Online consultations with MCSC doctors n. a. A. S. Loginov

Lactation mastitis

Lactation mastitis is an inflammatory disease of the breast that occurs after childbirth.

Most often it appears in the first 2 weeks of feeding the baby, less often - in later terms. It develops, approximately, in 5-8% of women after the birth of a child, of which about 80% are first-time women and 25-36% are women who have become mothers again.

Why does mastitis develop?

· Incorrect application;

·                    Pathological conditions of the child (short frenulum of the tongue, congenital anomalies, premature birth);

·                    Pathological conditions in a nursing mother (postpartum depression, nipple injuries, infectious diseases);

There are several stages of lactation mastitis development, each of which has its own characteristics:

1) Breast filling - the milk flows out easily, the body temperature is not elevated.

At this stage, timely and correct application of the child is necessary. 

2) Engorgement – the release of milk from the breast is difficult, there are episodes of an increase in body temperature to 37.5 C.

At this stage, it is necessary to:

- frequent and correct application of the baby with alternating poses for feeding;

- the use of methods that facilitate the release of milk: a warm shower, applying a warm wet towel to the chest for 2-3 minutes, a light massage of the back and neck, drink a warm delicious drink;

- limit the impact of stressful factors.

These measures are aimed at increasing the production of oxytocin in the woman's body, which becomes achievable if the mother experiences positive emotions.

3) Lactostasis - the breast is hot to the touch, the skin is glossy, dense areas are determined. The stage can last about a day.

At this stage, the above measures complement:

- softening of dense areas with massage movements before and during active pumping/feeding;

- if this condition lasts for more than 12 hours, then after feeding, a cool towel is applied to the mammary glands for 3-5 minutes.;

- applying the baby to the breast in such a way that his chin looks in the direction of the compacted area;

- intake of B and C vitamins.

4) Non-infectious mastitis. Develops after 24 -36 hours, if it was not possible to cope with the process at the stage of swelling. Body temperature rises to 38-39C. Flu-like condition.

At this stage, all of the above measures apply.

5) Infectious mastitis. Develops after 48-72h. Often the causative agent is Staphylococcus aureus. This stage occurs with an increase in body temperature of at least 39 C, chills, weakness, the chest is painful over the entire surface, pumping does not bring relief, the skin is red.

At this stage, it is necessary to supplement the above measures with medication:

- paracetamol;

- antibiotics of the penicillin series (because they do not require interruption of breastfeeding).

6) Abscess, phlegmon. The examination and treatment of this complication takes place in the conditions of the surgical department.

What to do if you have difficulties with lactation:

At the first stages of difficulties with breastfeeding, seek qualified help from a mammologist. Timely medical care prevents the development of more severe conditions. The specialist will perform an examination and palpation of the mammary glands, ultrasound of the mammary glands and regional lymph nodes (Fig. 1). If an infectious process is suspected, the doctor prescribes a general blood test, a bacteriological culture of milk. An abscess may require a puncture.

 

 

Fig. 1. Ultrasound picture of breast abscess

Prevention:

·       Wearing special underwear for nursing women.

 

* Regular correct application of the child.

 

·       Do not express additional breast after feeding.

 

·       After each feeding - air baths for 5-7 minutes.

 

·       In case of cracks and infection of the nipples - timely treatment.

 

 

 

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