Mastitis is a disease associated with an inflammatory process in the tissues of the mammary gland. Most often, women who are breastfeeding are exposed to it in the first two weeks after childbirth. Signs of mastitis are: severe arching pain in the chest, redness of the skin, thickening, swelling, chills, a rapid rise in temperature. As a result of the disease, a purulent abscess may occur. The reason is the activity of microbes from the group of staphylococci and streptococci that enter through the damaged nipple. The infection is transmitted from the child or through clothing and household items. The disease sometimes occurs after infection in the postpartum period of the genital organs, i.e. as a secondary infection.
Why does mastitis occur?
Mastitis is caused by staphylococcal and streptococcal infections. Infection is possible both inside the hospital and outside it. Bacteria can get through poorly processed linen, care items, from hidden bacteria carriers (medical personnel,roommates, relatives). Another source of the disease may be a baby. Sometimes he develops inflammatory diseases of the oral cavity, nasopharynx, pustular lesions of the dermis. Once on the skin of the breast, the bacteria do not cause disease. This requires certain factors to develop mastitis:
- features of the structure of the nipples - retracted flat, lobed;
- mastopathy - proliferation of glandular tissue associated with hormonal failure;
- presence of rough scars after surgery;
- abnormal course of pregnancy - premature birth, threatened miscarriage, toxicosis;
- abnormalities during childbirth - large blood loss, manual separation of the placenta, large fetus;
- complications after childbirth - exacerbation of chronic diseases, bleeding, fever.
As a result of these phenomena, the resistance of tissues to the harmful effects of bacteria decreases with reduced immunity after childbirth and the presence of hypovitaminosis. A fertile ground appears for the development of the disease.
Causes of mastitis
Any inflammation, including the mammary gland, is caused by the penetration of pathogenic microbes into the organ. In a woman during breastfeeding, this process can occur for the following reasons:
- Lactostasis is the stagnation of milk in one or more areas of the gland. Without taking urgent measures to eliminate it, uninfected, serous mastitis occurs, which subsequently with penetrationmicrobes from the surface of the dermis, turns into purulent, spreading inward. Stagnant milk is an excellent breeding ground for pathogens.
- Cracked nipples. The causative agents of infection penetrate through skin defects. From the wound surface, cracks, bacteria enter the lymph, from which they spread through the vessels through the gland.
- The presence of chronic diseases. Diseases such as sinusitis, pulpitis, tonsillitis are a constant source of infection. With the blood flow, it can penetrate the mammary gland and cause inflammation.
- Weakened immunity. With the restructuring of the body during pregnancy and the postpartum period, there is a decrease in the protective functions of the woman's body and fertile ground for the development of the disease.
Diagnosis
For any signs of mastitis, such as pain in the chest, tightness, fever in a nursing mother, you need to see a doctor: a mammologist, surgeon or gynecologist. The doctor listens to complaints, conducts an external examination of the organ and, if necessary, prescribes the following studies:
- general analysis of urine and blood;
- cytological (leukocyte count) and bacteriological (bacteria content in 1 ml) evaluation of milk;
- analysis of the secret of the female breast - the acidity of milk increases with inflammation;
- Ultrasound - used to diagnose mastitis of destructive (purulent) forms to determine the exact location of the affected area;
- thermography - shows a picture of the distribution of temperature fields;
- mammography;
- puncture -used with subsequent analysis of purulent secretions.
Based on all the diagnostic tests performed, the patient is prescribed a course of therapy.
Systematization of mastitis
The classification of the disease has several directions and is very confusing. It causes a lot of controversy among representatives of medicine. Mastitis - inflammation of the mammary gland - is divided into two types:
- infectious;
- non-infectious.
Next comes the classification, depending on the time of its occurrence, depending on the functional activity of the mammary gland, two forms are recognized:
- lactational - after childbirth;
- non-lactational - before childbirth.
In the course of the inflammatory process, it is divided into:
- spicy;
- chronic.
According to the nature of inflammation, mastitis happens:
- serous - more common in nulliparous women;
- infiltrative;
- purulent - has its own classification;
- abscessing;
- phlegmonous;
- gangrenous.
Symptoms of mastitis in a nursing mother
When inflammation develops, mastitis goes through the following stages: serous, infiltrative, purulent. After that, three development options are possible:
- abscess - limited purulent focus;
- phlegmon - the entire mammary gland is inflamed;
- necrosis - tissue death.
Signs of the disease depend on the stage of development of mastitis. The inflammatory process begins with a sharp rise in temperature. Weakness appears, chills begin andprofuse sweating. There is an increase in the breast. It thickens, there is severe pain, the chest seems to be bursting. The place where the inflammation is located becomes pinkish on the outside. With lactational mastitis, against the background of inflammation, milk begins to be produced less. The appearance of cracks in the nipples of a woman contributes to the infection inside the gland. Lack of treatment at this stage of the disease leads to a sharp deterioration in the patient's condition.
The high temperature continues to hold, the reddening of the skin on the inflamed area becomes brighter. On palpation, the affected area can be clearly identified. The phlegmonous stage is characterized by a sharp increase in the volume of the mammary gland. The inflamed dermis becomes cyanotic. Lymph nodes located near the diseased chest become inflamed. The process continues further and comes the gangrenous stage of mastitis. To the existing symptoms of mastitis in a nursing mother, bloody blisters and areas with dying skin are added. Edema begins to capture areas of the body that are near the chest. With mastitis, the development of general sepsis, inflammation of the lymph nodes and the formation of fistulas are possible.
Therapy
The process of treating the disease should begin with the appearance of the very first signs - breast distension, slight swelling or the formation of cracks in the nipples. To do this, you must immediately consult a doctor. Depending on the condition of the nursing woman, he will give recommendations, prescribe treatment, and in a more advanced case, write out referrals for examination. In addition to a complete blood countyou will need to study breast milk for the content of pathogenic bacteria in it. The issue of continuing to breastfeed the baby is immediately resolved. In the inflammatory process, breast milk may contain pathogens.
In order to avoid infection of the baby, doctors recommend transferring the baby to artificial feeding until the mother fully recovers, especially since she will be prescribed a course of antibiotics to treat mastitis. Only a doctor can choose the right medicines after receiving the results of tests for the sensitivity of bacteria to drugs. Drugs are prescribed in the form of droppers, injections or orally. During treatment, mom needs to constantly express milk so that congestion does not form again. Sometimes a doctor prescribes hormonal drugs to reduce lactation and make it easier to express milk. Treatment of mastitis at the purulent stage is carried out in a hospital. In some cases, the patient is shown only surgery. Supportive care is also provided. A woman is prescribed drugs to increase immunity and reduce general intoxication. After the end of the course of treatment, the patient again takes tests for the study of breast milk. If there is no infection in it, the baby can be breastfed again. After the course of treatment of mastitis, it is necessary to carefully monitor the condition of the mammary glands.
Mastitis surgery
Conservative treatment in some cases does not give a positive result, the disease passes into a purulent stage. In this case, it is shownurgent surgical intervention, which is performed in a hospital. The operation is done under general anesthesia. After opening the abscess, purulent-necrotic tissue is removed and the cavity is washed with an antiseptic solution. The incision is closed with a primary suture by installing a drainage-washing system. It allows you to wash the wound with antibacterial agents and allows the outflow of fluid. Washing ends after the localization of the inflammatory process. After the operation period, antibacterial treatment is carried out using antibiotics and maintenance therapy.
Antibiotics
When diagnosed with "lactational mastitis" with the manifestation of such signs as a serious condition and high body temperature; the presence of nipple cracks and pain in the mammary glands; milk was expressed, but the condition did not improve, a course of antibiotics should be started, this is done in order to prevent an abscess. The treatment regimen and the drug itself are selected by the attending doctor individually for each patient. On average, antibiotic treatment for mastitis lasts a week.
To do this, drugs of the following groups are used:
- Penicillins are broad-spectrum drugs with rapid absorption. They have side effects: disorders in the digestive tract, skin reactions. Partially pass into mother's milk, take with caution during lactation.
- Cephalosporins - characterized by rapid absorption from the stomach, have an effect on the affected tissue. Excreted with urine. Cancause an allergic reaction, headache. A small amount enters the mother's milk, the risk to the child is minimal.
- Macrolides - after taking drugs by a nursing woman, their high concentration in breast milk is observed. The drugs of this group of antibiotics do not have a negative effect on the baby's body.
- Aminoglycosides - drugs are not used when breastfeeding and pregnant women. Treatment with antibiotics for mastitis from this group is possible if the baby is temporarily transferred to artificial feeding.
- Fluoroquinolones - Breastfeeding is not recommended while taking these drugs. They are absorbed into milk and have some toxicity.
Necessary antibiotics are selected for the treatment of a nursing woman only by a doctor. He will prescribe a certain course of therapy and give advice on breastfeeding the baby.
Another form of mastitis
It includes non-lactational mastitis, when inflammation of the mammary gland does not occur during the period of breastfeeding. Its cause is usually related to:
- hormonal changes during puberty in adolescents or women in menopause;
- weakened state of the immune system: chronic infectious diseases, oncological processes, diabetes mellitus;
- Previous breast surgery.
The disease occurs with less pronounced signs of mastitis than in women during lactation. Soreness, slight swellingmammary glands and a slight increase in lymph nodes in the armpit. When contacting a doctor during this period, the disease is easily treated. Under certain circumstances, the process can turn into a purulent form. In this case, the general condition worsens, the body temperature rises sharply, the pain intensifies, the area of \u200b\u200bthe mammary gland becomes bright pink. Urgent medical attention is needed. Otherwise, a mature abscess of non-lactational mastitis may open, forming a fistula with pus. The treatment of the disease is carried out depending on the stage of the disease, both by conservative methods and by surgical intervention.
Physiotherapy
In the treatment of the initial form of mastitis, physiotherapeutic methods are used that increase lymph and blood flow in the stagnant area, have analgesic, anti-inflammatory and anti-edematous effects. They do not cause pain and do not create discomfort. Basically, the following procedures are used:
- Ultrasound. It penetrates deep into the tissues and gently massages the breast tissue. The duration of the session is 3-5 minutes, the course of treatment is up to 10 sessions, improvement occurs after three procedures.
- Pulse magnetotherapy. Inductors are placed on the affected area on both sides of the mammary gland, the impulses from which act on the seal. Sessions are held daily, up to 10 days, for five minutes.
Physiotherapy is provided in addition to the main course of drug therapy.
Therapy with folk remedies
The disease is characterized by the rapid development of inflammation. A woman, noticing signs of the disease, should immediately consult a doctor. You should not start treatment with folk methods, although there are a great many of them. In this case, you can simply lose time and aggravate the development of the disease. The benefits of treating mastitis with folk remedies should not be completely denied, but it should be started after consulting a doctor, using it in conjunction with medications. In the treatment of the disease, the following folk remedies have proven themselves well:
- Dill seeds. Their unique chemical composition contains vitamins and microelements: zinc sulphur, phosphorus, selenium, vitamins of group B, C, A, which will help recovery. A decoction is prepared from them: a tablespoon of seeds in half a liter of water. Consume three times a day in small portions.
- Honey. On the first day of the appearance of signs of the disease, apply a honey compress to the chest. It will help relieve pain and make pumping easier.
- Cabbage. It has long been used to treat various diseases. Beat a fresh cabbage leaf from the inside with a culinary mallet until the juice comes out. Attach it to the inflamed area and loosely fix it. It will relieve fever and pain relief.
- Burdock root. Contains many vitamins and microelements. It has anti-inflammatory and mild analgesic effect. A decoction is made from it: a tablespoon of crushed raw materials is poured with a liter of boiling water. The prepared drug is drunk three times a day in small portions.
- Beets. Raw pulp is rubbed on a grater and a compress is made whenthe occurrence of cracks in the nipple. It promotes wound healing, prevents inflammation.
By using natural medicines that have been proven over the years, along with medical preparations and constant medical consultations, signs of mastitis can be cured quickly.
Breast massage
At the first symptoms of mastitis, massage has a good effect. To carry it out, it is necessary to wash and dry your hands well, while the nails should be cut short. First of all, you need to do preparatory exercises. To do this, make light movements with the fingertips from the edge of the chest to the center in the form of a spiral. Then find areas for massaging. To do this, they feel the chest, and determine the seals and painful areas. Each seal is massaged separately. Movements are made clockwise from the center to the periphery. Then proceed to work on the entire mammary gland. Massage for mastitis begins with the armpit. The duration of the procedure is no more than five minutes. It should be remembered that all movements should be smooth and not cause pain. It is desirable to do the procedure regularly to obtain the desired effect.
Measures to eliminate milk stagnation
Some women feel the pain associated with milk stasis and start to panic. They are lost and do not know what to do with mastitis, what to do, who to turn to for help. Inflammation develops very quickly, especially in the evening and at night, so you should immediately consult a doctor. Signs of disease:
- appeared seal, mammary glandincreased;
- there is a sharp throbbing pain in the place where the inflammatory process occurred;
- pronounced reddening of the skin in the area of inflammation;
- temperature during mastitis rises sharply to forty degrees;
- comes general weakness, aches and malaise;
- headache.
The same picture of the patient's condition is also characteristic in the event of lactostasis - a disease preceding mastitis. The difference is only in the absence of temperature. Due to the seriousness of the pathology, it is necessary to urgently apply in the evening and at night to the emergency room of the hospital. Which doctor should I contact with mastitis? In the daytime - to the clinic, to the surgeon or obstetrician-gynecologist. There is an erroneous opinion that mastitis should be addressed to a mammologist. A doctor of this qualification deals with the problem of neoplasms of malignant and benign origin in the mammary glands.
Breast Prevention
One of the most important measures to prevent mastitis in the postpartum period is the hygiene of the mammary glands and the implementation of the correct feeding regimen for the child. With the implementation of simple rules, it is quite possible to prevent milk stagnation. When breastfeeding should:
- pre-treat the mammary gland with an antiseptic (you can use breast milk);
- correctly attach the baby to the breast, make sure that the nipple and areola (dark circle near the nipple) are completely in the mouth;
- let the baby alternately suck from both mammary glands;
- afterfeeding the remaining milk to express;
- avoid long breaks in feeding, be sure to feed the baby at night;
- feeding is carried out at the request of the child, not keeping a certain time.
To prevent cracked nipples:
- wash breasts with warm water then cool water;
- Sometimes rub your nipples with a clean towel;
- use comfortable underwear;
- systematically change your bra and milk-absorbing pads.
Recommendations for the first symptoms of lactostasis:
- make breast massage or warm compress before feeding;
- start feeding the baby from the diseased breast;
- increase the amount of fluid you drink;
- protect your chest from injury and hypothermia;
- see your doctor for advice.
In order to prevent mastitis, it is necessary to lead an active lifestyle, support the immune system, take water procedures twice a day, and eliminate foci of infection in time. Mastitis is a serious disease that can harm the he alth of the mother and leave the child without breastfeeding, which he so needs in the first days of life. It is necessary to start the fight against the disease along with the first signs of its manifestation, and the best thing is to try to prevent it.
