Mastitis - an acute inflammatory disease of the breast that occurs predominantly in women (but can also occur in children, and men).
Most of mastitis occurs during breastfeeding, although it is possible the development of the disease in nulliparous, non-breastfeeding women, and even men.
Separately allocated mastitis newborn.
Causes
Mastitis is an aseptic (non-purulent) and purulent.
The first reason is injuries to the chest, stagnation of milk in breastfeeding women without breast tissue infection by microbes.
Purulent form occurs as a result of penetration into the breast tissue and its channels of pathogens - aureus, Streptococcus and other disease-causing agents.
Ingress of microbes in the mammary gland may occur:
- exogenously (outside) through the nipple fissures, skin defects (primary mastitis),
- endogenously, it skid infection in the mammary gland of a blood or lymph from other foci of infection (secondary mastitis).
The reasons for the overwhelming number of episodes in the postpartum period is a violation of the techniques of breastfeeding, milk stasis (lactostasis), cracked nipples and reduced immunity, hormonal disruption balance.
For the most part, there are mastitis during lactation, if a woman has difficulty with breastfeeding.
Often this is due to the following factors:
- rare feeding regime,
- improper attachment of the child, resulting in formation of cracked nipples,
- incomplete emptying of the mammary glands,
- wearing tight clothes, which compresses the ducts,
- violation of rules of personal hygiene.
Milk in the ducts is a breeding ground for germs penetrating into the chest. Mastitis usually develops in 3-4 days from the beginning lactostasis (stagnation of milk), if it is not recognized in time and is not eliminated. But breast size, contrary to popular belief, does not affect the development of the disease.
symptoms of mastitis
Mastitis in lactating (lactation mastitis)
Usually seen seals in the chest, pain and bloating. Against these phenomena the temperature rises and can be disrupted overall health. If not removed at 1-2 days lakstostaze there are signs of aseptic (non-purulent) mastitis:
- pain in the gland,
- diffuse or focal erythema,
- rise in temperature to 37-38 degrees gland,
- difficulty of outflow of milk.
As the progression of mastitis, and connection of infection appear:
- pus foci Palpable under the skin as the sealing portions with the liquid movement in the center,
- sharp pain,
- allocation of greenish-yellow pus from the nipple,
- a sharp increase in body temperature to 39-40 degrees,
- symptoms of intoxication,
- an increase in temperature in the area of his chest.
Attention! When breastfeeding axillary temperature is not measured, it will always be too high, the true body temperature is measured in the popliteal fossa or elbow temperature.
Not lactation mastitis (men and women)
Usually occurs after trauma or piercing in contact with infection on breast tissue.
Symptoms such mastitis:
- pain in the chest,
- presence of severe redness,
- outflow of pus from the nipple,
- temperature rise,
- intoxication,
- inflammatory changes in the blood.
Diagnostics
Diagnosis and treatment of mastitis engaged mammologist doctors, gynecologists and surgeons.
Mastitis occurs and stage is necessary to recognize it in its early stages. This allows non-surgical treatments.
Basically diagnosed on clinical grounds, they are complemented with the analysis of blood and inflammatory changes data ultrasonic breast examination.
Thus infiltration detected (in this case, looking like seal) or pus foci (abscesses). To establish germ, povinnogo in mastitis, seeding is carried milk (or purulent) with determination of sensitivity to antibiotics.
treatment of mastitis
If early detection of mastitis can be cured without surgery.
Treatment of lactation mastitis form
In this case, it is recommended to follow the following principles:
- establish full outflow of milk from the breast, whether it Sucking child or pumping, treatment is not very effective at stagnation of milk,
- you need to expand the feeding ducts (warm shower, a cup of warm liquid, a warm compress), and after feeding - a cool compress,
- in case of cessation of feeding - a solution of dimethyl sulfoxide diluted 1: 5, topically to the affected gland as a compress
- the development of non-infectious mastitis with preventive aim prescribe antibiotics, antiinflammatories and antipyretics as needed.
If pumping is not possible and there is a need for inhibition of lactation, use preparations - cabergoline 0,25 mg p 2 / day for two days, bromocriptine 0,005 g 2 r / day for 4-8 days
Antimicrobial therapy while continuing breastfeeding - semisynthetic penicillins, cephalosporins: cefalexin 5 00 mg 2 r / d Cefaclor 250 mg 3 / day, amoxicillin + clavulanic acid, 250 mg 3 / day (in the case of failure can be used by feeding any antibiotics)
Completely wrong would prohibit breastfeeding as the child empties the ducts more effectively. Even if the milk is not sterile, acidic environment of the stomach child neutralize germs.
It can be temporarily banned from breastfeeding only when purulent mastitis (abscess), and then only with a sore chest.
At the expiration of pus compulsorily appointed powerful antibiotics orally or by injection.
If an abscess in the chest - a direct indication for surgical treatment. Physician under local or general anesthesia makes accurate incision in the skin and underlying tissues, pus conducting suction from the cavity and its drain to the processing antiseptics. Postoperative treatment principles described above are also relevant. Without the normal outflow of milk lactation mastitis will recur.
Mastitis - is not a contraindication to breastfeeding, and certainly not a reason to take drugs to suppress lactation! Antibiotics - it is not an indication for termination of breastfeeding, antibiotics are selected are compatible with breastfeeding.
Treatment of non-infectious mastitis
Such mastitis is treated by general principles:
- antibiotics in the early stages,
- the formation of purulent foci - opening them from draining and washing with antiseptic,
- treatment of wounds,
- use of immunomodulators, vitamins,
- as stihanija manifestations assigned physiotherapy for resorption of inflammatory foci.
prevention
lactation mastitis
The basis of its prevention - this is the correct breastfeeding.
It is based on the following principles:
- baby feeding on demand,
- adequate breast hygiene (use of green fodder is usually ineffective), the regular daily shower is enough,
- right breast grab the baby,
- selection of comfortable clothes,
- No additional decanting unnecessarily.
- appeal for help and advice from consultants on breastfeeding once the formation lactostasis, seal in the chest, with the appearance of the slightest doubt.
Nelaktatsionny mastitis
The following procedures will minimize the risk of its occurrence:
- respect for the breast area with no injuries, punctures and beats in the chest,
- personal hygiene,
- regular check-ups in the field of breast tissue in order to identify seals,
- hormonal agents only on prescription.
