Why does mastitis appear? Mastitis and breastfeeding

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

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

The trouble of nursing mothers

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

When pumping and feeding improperly, microcracks appear on the nipples, which become entrance gate infections. Staphylococcus aureus and other types of microorganisms penetrate through cracks into the breast and cause inflammation. Sometimes mastitis in nursing is a consequence postpartum infection. But this happens extremely rarely.

Signs of mastitis

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

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

Other types of mastitis

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

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

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

Mastitis in men is very rare, but still occurs. First of all, this is a sign hormonal imbalance in organism; mastitis often appears in those who suffer diabetes mellitus. Sometimes in men who have undergone sex reassignment surgery and implantation breast prostheses, mastitis also develops, but such cases are rare. As a rule, treatment of male mastitis is done without surgical intervention, by medicinal methods.

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

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

Mastitis affects girls in adolescence- this is usually the fault hormonal changes body, leading to temporary weakening protective forces. Treatment of mastitis in adolescents is similar to the treatment of non-lactation mastitis in adult women.

Treatment of mastitis

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

At the same time, to alleviate the condition, applying ice to the chest is prescribed, drinking plenty of fluids, warm shower. No matter how much it hurts, you can't stop breast-feeding or pumping. If purulent mastitis has developed, it is better to express milk. Otherwise, milk will accumulate in the breasts and mastitis will worsen.

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

Prevention of mastitis

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

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

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

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

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

Mastitis is an inflammation of the parenchymal layer mammary glands, which occurs for numerous reasons. Shape, dimensions and anatomical features Breasts are individual, so the range of norms is quite wide. Female breast has a lobular structure. All lobes are large, articulated with each other by intervals of connective tissue With alveolar structure. The alveoli is lined with thin epithelial layer with excretory duct. Multiple small ducts connect into large ones, where colostrum and milk accumulate. Any disturbances associated with the outflow of milk and congestion can trigger the development of mastitis.

Code according to MBK 10: 091-092

What is this

Mastitis in a nursing mother is an inflammation of the mammary glands in the area of ​​the breast parenchyma. The disease is diagnosed in only 5% of all lactating women. With each passing decade, the disappointing statistics are decreasing, which indicates that the female population is literate about breastfeeding. Mastitis is more common in rural areas, where there is no qualified advisory and medical assistance regarding issues of fulfilled motherhood. The disease is registered mainly 2-3 weeks after birth, but in some cases it can occur later. There are two main types of mastitis:

lactation(associated with breastfeeding in women);

non-lactational in women and men(related to other reasons).

In the majority of women, only one gland is affected, with the left one being more common than the right one. This is explained by the ease of expressing milk with the right hand of the left breast. During the first 3 days after birth, a woman produces colostrum, which is more reminiscent of whey in composition. The substance is enriched with fats and proteins. The required volume of milk matures by the 12th day of a baby’s life. Stabilization of volume occurs by 6 months of the child’s life. Average duration The lactation period lasts from 6 to 24 months, which depends on the woman’s capabilities and desires.

The main condition for the development of mastitis is the formation of congestion in the ducts of the mammary glands. When an infection is attached, mastitis is infectious in nature; in the absence of such, it is non-infectious. The risk group includes primiparous women due to poor development glandular tissue. Today, there are many methods for attaching a baby to the breast, and modern breast pumps for quickly emptying the mammary glands.

Causes

The inflammatory focus of mastitis in women is formed under the condition of the pathogenic activity of Staphylococcus aureus. Pyogenic bacteria cause serious illnesses from purulent lesion skin, before the disease internal organs and tissues (osteomyelitis of bones, meningeal infections, pneumonia). IN Lately the combined pathogenic activity of Staphylococcus aureus and gram-negative Escherichia coli is sown.

Causes of lactation mastitis

The cause of typical postpartum mastitis often lies in hospital infection (insufficient asepsis, roommates, crowds of relatives). Infection can occur through household contact. In rare cases, mastitis is caused by the newborn baby itself, infected with staphylococcal bacteria. This can occur with umbilical sepsis, pustular skin lesions. For pathological activity of staphylococcus in the body healthy woman many factors must come together. The main causes of lactation mastitis are the following:

scars and scars on the mammary glands;

anatomical defects of the breast (shape of the nipple and areola);

woman's history of mastopathy;

pathological pregnancy, complicated childbirth;

postpartum fever;

emotional and mental disorders after childbirth;

exacerbation of existing chronic diseases.

Insomnia, weakened immunity, loss of energy, lack of sleep - all this can contribute to the development staphylococcal infection. It should be understood that Staphylococcus aureus present in environment ubiquitous and is an opportunistic bacterium. When creating a favorable environment for the growth and development of coccal colonies, inflammatory foci of various localizations arise.

Causes of non-lactation mastitis

Non-lactation mastitis can occur in men and women as a result of reduced immunity, trauma, excess weight And hormonal disorder. Other causes of non-lactation mastitis include the following:

hypothermia;

emotional disorders, mental illness;

pustular skin diseases in the chest area;

damage of any nature.

Decreased immunity in many cases is the main reason for the development of pathogenic microflora in the human body. The severity of advanced forms of lactation and non-lactation mastitis is the same, as is the degree of harm to human health.

Symptoms

The symptoms of mastitis are quite easy to distinguish from classic lactostasis. In both cases, congestion, pain, and tension in the chest are noted, but there are 3 main features that make it possible to determine lactostasis:

severe pain when pumping;

absence of fever, malaise;

in one or more lobes of the mammary gland a movable compaction with clear boundaries is palpated.

Usually, lactostasis disappears on its own with proper pumping or intensive feeding of the baby. If over the course of several days the compaction in the area of ​​the affected breast does not decrease, and the temperature rises to 37 C°, then the onset of mastitis can be suspected.

Serous form

Serous mastitis is the initial form purulent mastitis. The affected tissues become saturated with serous exudate, which can result in an inflammatory process. The main symptoms are:

slight malaise;

breast swelling;

pain when emptying the gland;

temperature increase.

Sometimes when serous form the woman recovers on her own, but if the condition worsens, the temperature rises to high values, then further progression of mastitis occurs.

Infiltrative form

The disease at the stage of infiltration formation (pronounced compaction) is the second stage of mastitis formation. The main symptoms of the infiltrative form are:

tenderness in the affected breast;

slight redness;

temperature rise to 37-38 C°.

The tissues remain unchanged, there is no swelling. An increase in temperature is associated with milk entering the bloodstream through damaged ducts. If left untreated, after 5 days a purulent form of mastitis forms.

Destructive or purulent form

At this stage of development of the pathology, the patient’s health sharply worsens due to symptoms of intoxication of the body. Nausea and malaise increase, the temperature reaches 40 C°. The breast tissue resembles a honeycomb soaked in purulent exudate. Other signs are also included:

redness of the breast;

swelling of the nipple, areola;

enlargement of the affected breast;

severe pain during palpation and pumping;

enlargement and tenderness of the axillary lymph nodes.

The purulent form is dangerous due to the spread of pus through the bloodstream, infection of internal organs or systems, especially in the presence of chronic diseases.

Infiltrative-abscessing form

Abscess mastitis is characterized by the formation of cystic cavities with purulent exudate. On palpation of the infiltrate, softening is noted, the boundaries become unclear. Almost all women experience fluctuation syndrome (fluid transfusion in the cavities) when palpated. At this stage, purulent foci are formed with different localization:

near the nipple (subalveolar);

inside the mammary gland (intramammary);

subcutaneous (in subcutaneous fat):

behind the mammary gland (retromammary).

As the disease progresses, the infiltrate resembles a cluster of multiple abscesses of varying sizes. Considering the small size of the abscesses inside the seal, the infiltrate may falsely appear homogeneous and resemble the infiltrative form of mastitis. Fluctuation syndrome is observed in only 10% of women.

Phlegmonous form

Phlegmonous mastitis is expressed in total enlargement and swelling of the mammary gland. The skin in the affected area is red, sometimes bluish-red, the nipple is slightly retracted. On palpation, patients experience severe pain, fluctuation syndrome is clearly expressed, involving almost 3-4 quadrants of the glandular structure in the process. The indicators of clinical and laboratory research are also violated:

protein levels in the urine change;

leukocyte formula with a shift to the left (increased leukocytes and inflammation);

decrease in hemoglobin in the blood.

It should be noted that the phlegmonous stage occurs already 7-10 after the initial stage of mastitis. In the absence of adequate treatment, the final stage occurs pathological lesion mammary gland.

Gangrenous form

IN pathological process the vascular system is involved. The formation of blood clots prevents adequate blood supply to tissues, leading to their necrosis. On the surface of necrotically changed areas of the skin, blisters with sanguineous contents appear. The affected breast takes on a bluish or purple-bluish tint in all quadrants of the mammary gland. The patient becomes seriously ill clinical condition with reduced blood pressure, thready pulse, confusion. Treatment for this form of mastitis is only surgical.

To eliminate the risks of rapid progression of mastitis, especially in women located far from medical centers, any moving compaction into pain is considered the initial stage of mastitis. Already at the onset of lactostasis, you should prepare for consultation with specialists.

Diagnostics

Which doctor should I contact for mastitis? If you suspect any lump or pain, you should consult a surgeon or mammologist. In the absence of these specialists, you can resort to the help of a general practitioner who can initially determine pathological changes. Diagnosis of mastitis does not present any particular difficulties, and all measures boil down to the following:

studying the patient’s complaints and clinical history;

visual examination of the mammary glands (nature of discharge, condition of the nipple and skin, anatomical features);

palpation of the mammary glands (determining lumps, pain intensity);

collection of urine and blood tests;

bacteriological examination milk;

milk cytology and pH determination;

ultrasound of the mammary glands (for destructive changes in glandular structures);

puncture of the infiltrate to study pus and identify the pathogen.

In controversial situations, they resort to X-ray examination of the breast. In case of chronic mastitis, it is important to differential diagnosis regarding breast cancer. In such cases, a biopsy is performed and histological examination biological material.

Treatment of mastitis

Treatment of mastitis can be carried out both at home and in a hospital setting. In the early stages of mastitis, women do not need to interrupt breastfeeding; on the contrary, complete emptying of the mammary glands is necessary. What to do when initial stages mastitis?

Early stage

For lactostasis and serous mastitis, treatment is conservative. Therapeutic tactics include intensive pumping and massage of the mammary glands. Activities are permissible if:

the condition lasts no more than 3 days;

general state remains stable;

no temperature;

blood tests are normal;

there are no signs of inflammatory nature.

Pumping is done every 2-3 hours. They begin to express or feed the baby first from the healthy breast, then from the affected breast. If the baby has not finished eating, it is recommended to express completely and give a high-quality massage.

Desensitization therapy

Desensitizing therapy is aimed at improving milk production, preventing the development of mastitis, eliminating and resolving the infiltrate.

The main drugs for the treatment of lactostasis (early stage of mastitis) are the following:

Magnesia. Magnesium sulfate is used as a pronounced antispasmodic, hypotensive, choleretic agent. Widely used in clinical practice, thanks to its beneficial properties.

Dimexide. The drug for lactostasis is used as a conductive agent that stimulates milk flow. Dimexide has anti-inflammatory and antimicrobial effects.

Oxytocin. Hormonal drug to stimulate lactation and the birth process. The drug selectively affects smooth muscles, vascular system and milk ducts.

No-shpa. Antispasmodic intended as an adjuvant therapy for lactostasis. The drug has a pronounced myotropic effect, which has a stimulating effect on milk secretion.

Amoxiclav. A drug for etiotropic therapy in inflammatory processes, belongs to the group of combined antibiotics. It is used during preserved lactation without harm to the child’s health.

Malavit. Used as medicinal compresses simultaneously with other drugs. It has disinfecting properties and stimulates the normal flow of milk through the milk ducts.

Progestogel. Gel for the treatment of lactostasis, widely used in clinical practice. The drug has a specific effect on breast tissue, penetrates deeply into cells, reduces permeability vascular walls. During treatment, swelling decreases, milk flow normalizes, and the infiltrate resolves.

All medications are prescribed by a doctor based on general clinical picture diseases. If symptoms rapidly increase due to the progression of pathology, therapy is prescribed for a short period.

Late stages

Conservative therapy lasts about 4 days, in the absence of therapeutic effect don't continue. If conservative therapy does not produce results, then drug treatment is prescribed:

antispasmodics (Drotaverine, No-shpa);

nonsteroidal anti-inflammatory drugs (Ibuprofen, Ketoprofen);

antibiotics of the group of cephalosporins, macrolides.

At the same time, UHF therapy, ultrasound, and electrophoresis are performed to resolve the infiltrate and normalize the function of the mammary gland. If a woman undergoes treatment on an outpatient basis, then constant examinations of the woman are required at least every 48 hours. With absence positive dynamics The woman is hospitalized for recovery.

Surgical intervention

The operation is performed in a hospital under general anesthesia. The main aspects of effective surgical treatment lactation mastitis the following are considered:

the importance of the aesthetic component of the incision (location of the scar, its length);

postoperative drainage of the wound canals and constant washing;

radical treatment of an opened purulent lesion.

The gangrenous and phlegmonous stage of the pathology presupposes a full surgical intervention in full. Subsequently, plastic surgery of the affected breast may be required. Installation of a drainage system is carried out when 2 or more quadrants of the glandular structure are affected. Drip rinsing wound surface is carried out almost 2 weeks from the moment of the operation to full recovery women. Particles of epithelium, pus, mucous membranes, and blood should completely disappear from the washing water.

In the early postoperative period intensive antibiotic therapy is prescribed. Antibiotics for mastitis after surgery prevent recurrence of the pathology. More often practiced intramuscular injection cephalosporin antibiotic (Ceftriaxone, Cefazolin, Cephalexin, Cefoxitin). IN severe cases For mastitis, the antibiotic Tienam is prescribed.

It is recommended to stop breastfeeding in case of phlegmonous and destructive forms. Expressing is also prohibited due to painful sensations and constant trauma to the wound. Drug therapy, also negatively affects the condition of the woman and child. Usually, lactation is stopped with medication, with double use of the drug Bromocriptine. Other methods of stopping lactation (tightening or ligating the mammary glands) are prohibited.

Mastitis is a serious complication of typical lactostasis, therefore, if there is any suspicion of the development of lumps and difficulty in the outflow of milk, you should contact a surgeon, mammologist or therapist.

Proper breastfeeding usually eliminates the risk of developing congestion, so competent consultation with specialists is important. For prevention, women should treat everything on time infectious diseases, carious teeth, purulent formations on the skin, monitor the child’s nutrition, and fully empty the breast. A timely reaction will preserve not only health, but also the possibility of maintaining breastfeeding.

Mastitis (breast) is an infectious and inflammatory disease that occurs in the mammary glands. The lesions quickly spread, capturing healthy tissue. A disease left to its own devices leads to dangerous complications. Against this background, sepsis, abscess, phlegmon and gangrene develop. If mastitis occurs, treatment at home is carried out with medications and folk remedies.

Usually the mammary glands become inflamed in postpartum period. This happens due to increased milk production. When breastfeeding, women develop lactation mastitis. The disease manifests itself in 2 forms:

• unilateral (more common);
• double-sided

There is non-lactation mastitis - a pathology not associated with milk production and breastfeeding. The symptoms of this form of the disease are vague. The inflammation is localized, it does not involve adjacent tissues. Such breastfeeding often takes a chronic form. Sometimes it occurs in newborn girls. Hormones received from the mother in excess lead to the disease.

According to the nature of the course, mastitis is distinguished:

• spicy;
• chronic;
• serous;
• purulent.

Causes

There are many factors that cause mastitis. The lactation form of the disease is most often caused by Staphylococcus aureus. After harmful bacteria get on the skin, the appearance of pathology is provoked by reasons such as:

• mastopathy;
• post-operative scarring;
• peculiarities anatomical structure organ;
• difficult pregnancy;
• complicated childbirth;
• chronic diseases;
• disturbed sleep;
• postpartum depression.

Most often, inflammation of the mammary glands occurs in women who have given birth to their first child. They lack the skills to breastfeed and express milk. Breast congestion leads to the development of an inflammatory process.

A non-lactating breast appears when the immune system is weakened. Her reasons are:

• hypothermia;
• severe infections;
• accompanying pathologies;
• neuropsychic and physical overload;
• silicone implants;
• chest injuries.

The provoking factor in this case is bacterial infection. The causative agent is the same as for lactating infants - staphylococcus.

Symptoms

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

• heaviness in the mammary glands;
• discomfort;
• minor tissue compactions.

But with lactostasis, which lasts only 1-2 days, the temperature does not rise, milk easily oozes from the nipple. With mastitis, the lumps grow and the temperature rises. Serous exudate accumulates in the lesions.

Subsequently, the disease passes into the infiltrative stage. A compaction forms in the inflamed area without clear boundaries. The breasts swell, hurt, and the temperature rises. The skin does not undergo changes.

In advanced conditions, destructive breast development develops - dangerous pathology. If purulent mastitis occurs, the woman suffers from the following symptoms:

• intoxication;
• high temperature jumping to 40 degrees;
• loss of appetite;
• disturbed sleep;
• headache.

At purulent mastitis skin turn red, the lymph nodes in the armpit become enlarged. The disease can develop into an abscess, phlegmon, and gangrene.

Drug therapy

For treatment simple shapes breastfeeding use methods conservative therapy. Serous mastitis is treated as follows:

Non-lactation mastitis can disappear spontaneously. If the disease does not go away, drug therapy is carried out.

Treatment at home

Treatment for breastfeeding begins after consulting a doctor. Most medications should not be used while breastfeeding. Therefore, mastitis is treated with folk remedies, for the preparation of which honey, plants, and camphor are used.

Cabbage leaves

Cabbage effectively fights breastfeeding. The leaves of the plant are used for applications. Compresses are made like this:

Cabbage fights swelling, inflammation, and resolves seals.

Oils

To treat mastitis at home, use camphor and Castor oil. They make applications with them.

Camphor oil for mastitis helps relieve pain and eliminate the inflammatory process. Thanks to it, compactions are reduced.

Castor oil quickly relieves aggravation. After rubbing it into the chest, apply a film and a warm bandage.

For older patients, mint oil helps get rid of mastitis. The product stimulates blood circulation and fights swelling. Add 3-5 drops of mint essential oil to 1 tablespoon of vegetable oil. The mixture is rubbed into the chest at night.

For mastitis, make applications with honey:

Applications with salt

Women should know how mastitis is treated with salt compresses. This accessible remedy getting rid of the disease at home. Salt applications are effective for lungs and running forms breastfeeding Salt draws out exudate, relieves swelling, inflammation, improves blood circulation.

The method of preparing a salt compress is simple: heat the water to 50 degrees, dissolve 1 tablespoon of salt in it. Slots are made in a cotton napkin for the nipples (they will avoid irritation of the epithelium in this area), the fabric is soaked in a solution, placed on the chest, covered with polyethylene, and secured with an insulating bandage. Remove the application after cooling.

Applications for purulent breastfeeding

The following methods help cure purulent mastitis:

Herbal extracts

When treating mastitis at home, compresses alternate with lotions from plant extracts. At the same time, drink herbal teas and herbal decoctions. They are prepared using the following recipes:

Compresses are a warming procedure. Doctors note that heat applications can aggravate the disease, so they should not be used during exacerbation and fever. To avoid undesirable consequences, use the products recommended by the doctor. For severe forms of breastfeeding traditional methods are ineffective, and the disease is treated surgically.

Mastitis is an inflammatory process in the tissues of the mammary gland. It manifests itself as severe bursting pain in the chest, swelling, thickening, redness of the skin of the gland, a sharp rise in body temperature, and chills. Mastitis is diagnosed by visual examination by a mammologist; an additional ultrasound of the mammary gland is also possible. The disease can lead to the formation of an abscess, abscess, phlegmon, necrosis in the mammary gland, the development of sepsis and even death. In case of microbial contamination of milk, breastfeeding will have to be stopped. IN long term Deformation of the mammary gland may occur, increasing the risk of developing mastopathy and breast cancer.

Symptoms of mastitis

Spicy postpartum mastitis- This is most often an inflammatory complication of lactostasis in nursing mothers. Sometimes it develops without being preceded by pronounced signs of milk stagnation. Manifested by the appearance painful lump in the mammary gland, redness and increased temperature of the skin in the area of ​​​​induration, fever and general symptoms intoxication. As the pain progresses, the pain intensifies, the breasts enlarge and become hot to the touch. Feeding and pumping are extremely painful; blood and pus may be found in the milk. Suppurative mastitis often progresses with the development of a breast abscess.

Plasma cell mastitis is rare disease, developing in older women who have given birth repeatedly after cessation of lactation. Characterized by infiltration plasma cells tissues under the nipple and hyperplasia of the epithelium of the excretory ducts. This type of mastitis does not fester and has some common external features with breast cancer.

Neonatal mastitis is a fairly common condition in children of both sexes, manifested by swelling of the mammary glands and discharge when pressing on them (usually the result of the residual effect of the mother’s sex hormones). With the development of acute purulent inflammation and the formation of an abscess, surgical sanitation of the purulent focus is performed, but most often the symptoms subside after three to four days.

Diagnosis of mastitis

The source of inflammation in the mammary gland is determined by palpation. There is also an increase (sometimes moderate pain on palpation) of the axillary lymph nodes on the side of the affected breast. Suppuration is characterized by determining the symptom of fluctuation.

If mastitis is detected at the stage of serous inflammation or infiltration, conservative treatment of mastitis is carried out. Antibiotic therapy is prescribed using strong existing funds wide range actions. Serous mastitis, as a rule, goes away in 2-3 days; it may take up to 7 days for the infiltrate to resolve. If inflammation is accompanied by severe general intoxication, detoxification measures are carried out (infusion of electrolyte solutions, glucose). In case of severe excess lactation, drugs are prescribed to suppress it.

Purulent forms of mastitis usually require surgical intervention. A developed breast abscess is an indication for emergency surgical sanitation: opening the mastitis and draining the purulent focus.

Progressive mastitis, regardless of its stage, is a contraindication to further feeding (including healthy breasts), since breast milk, as a rule, is infected and contains toxic tissue breakdown products. For a child, pathologically altered breast milk can cause the development of dysbiosis and disorder functional state digestive system. Since treatment for mastitis includes antibiotics, feeding during this period is also not safe for the baby. Antibiotics can cause noticeable damage normal development and dew of organs and tissues. During the treatment of mastitis, you can express milk, pasteurize it and only then give it to the child.

Indications for suppression of lactation: lack of dynamics in serous and infiltrative mastitis within three days of antibiotic therapy, development of a purulent form, concentration of an inflammatory focus directly under the nipple, a history of purulent mastitis in the mother, concomitant pathologies of organs and systems that significantly worsen the general well-being of the mother.

Prevention of mastitis

Measures to prevent mastitis coincide with measures to prevent lactostasis, since this condition is a precursor to mastitis in the vast majority of cases.

To prevent milk stagnation, complete and thorough emptying of the mammary glands is necessary: ​​regular feeding and subsequent expression of the remaining milk. If the baby is full of milk from one breast, at the next feeding it is first applied to the gland that was untouched the last time.

You should not allow your baby to simply suck on the breast for comfort, without sucking out the milk. Cracks in the nipples contribute to the development of inflammation of the mammary gland, so it is necessary to prepare the nipples for feeding and carefully observe hygiene rules(clean hands, breast), apply the baby to the breast correctly (the baby should grasp the entire nipple with his mouth, along with the areola).

One of preventive measures the development of mastitis can be called timely detection and sanitization of foci of infection in the body, however, it is worth remembering that the general antibacterial therapy Contraindicated during lactation.

Mastitis is an inflammatory disease of the breast tissue. As a rule, it develops in the postpartum period (approximately three to four weeks after discharge from the hospital) in breastfeeding mothers, especially first-time mothers. However, there are cases of the disease occurring in women outside the lactation period, as well as in men and children, including newborns.

Symptoms and signs of mastitis.
This inflammatory disease occurs and progresses very quickly. The first symptoms appear from several hours to two days and are expressed in the appearance of quite noticeable pain in the mammary gland of an aching nature, while its contours are preserved, and the skin does not undergo any changes. This disease also manifests itself in the form of increased body temperature (above 38 degrees), headaches, weakness, discomfort and increasing pain when breastfeeding, chills, enlarged and red breasts, loss of appetite, and sleep disturbances. Besides, in axillary area due to the increase in size, the lymph nodes begin to be palpated in the form of small, dense, painful formations. It should be noted that untreated mastitis at an early stage is fraught with the development of a more serious form of the disease - purulent.

IN this option It is not recommended to self-medicate, because all the means and methods used in this case do not eliminate the source of the inflammatory process, but only relieve its manifestation (symptoms), as a result of which the process progresses. As the disease progresses, softening appears at the site of compaction in the mammary gland, indicating the appearance of an abscess. The only solution in this situation is to carry out urgent surgery, delay can cause serious complications. To prevent such consequences, it is important early diagnosis and treatment of the disease.

Causes of mastitis.
The main cause of the occurrence and development of mastitis are bacteria (mainly staphylococci) that penetrate the breast tissue. A bacterial infection can enter the tissue through cracks in the nipples or through the blood if there are foci of infection in the body (pyelonephritis, chronic tonsillitis and so on.).

The appearance of cracks or small defects in the nipple area is a kind of gateway for infection. Usually, if bacteria enter the mammary gland, our defense system can cope with it. But since in postpartum period Since the female body is very weakened, in most cases it is not able to cope with infections on its own. As a rule, immediately after the appearance of cracks in the nipples (which happens in approximately the majority of women after discharge from the maternity hospital, especially in first-time mothers), bursting pain appears in the mammary gland, which at the same time swells greatly, thickens, becomes tight, and the skin turns red. All this condition is accompanied by an increase in temperature. There are many reasons for the appearance of cracked nipples, but the most common is considered to be the nursing mother’s failure to comply with basic hygiene rules before and after feeding the baby.

Another reason for the development of mastitis may be the so-called lactostasis, which is stagnation of milk in the ducts of the mammary glands due to incomplete or insufficient expression of milk or insufficiently frequent feedings. The presence of milk in the mammary ducts is considered a favorable environment for the growth of bacteria, since it contains a large number of nutrients. Lactostasis is expressed in painful sensations in the area of ​​the mammary gland, the appearance of focal compactions(nodules). Usually, with this phenomenon, the body temperature does not increase. However, lactostasis that is not eliminated inevitably develops into mastitis within a couple of days, accompanied, first of all, by an increase in temperature. Flat or inverted nipples are one of the causes of lactostasis, because it is very difficult for the baby to suckle at the breast, as a result of which it is not emptied enough.

To avoid the development of lactostasis at the first signs of stagnation of milk or engorgement of the mammary gland, it is recommended to express milk more often and apply cold to the mammary gland, it will facilitate its passage. It is also recommended to perform self-massage of the breast every day. It must be done according to this scheme: right hand place your palm down on your head, and at this moment massage with your left hand in the direction from the outskirts to the nipple, while the nipple area itself does not need to be massaged.

Two types of mastitis can be observed: lactation (in nursing mothers) or postpartum and non-lactation, which occurs outside the lactation period. The latter type is quite rare; as a rule, it occurs and develops against the background of trauma to the mammary gland, its compression and as a result of disturbances in female body hormonal in nature. On the background adolescence or hormonal imbalance, mastitis often occurs in women reproductive age in the period from 14 to 18, from 19 to 24 and from 30 to 45 years. Cystic and fibrous mastitis are nothing more than fibrocystic mastopathy.

Stages of development of mastitis.
Mastitis develops in three stages: serous, infiltrative and purulent. The serous stage characterizes the earliest stage of the development of the disease, occurring two to four days after infection and manifested by increased temperature, increased and slight compaction mammary gland, its soreness, which increases during breastfeeding or pumping, and relief does not come after that. A general blood test shows the presence of signs of an inflammatory process. Incorrect treatment or its absence inevitably leads to the fact that the early stage of the disease turns into infiltrative in two to three days.

Signs of infiltrative and purulent mastitis.
The infiltrative stage of mastitis is characterized by pronounced inflammatory process and a more severe general condition of the woman. When palpating the mammary gland, a clear inflammatory compaction (infiltrate) with redness of the skin above it is observed, which becomes larger and the redness intensifies. Heat does not subside, there are sudden changes in temperature. Fluctuation occurs (in medical terms, oscillation), indicating the presence of fluid (pus) in the cavity.

In the phlegmanous form of mastitis (when the abscess is not delimited by a capsule from healthy tissues), the body temperature remains at 40˚, accompanied by chills and weakness. The mammary gland significantly increases in volume, the skin above it takes on a swollen, shiny, reddened appearance with a bluish tint. There is inflammation of nearby lymph nodes.

In the gangrenous form of mastitis (tissue necrosis due to circulatory disorders), the woman’s general condition is characterized as extremely severe: body temperature is 40 - 41˚C, pulse is rapid 120 - 130 per minute, the mammary gland is greatly enlarged in size, the skin over it is swollen, covered with blisters containing bloody contents with areas of tissue necrosis. Swelling affects surrounding tissues. A blood test shows the presence of severe inflammation.

Chronic purulent mastitis.
The chronic form of breast mastitis is quite rare. It develops against the background of a rather long local treatment penicillin injections mainly for purulent mastitis. With this form of the disease, the condition of the patients is characterized as satisfactory: the body temperature is normal, or does not rise above 37.5-37.8 C. Upon palpation, some mildly painful compaction is felt, not fused to the skin. At chronic form Symptoms of the disease are mild. The mammary gland is painful and slightly enlarged, in rare cases there is inflammation in the nearby lymph nodes with a slight or, rarely, high fever.

Let me note once again that treatment of mastitis in the early stages of development is conservative, that is, antibiotics, anti-inflammatory drugs, etc. are prescribed. Purulent forms of the disease are treated only with surgical intervention.

Diagnosis of mastitis.
At the first signs of mastitis, you should immediately consult a doctor. Diagnosis of mastitis consists of detecting existing characteristic features identified during visual examination and palpation of the mammary gland. To clarify the diagnosis, a general blood test is performed to show the presence of inflammation in the body. In order to determine the type of bacteria and their sensitivity to certain antibiotics, a bacteriological examination of milk from an inflamed breast is carried out. Often, breast ultrasound is prescribed to diagnose mastitis.

Mastitis and breastfeeding.
Regardless of the stage and form of mastitis, you cannot feed a child, because milk even from a healthy breast (not to mention a sick one) can contain a huge amount of bacteria that are dangerous for the baby. Moreover, during treatment of this disease Antibiotics are prescribed, which, if released into mother's milk, can harm the baby. If you temporarily stop breastfeeding, you should not give up expressing milk; it is simply mandatory, and it must be done regularly and with special care. Firstly, complete emptying of the breast during illness significantly speeds up recovery. Secondly, pumping will help maintain lactation so that after recovery the mother can return to breastfeeding.

Complications of mastitis.
This disease is often complicated by inflammation lymphatic vessels(lymphangitis) and lymph nodes (lymphadenitis). In rare cases, especially with phlegmonous and gangrenous forms, the disease is complicated by sepsis (blood poisoning). When an abscess (often spontaneous) is opened, milk fistulas sometimes form (which are channels that connect the abscesses to the surface of the body), the closure of which occurs independently, but this requires sufficient a long period time.

Prevention of mastitis.
The main thing in the prevention of mastitis is to prevent cracks in the nipples (the main thing is to comply with the rules of personal hygiene, complete pumping after feeding). If cracks appear on your nipples, consult a doctor immediately and do not self-medicate. In preventing the development of the disease, it is important to promptly treat caries and chronic inflammatory diseases(tonsillitis), since microbes can penetrate the breast tissue through the blood from foci of inflammation in other areas.