
Radical surgical treatment includes not only removal of pus from the lesion cavity, but also excision of the formed abscess capsule and non-viable tissue. In the case of infiltrative-abscess mastitis, the entire inflammatory infiltrate within the boundaries of healthy tissue is removed.

Phlegmonous and gangrenous forms of mastitis require the maximum volume of surgery, so that in the future plastic surgery of the affected mammary gland may be necessary.

The installation of a drainage and lavage system in the postoperative period is carried out when more than one quadrant of the gland is affected and/or the patient’s general condition is severe.

As a rule, drip irrigation of the wound in the postoperative period is carried out for 5-12 days, until the patient’s general condition improves and components such as pus, fibrin, and necrotic particles disappear from the rinsing water.

In the postoperative period it is carried out drug therapy aimed at removing toxins from the body and correcting those caused by purulent processes general violations in the body.

Antibiotics are mandatory (most often intravenously or intramuscularly). In this case, as a rule, drugs from the group of cephalosporins of the first generation (cefazolin, cephalexin) are used, when staphylococcus is combined with E. coli - the second generation (cefoxitin), and in the case of the addition secondary infection- III-IV generations (ceftriaxone, cefpirome). In extremely severe cases, thienam is prescribed.

With destructive forms of mastitis, as a rule, doctors advise stopping lactation, since feeding a child from an operated breast is impossible, and pumping in the presence of a wound causes pain and is not always effective.
Lactation is stopped with medication, that is, drugs are prescribed that stop the secretion of milk - bromocriptine, etc. Routine methods of stopping lactation (breast bandaging, etc.) are contraindicated.

Treatment of mastitis without surgery

Most often, patients seek medical help for symptoms of lactostasis or in the initial stages of mastitis (serous or infiltrative mastitis).

In such cases, women are prescribed conservative therapy.

First of all, you should provide rest to the affected gland. To do this, patients are advised to limit physical activity and wear a bra or bandage that would support but not compress the sore breast.

Since the trigger for the occurrence of mastitis and the most important link further development pathology is lactostasis, a number of measures are taken to effectively empty the mammary gland.

A woman should express milk every 3 hours (8 times a day) - first from a healthy gland, then from a sick one.
To improve milk flow, 20 minutes before expressing from the diseased gland, 2.0 ml of the antispasmodic drotaverine (No-shpa) is injected intramuscularly (3 times a day for 3 days at regular intervals), 5 minutes before expressing - 0.5 ml of oxytocin, which improves milk yield.
Since expressing milk is difficult due to pain in the affected gland, retromammary novocaine blockades are performed daily, while the anesthetic novocaine is administered in combination with antibiotics wide range action at half the daily dose.

To fight infection, antibiotics are used, which are usually administered intramuscularly in medium therapeutic doses.

Since many of the unpleasant symptoms of the initial stages of mastitis are associated with the penetration of milk into the blood, so-called desensitizing therapy with antihistamines is carried out. In this case, preference is given to drugs of a new generation (loratadine, cetirizine), since drugs of previous generations (suprastin, tavegil) can cause drowsiness in a child.

To increase the body's resistance, vitamin therapy (B vitamins and vitamin C) is prescribed.
If the dynamics are positive, ultrasound and UHF therapy are prescribed every other day, promoting rapid resorption of the inflammatory infiltrate and restoration of the functioning of the mammary gland.

Traditional methods of treating mastitis

It should immediately be noted that mastitis is surgical disease, therefore, at the first signs of an infectious-inflammatory process in the mammary gland, you should consult a doctor who will prescribe proper treatment.

In cases where conservative therapy is indicated, traditional medicine is often used in the complex of medical measures.

So, for example, in the initial stages of mastitis, especially in combination with cracked nipples, you can include procedures for washing the affected breast with an infusion of a mixture of chamomile flowers and yarrow herb (in a ratio of 1:4).
To do this, pour 2 tablespoons of raw material into 0.5 liters of boiling water and leave for 20 minutes. This infusion has a disinfectant, anti-inflammatory and mild analgesic effect.

It should be remembered that in the initial stages of mastitis, under no circumstances should you use warm compresses, baths, etc. Warming up can provoke a suppurative process.

Prevention of mastitis

Prevention of mastitis consists, first of all, in the prevention of lactostasis, as the main mechanism for the occurrence and development of the infectious and inflammatory process in the mammary gland.

Such prevention includes the following measures:

Early attachment of the baby to the breast (in the first half hour after birth).
Developing a physiological rhythm (it is advisable to feed the baby at the same time).
If there is a tendency to stagnation of milk, it may be advisable to perform a circular shower 20 minutes before feeding.
Compliance with the technology of correct milk expression (the manual method is the most effective, and it is necessary special attention give to the outer quadrants of the gland, where stagnation of milk is most often observed).

Since the infection often penetrates through microcracks in the nipples of the gland, the prevention of mastitis also includes the correct feeding technology to avoid damage to the nipples. Many experts believe that mastitis is more common in primiparous women precisely because of inexperience and violation of the rules for attaching a child to the breast.

In addition, wearing a cotton bra helps prevent cracked nipples. In this case, it is necessary that the fabric in contact with the nipples is dry and clean.

Predisposing factors for the occurrence of mastitis include nervous and physical stress, so a nursing woman should monitor her psychological health, get good sleep and eat well.
Prevention of mastitis not associated with breastfeeding consists of observing the rules of personal hygiene and timely adequate treatment of skin lesions of the breast.

Is it possible to breastfeed with mastitis?

According to the latest WHO data, breastfeeding during mastitis is possible and recommended: " ...a large number of studies have shown that continued breastfeeding is usually safe for the baby's health, even in the presence of Staph. aureus. Only if the mother is HIV positive is there a need to stop feeding the infant from the affected breast until she recovers."

There are the following readings to interrupt lactation:

severe destructive forms of the disease (phlegmonous or gangrenous mastitis, the presence of septic complications);
appointment antibacterial agents in the treatment of pathology (when taking which it is recommended to refrain from breastfeeding)
the presence of any reasons why the woman will not be able to return to natural feeding in the future;
the patient's wish.

In such cases, special medications are prescribed in tablet form, which are used on the recommendation and under the supervision of a doctor. The use of “folk” remedies is contraindicated, since they can aggravate the course of the infectious-inflammatory process.

With serous and infiltrative forms of mastitis, doctors usually advise trying to maintain lactation. In such cases, a woman should express milk every three hours, first from the healthy breast and then from the diseased breast.

Milk expressed from a healthy breast is pasteurized and then fed to the baby from a bottle; such milk cannot be stored for a long time either before or after pasteurization. Milk from a sore breast, where there is a purulent-septic focus, is not recommended for the baby. The reason is that for this form of mastitis, antibiotics are prescribed, during which breastfeeding is prohibited or not recommended (the risks are assessed by the attending physician), and the infection contained in such mastitis can cause severe digestive disorders in the infant and the need for treatment for the child.

Natural feeding can be resumed after all symptoms of inflammation have completely disappeared. To ensure the safety of restoring natural feeding for the child, a bacteriological analysis of the milk is first carried out.

What antibiotics are most often used for mastitis?

Mastitis refers to purulent infection Therefore, antibiotics are used to treat it bactericidal action. Unlike bacteriostatic antibiotics, such drugs act much faster because they not only stop the proliferation of bacteria, but kill microorganisms.

Today it is customary to select antibiotics based on the microflora’s sensitivity to them. Material for analysis is obtained during puncture of the abscess or during surgery.

However, at the initial stages, taking material is difficult, and carrying out such an analysis takes time. Therefore, antibiotics are often prescribed before such testing is performed.

In this case, they are guided by the fact that mastitis in the vast majority of cases is caused by Staphylococcus aureus or the association of this microorganism with Escherichia coli.

These bacteria are sensitive to antibiotics from the penicillin and cephalosporin groups. Lactation mastitis is a typical hospital infections, therefore, it is most often caused by strains of staphylococci that are resistant to many antibiotics and secrete penicillinase.

To achieve the effect of antibiotic therapy, penicillinase-resistant antibiotics such as oxacillin, dicloxacillin, etc. are prescribed for mastitis.

As for antibiotics from the cephalosporin group, for mastitis, preference is given to drugs of the first and second generations (cefazolin, cephalexin, cefoxitin), which are most effective against Staphylococcus aureus, including against penicillin-resistant strains.

Is it necessary to apply compresses for mastitis?

Compresses for mastitis are used only in the early stages of the disease in combination with other therapeutic measures. Official medicine advises using semi-alcohol dressings on the affected chest at night.

Among traditional methods You can use cabbage leaves with honey, grated potatoes, baked onions, burdock leaves. Such compresses can be applied both at night and between feedings.

After removing the compress, you should rinse your breasts with warm water.

However, it should be noted that the opinions of doctors themselves regarding compresses for mastitis are divided. Many surgeons indicate that warm compresses should be avoided as they can aggravate the disease.

Therefore, when the first symptoms of mastitis appear, you should consult a doctor to clarify the stage of the process and decide on treatment tactics for the disease.

What ointments can be used for mastitis?

Today, in the early stages of mastitis, some doctors advise using Vishnevsky ointment, which helps relieve pain, improve milk flow and resolve the infiltrate.

Compresses with Vishnevsky ointment are used in many maternity hospitals. At the same time, a significant portion of surgeons believe healing effect ointments for mastitis is extremely low and indicates the possibility adverse effects procedures: more rapid development of the process due to stimulation of bacterial growth elevated temperature.

Mastitis serious illness, which can lead to serious consequences. It is untimely and inadequate treatment that leads to the fact that 6-23% of women with mastitis experience relapses of the disease, 5% of patients develop severe septic complications, and 1% of women die.

Inadequate therapy (insufficiently effective relief of lactostasis, irrational prescription of antibiotics, etc.) in the early stages of the disease often contributes to the transition of serous inflammation into a purulent form, when surgery and associated unpleasant moments (scars on mammary gland, disruption of the lactation process) are already inevitable. Therefore, it is necessary to avoid self-medication and seek help from a specialist.

Which doctor treats mastitis?

If you suspect acute lactation mastitis, you should seek help from a mammologist, gynecologist or pediatrician. In severe forms of purulent forms of mastitis, you must consult a surgeon.

Women often confuse an infectious-inflammatory process in the mammary gland with lactostasis, which can also be accompanied by severe pain and increased body temperature.

Lactostasis and initial forms mastitis is treated on an outpatient basis, while for purulent mastitis hospitalization and surgery are required.

For mastitis that is not associated with childbirth and breastfeeding (non-lactation mastitis), contact a surgeon.

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 in 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. With intense inflammation, secreted active substances act on the entire body, including the thermoregulation center in the brain, changing its settings. A general reaction appears 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. All these factors determine the difference between the course of mastitis and other acute diseases. 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 birth. 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 - painful area denser fabric, without 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, enlarged, painful axillary lymph nodes can be detected, which become a barrier to the spread of microorganisms through the lymphatic tract.

This stage of the disease lasts from 5 to 10 days. After 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.

In the gangrenous form, the patient's condition is very serious. High fever is combined with increased heart rate up to 120 per minute or higher, decreased 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 (more often after spontaneous opening of the 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 mellitus, 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 neonatal 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 purulent process on the skin (pyoderma) and mechanical irritation iron

At the onset of the disease there is unilateral increase mammary gland. 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 chest wall with the formation of its 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. They evaluate the patient’s complaints, ask her about the duration of the disease and the connection with feeding the child, clarify the concomitant pathology, and conduct an examination and palpation of 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 be provided by bacteriological examination of milk, and if sepsis develops, of 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” them with them. clinical picture, 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 is no local signs 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 in mild forms of the disease. The treatment regimen includes the following areas:

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 conservative treatment acute mastitis. These methods can mask the course of the purulent process or, on the contrary, cause its rapid spread.

At high temperature body and the presence of infiltrate in the gland tissue requires surgical intervention. In case of severe lactostasis, which is also accompanied by similar symptoms, you must first free the gland from milk. To do this, a retromammary novocaine blockade is performed, 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 lump 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 with antiseptic agents, a drainage-washing system is installed to drain fluid and wash the wound with antibiotics and antiseptics after surgery. The wound is closed primary seam. 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, it is impossible to carry out such an operation, for example, with anaerobic microflora or 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 the postoperative period, conservative therapy is carried out, which includes antibiotics, desensitizing drugs, and 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:

do before feeding warm compress or breast massage;
feed the baby from the diseased 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, it is necessary urgent appeal See a doctor as there is a high risk of developing mastitis.

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 strong 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 a bacterial infection and occurs mainly in women during breastfeeding, but can also occur 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 may 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 good rest, no overvoltage. 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 using a heating pad or bottle. hot water. 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 fights inflammatory processes. It is necessary to reduce the temperature only in cases where its value is too high. high level. 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 full examination The breast doctor will prescribe a method for treating 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 medications that can be used during breastfeeding and that do not have a negative effect on the quantity and quality of milk, as well as the baby’s health. 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 provide 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 the step-by-step instructions for 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 for extreme case. But in any case, medications of this kind must be on hand. Coping with early stage mastitis on our own 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 the case of an infectious origin of mastitis, pathogenic bacteria enter the baby’s digestive tract along with milk, his gastric juice will cope with them without much difficulty.

Many mothers are interested in whether it is possible to breastfeed with mastitis. Doctors repeat loudly that it is possible and even necessary in order to get rid of the disease as quickly as possible. Let's tell you in more detail.

Mastitis is a disease that usually occurs during breastfeeding or when a baby is weaned. Women have to deal with this disease after three months from the birth of their baby. This is a disease of the mammary glands, accompanied by an inflammatory process. Statistics show that mastitis develops in approximately 5–6% of women who breastfeed.

After giving birth, every woman has to face new difficulties and learn something new every day. In the first days after birth, the main task of a new mother is to establish breastfeeding in order to avoid problems with the mammary glands and not leave her child hungry. At first glance, this task may seem simple, but in fact it requires a lot of effort, time and certain skills.

Causes of mastitis

In order to understand whether it is possible to feed a child with mastitis, it is necessary to identify the causes of this disease. And in order not to face the disease face to face, you need to pay attention to these reasons. So, factors contributing to stagnation of milk in the breast can be called:

In order not to encounter mastitis, you need to avoid the factors described above and take care of yourself. If there is a lot of milk and the baby cannot eat it, it is recommended to express regularly. This measure is also necessary during the development of the disease itself.

To prevent mastitis, you need to properly attach the baby to the breast so that he eats as much milk as possible, this is the only way to prevent stagnation from forming, leading to the development of mammary gland disease.

Is it possible to breastfeed a baby with inflammation of the mammary glands?

Many mothers who are faced with a disease such as mastitis are concerned about whether they can continue breastfeeding, because they don’t want to switch the baby to formula feeding. The answer is yes. It is necessary and even necessary to continue feeding in order to prevent complications.

Doctors have conducted a lot of research to determine whether it is safe to feed children with mastitis. It was possible to prove that this disease does not harm the baby in any way (does not affect the gastrointestinal tract).

If a mother thinks that during mastitis she will only harm her child, then she is deeply mistaken. Doctors say that with this disease it is necessary to continue feeding to maintain lactation. Breast milk produces antibodies that can protect the baby from infections entering the body.

But, despite the fact that you can still breastfeed your baby, this may cause side effects. This is, first of all, warming up the baby, that is, a slight increase in body temperature. Indeed, in the body of a mother suffering from mastitis, an inflammatory process occurs, the symptom of which is an increase in body temperature. Accordingly, the milk reaches the baby warm and warms him up. But some time after feeding, his body temperature returns to normal.

Important! During feeding, the mother not only improves the process of breastfeeding, she also alleviates her condition.

If you stop breastfeeding, there is a high chance of cessation of lactation, since during pumping the baby will wean off breast milk. He will understand that it is much easier to get food from a bottle, and therefore, after the mother’s treatment, he will refuse the breast.

When to stop breastfeeding

It is worth noting that not in all cases it is allowed to breastfeed a baby with mastitis. For example, if pus appears from the breast, you cannot continue feeding, as an infection may develop in the child’s body, especially when it comes to a newborn.

Typically, mastitis develops in one of the breasts. In order not to completely wean your baby off breastfeeding, you can give him milk only from a healthy gland. To prevent the child from becoming unaccustomed to the other breast, it is necessary to express the pus from it until only milk remains, and feed the child with it.

The doctor may also suggest that a woman temporarily stop lactation in the following cases:

Treatment of mastitis

Sometimes women confuse the development of mastitis with stagnation of milk, which can be eliminated. First of all, you need to make sure that the mother is putting the baby to the breast correctly. If not, then it’s worth mastering the technique of proper application.

In order to be completely cured, you need to completely empty the breast: express part of it, and the baby must suck the rest. It is worth noting that no breast pump will cope with the task of emptying the breast better than a baby. But even after emptying, the breasts need to continue to be massaged, “breaking up” the lumps that have formed in the mammary glands. Stagnant milk should be driven closer to the nipple and expressed so that new stagnation does not form.

In order to get rid of milk stagnation, the doctor may prescribe an appointment medicines. But you cannot self-medicate, as this can harm the child. After all, there is no need to cancel breastfeeding; you just need to select medications that are allowed to be combined with breastfeeding.

In order to get rid of mastitis as soon as possible and restore lactation, you need to start treating mastitis immediately after its first symptoms appear. Moreover, to achieve effective result treatment must be completed, even if the disease has receded and no longer bothers you.