When the mammary gland is inflamed. Let's talk about mastitis

The symptoms and treatment of mastitis are inextricably linked. Timely identification of signs will allow you to quickly identify and eliminate the inflammatory disease occurring in the breast tissue. In case of late consultation with a doctor and improper therapy, purulent mastitis may develop, requiring surgical intervention. Therefore, it is important to know the first signs and symptoms of the disease, the causes of its occurrence, in order to prevent serious consequences.

Causes of mastitis

In most cases, mastitis in women is provoked by a staphylococcal infection, which enters the ducts of the mammary glands and actively develops there. The most common causes of mastitis are the following:

1. of chronic diseases in the body , including infections of the respiratory tract, reproductive system, etc.;
2. Acute intestinal infections , when the stick enters the mammary glands through the circulatory system;
3. Cracked nipples . Even microscopic lesions are vulnerable to infection;
4. Lactostasis . Stagnation of milk in the gland encourages the proliferation of pathogenic organisms;
5. Weakened immunity caused by recent childbirth or the presence of concomitant diseases;
6. Failure to comply with basic hygiene rules.

If you have one of the listed factors, you need to pay special attention to your health and conduct regular breast examinations. To reduce the likelihood of mastitis, you should exclude its possible causes.

How to diagnose?

Breast cancer can mimic the symptoms of mastitis. To exclude oncology and confirm the disease, an examination is required.

It includes:

• Ultrasound – allows you to detect a lesion in the mammary gland, determine its size and shape;
• microscopy of milk - with mastitis, a microbial pathogen, remains of pus and leukocytes will be detected;
• A blood test will show an increase in ESR and a shift of the formula to the left, which indicates inflammation.

A biopsy will show the final point in diagnosis - but it is not always prescribed when previous methods do not allow a differential diagnosis.

Mastitis in nursing women

Most often, breastfeeding women suffer from mastitis. Refusal to breastfeed or irregular pumping causes stagnation of milk in the glands. As a result, a favorable environment for the proliferation of microorganisms is created.

The first signs of mastitis may appear as early as the second week of breastfeeding or during weaning. However, mastitis in a nursing woman also occurs at other stages. Milk is rich in nutrients, making the infection develop very quickly. Even short-term disruptions in feeding the baby and expressing milk can cause mastitis.

Read more: Symptoms of mastitis in a nursing mother.

Medical care for purulent mastitis

At the first signs of lactostasis, it is best to immediately consult a doctor and get advice on proper feeding.

Diagnosis of the patient

If mastitis is suspected, the doctor prescribes the following to the woman:

• general blood test and determination of sugar levels;
• Analysis of urine;
• Ultrasound.

Ultrasound diagnostics makes it possible to detect areas of accumulation of pus in tissues, determine their location and size. Under the control of the device, it is convenient to perform a puncture to examine the affected tissues.

We recommend reading more about ultrasound examination of the mammary glands. What diseases can be detected using ultrasound, what advantages does ultrasound examination have in comparison with other methods.

Features of the treatment of purulent mastitis

For lactostasis and at the stage of serous mastitis, conservative treatment is used. Doctors recommend:

• regular expression of milk every 3 hours from healthy and diseased breasts;
• antispasmodics intramuscularly (relieves spasms in the ducts, facilitates pumping);
• antihistamines (provide desensitization);
• antibacterial drugs (kill pathogens);
• UHF therapy;
• compresses, semi-alcohol wraps.

Treatment of purulent mastitis involves surgery. The inflamed tissues are opened under general anesthesia and the lesion is drained.

After the operation, antibacterial therapy is indicated, the abscess cavity is washed with antiseptics (furacillin, chlorhexidine, etc.). If the inflammation has stopped and the milk analysis has confirmed the absence of bacteria in it, you can continue breastfeeding.

If the doctor advises not to put the baby to the breast, this applies even to a healthy gland. In this case, the expressed milk from the inflamed breast must be poured out, and from the healthy breast, it must be given to the baby through a bottle after pasteurization. In some cases, permanent interruption of lactation with the help of medications is indicated.

Non-surgical treatment of purulent mastitis is not effective and can lead to worsening of the condition.

Purulent mastitis: how the operation is performed

The method of performing the operation depends on the characteristics of the disease. The volume of affected tissues and their location determine the choice of surgical approach. Paraareolar incisions for mastitis can be performed in the case of central intramammary and subareolar types. If the mastitis is located in the upper or medial quadrants, a radial Angerer incision is made. You can get to the lateral quadrants along Mostkov (along the outer transitional fold). If the lesion is located in the lower quadrants or total mastitis occurs, a HOGO incision (Hennig approach) is used. However, this method, like the Rovninsky access, does not provide the desired cosmetic effect, and therefore is practically not used.

Mechanism of disease development

Pathogenic microorganisms enter the woman’s mammary gland through blood or microcracks in the nipples. After this, the pathogens begin to actively multiply and secrete waste products that have a detrimental effect on the human body. As a result, the first symptoms of mastitis appear in the form of fever and general malaise.

The immune system responds to the inflammatory process by producing white blood cells designed to suppress the source of infection. This is accompanied by dilation of blood vessels and the appearance of characteristic signs of mastitis.

How does the disease begin?

Mastitis develops after infection enters through the nipple opening. As a result of infection, pathogenic microorganisms settle on the wall of the duct. When milk stagnates, favorable conditions are created for the reproduction and growth of colonies, which gradually causes the death of gland cells.

The disease goes through three stages:

1. Serous-infiltrative – acute mastitis begins with it. The affected tissues swell, and there is an accumulation of leukocytes - protective cells for destroying microbes. All pathological processes at this stage are still reversible.
2. Stage of phlegmon - if the pathogen is not destroyed, the colonies infect new tissues, causing the death of entire areas. There is limited accumulation of pus.
3. Gangrene develops if left untreated. It is characterized by blockage of large vessels with blood clots or their compression by growing purulent foci. Due to poor circulation, most of the gland dies.

Stages

Mastitis is divided into several stages, which are characterized by certain symptoms and signs. The main classification of mastitis is as follows:

• Serous is the initial stage of the disease, which responds well to treatment. At this stage, it is important to recognize the first symptoms: a slight inflammation forms, without visible changes on the skin. In this case, there is an enlargement of the mammary gland, pain and an increase in temperature.
• Infiltrative - occurs two days after the lack of proper treatment for serous mastitis. The area of ​​inflammation increases, and upon palpation you can feel a pronounced compaction (infiltrate).
• Purulent - at this stage, purulent formations appear, causing a significant increase in temperature to 40 degrees and a sharp deterioration in well-being. The breasts become swollen, and the skin in the area of ​​the mammary gland changes color.
• Chronic – occurs due to improper treatment or lack thereof. In most cases, this is untreated mastitis of the mammary gland, which subsequently responds poorly to therapy.

In addition to those described, there are also several other classifications of mastitis:

• Abscess – characterized by the presence of a purulent formation that is localized in a certain area and does not extend beyond its limits.
• Phlegmonous is one of the advanced forms of purulent mastitis, when inflammation spreads throughout the mammary gland.
• Gangrenous – a severe stage at which tissue necrosis occurs. The woman feels a sharp deterioration in her health, and her body temperature can rise above forty degrees. These symptoms require immediate hospitalization.

It is worth noting that mastitis in a nursing mother develops very intensively. In just a few hours, the disease can progress to the next stage. Therefore, when the first symptoms appear, you need to contact a clinic where professional help will be provided.

When the mammary gland is inflamed. Let's talk about mastitis

Pain, redness of the skin in the area of ​​the mammary glands, bursting pain in the mammary glands - these symptoms may indicate the development of such a serious disease as mastitis. What kind of pathology is this? To whom and why does it occur? How to prevent its development? The topic of mastitis is covered by Efim Semenovich Asnin, a surgeon at the Expert Clinic Smolensk.

— Efim Semyonovich, what is mastitis? Who usually develops it?

— Mastitis is an inflammation of the mammary gland. It develops most often in women after pregnancy and the birth of a baby, as it is mainly associated with disruption of the normal outflow of breast milk (lactostasis). They constitute a risk group for the disease.

Mastitis of non-lactating (non-milk-producing) glands occurs, as a rule, in women under 30 and after 50 years.

— How common is mastitis?

— 90% of all cases of mastitis occur during the period of breastfeeding a child, i.e., the inflammatory process develops in the lactating mammary gland. According to statistics, about 16% of women who breastfeed suffer from inflammation of the mammary glands. Among them, the vast majority are primiparous.

Mastitis in women who do not breastfeed occurs in 5-10% of cases.

“Breastfeeding a child is painful,” young mothers say. Is breastfeeding always accompanied by pain for a woman?” Quote from the material “Which of these is NOT true about breastfeeding?”

— What are the causes of mastitis?

— The main reason is the penetration of pathogenic microflora into the mammary gland tissue, in particular a bacterial infection (most often staphylococcal). If a woman does not attach the baby to the breast correctly, if her nipples are not prepared, cracks may appear on them, forming an entrance gate for the penetration of microbes. Incomplete expression of milk from the breast contributes to the development of lactostasis, and this is a favorable environment for the development of inflammation.

The cause of mastitis can also be a hormonal imbalance (namely, excess production of the hormone prolactin, dysfunction of the thyroid gland), or abrupt weaning of the child from the breast.

Incorrect implantation, nipple piercings, and injuries to the mammary gland can also lead to the development of inflammation in it.

— Tell us about the types of mastitis

— According to the course, acute and chronic mastitis, unilateral and bilateral, are distinguished. According to the nature of the inflammatory process, they are serous, infiltrative, purulent, abscessing, gangrenous, and phlegmonous. The first two forms are characterized by a limited focus of inflammation. If a good flow of milk is ensured, they usually do not fester. All other forms of the inflammatory process require surgical intervention.

— What symptoms are characteristic of mastitis?

- Painful sensations in the mammary gland when feeding a child, bursting pain in it, thickening of the gland tissue, redness of the skin in this area, cracks and abrasions on the nipple and around it, enlargement of nearby lymph nodes, signs of intoxication - high fever, chills, headaches. These symptoms should be a signal for a woman to immediately consult a doctor.

In more advanced cases, discharge from the mammary glands mixed with pus and blood can be observed.

— What does the diagnosis of mastitis consist of?

— First of all, from the collection of complaints and anamnesis, examination by a doctor. If necessary, it is recommended to conduct a series of blood tests, ultrasound of the mammary glands, and bacteriological culture of secretions from the mammary glands for microflora.

Read materials on the topic:

What does an ultrasound of the mammary glands show? Bacteria: find and identify. What will bacterial culture tell you?

— How and with what is mastitis treated?

— Treatment tactics are selected by the doctor individually depending on the form and severity of the inflammatory process. Conservative treatment methods include antibacterial, anti-inflammatory, immunomodulatory therapy, and some types of physiotherapeutic procedures.

If the inflammatory process progresses or there are cavities in the gland filled with pus, surgical intervention may be required.

Read materials on the topic:

How to use antibiotics correctly? Instructions for use Why don't antibiotics help?

— How do you feel about traditional methods of treating mastitis?

— I can recommend proven folk remedies only after a personal examination of the patient, if I think that they will be effective in this case.

— What needs to be done to avoid mastitis?

— First of all, observe the rules of personal hygiene when feeding and caring for the mammary glands, prevent congestion by regularly feeding the child with both glands alternately, followed by expressing the remaining milk. Contact obstetricians or lactation consultants for information on techniques and rules of feeding and pumping. It is important that a woman wears correctly sized underwear made from natural fabrics.

A breastfeeding woman should not have chronic foci of infection in her body, so even while planning a pregnancy, she should consult a doctor to eliminate them.

Relatives should provide the nursing woman with adequate nutrition, sleep, and protect her from stress and excessive physical activity.

I urge women to immediately consult a doctor if there are any changes in the mammary glands. Do not forget that timely diagnosis and treatment will help maintain lactation without resorting to surgical intervention.

Interviewed by Sevilya Ibraimova

You can make an appointment with a surgeon here. ATTENTION: the service is not available in all cities

The editors recommend:

Is mastopathy dangerous? Let's not panic, but heal! Breast fibroadenoma: how can a doctor help? Breast cancer is not a death sentence! Do's and Don'ts in a nursing mother's diet

For reference:

Asnin Efim Semyonovich

In 1972 he graduated from the medical faculty of the Smolensk State Medical Institute. In 1973, he completed his internship in the specialty “Surgery”. He underwent advanced training in various areas of surgery and orthopedics. Doctor of the highest category. Currently, he is a surgeon at the Expert Clinic, Smolensk. Receives at the address: st. 8 March, no. 20.

Symptoms of mastitis

Unlike many diseases, mastitis is characterized by the appearance of pronounced symptoms even at an early stage. This allows you to consult a doctor in a timely manner and undergo a course of therapy to prevent further development of the infection. Among the main symptoms are:

• pain in the affected area;
• increase in breast size;
• breast lump;
• malaise and weakness;
• headache;
• increased body temperature;
• change in skin color in the breast area;
• deterioration of milk flow;
• swelling of the skin of the breast;

Each stage of the disease is characterized by certain signs of mastitis. At the initial stage, thickening of the mammary gland and an increase in body temperature appear. These symptoms are enough to suspect the disease and undergo a professional examination to make an accurate diagnosis.

How to prevent it?

The main task of prevention is to ensure the natural drainage function of the mammary gland - this will prevent stagnation of milk and create a favorable emotional background. We list the basic rules that must be followed to prevent the development of mastitis:

1. Immediately after birth you need to breastfeed - it is advisable to do this in the first 30 minutes. In the future, feeding should be continued, strictly observing the daily routine.
2. Always express the remaining milk - place your fingers around the periphery of the areola, do not pull on the breast or pinch the skin. Alternate these movements with a light massage.
3. Wear only a loose bra made from natural fabrics - the seams should not dig into the skin. If there is discharge from their nipple, use special wipes.
4. Do a light breast massage every day - gently, in a circular motion. The procedure should last 5-10 minutes.
5. If sores appear on the nipple, you should immediately consult a doctor. The doctor will prescribe medications for healing and special creams.

The best prevention is timely attendance at antenatal clinics and breast care. If you adhere to all of the above rules, the likelihood of developing pathology is very low. When symptoms of mastitis appear, urgent conservative therapy is required.

Diagnostics

Diagnostics plays an important role, since timely identification of the problem will allow for effective therapy and quickly eliminate the inflammatory process. The patient must carry out the initial diagnosis independently. This will allow you to identify the first symptoms of mastitis, suspect the presence of the disease and seek help from specialists.

When visiting a doctor, an examination is carried out and complaints are identified. The specialist palpates the breast, which allows you to make a diagnosis and determine a list of further examinations to determine effective treatment tactics.

Depending on the situation, the patient may be prescribed the following tests:

• general blood analysis;
• discharge from the nipples, to identify the causative agent of infection and sensitivity to antibiotics;
• examination of milk for the presence of bacteria and leukocyte levels.

To accurately determine the location of inflammation, as well as its extent, an ultrasound examination is performed. If the clinical picture is questionable, a biopsy is prescribed to rule out the possibility of cancer. The list of studies may vary and depend on factors such as the presence of concomitant diseases, the stage of mastitis, and so on.

What are the different forms of mastitis?

There are several classifications; when making a diagnosis, the doctor identifies the type of pathology depending on the conditions of its occurrence. This gradation includes two forms of mastitis:

1. Non-lactational – rare and not associated with breastfeeding. Usually it is predisposed to injury, hypothermia, and infection entering the gland through the blood or lymph.
2. Lactation - most diseases are represented by this form. It develops after childbirth, is acute and requires immediate treatment.

The doctor indicates the type of mastitis in the medical history. This classification is paid attention to when prescribing therapy. If a non-lactational form is diagnosed, testing may be expanded to look for the cause.

According to the clinic, several types of mastitis are distinguished:

• infiltrative - when swelling of local tissues is noted, compactions appear;
• serous - with this form, fluid accumulates in the intercellular space, symptoms are moderate;
• abscess – characterized by limited purulent inflammation;
• phlegmonous – a diffuse purulent area is observed;
• gangrenous – accompanied by the death of glandular tissue;
• chronic infiltrative mastitis - accompanied only by local symptoms.

There is also a classification according to the prevalence of pathological changes - mastitis can be superficial and deep. The latter is divided into several forms, the most dangerous is panmastitis, in which the entire area of ​​the gland is inflamed. When making a diagnosis, the classification of pathology is written in detail.

Treatment of mastitis

Treatment methods depend entirely on the stage of mastitis and the woman’s health condition. It is worth noting that mastitis progresses very quickly and requires qualified treatment. Trying to cope with the disease on your own can lead to serious consequences.

The initial stage of the disease allows you to achieve high results using conservative treatment methods. These include taking anti-inflammatory medications and regularly expressing breast milk (in the case of lactation mastitis). In case of weakened immunity, the doctor prescribes antibiotics. During this period, it is recommended to stop breastfeeding, as taking medications can affect the composition of milk.

To minimize the likelihood of relapse, during the treatment period it is necessary to eliminate the factors that led to the development of mastitis. For example, ensure regular expression of milk.

Treatment of mastitis in women should be carried out under the supervision of specialists. In the absence of a positive result and the formation of suppuration, surgical intervention will be required. Removal of an abscess can be carried out by puncture or opening with subsequent drainage.

After the operation, a course of antibacterial therapy and painkillers is prescribed. If the disease occurred during lactation, then breastfeeding can be resumed only after stopping the medication and complete recovery. To ensure the effectiveness of the therapy, the patient is scheduled to undergo repeated tests.

Read more: Treatment of mastitis in a nursing mother.

How to treat?

Treatment for mastitis requires mandatory cessation of breastfeeding, since Staphylococcus aureus can cause dangerous diseases in the child. You also need to remember that any medicine penetrates the glandular tissue, and then into the milk.

At the initial stages, conservative therapy is prescribed. It includes:

1. Drugs to reduce lactation (Dostinex, Bromocriptine) are prescribed by a doctor to relieve the strain on the mammary gland. When taking them, breastfeeding is strictly prohibited.
2. Expressing breast milk - done 4-5 times a day, the procedure begins with the sore breast. For severe pain, a novocaine blockade is first done.
3. Analgesics (Nise, Ibuprofen) or antispasmodics (Papaverine, No-Shpa) are prescribed for severe local symptoms. Medicines help cope with the manifestations of pathology.
4. Antibiotics for mastitis (Clarithromycin, Erythromycin) are prescribed by a doctor when Staphylococcus aureus is detected. Taken in courses along with painkillers.

In case of phlegmonous form or in the presence of an abscess, surgery is prescribed. During surgery, purulent foci are opened, drainage of the contents is performed, followed by disinfection. In case of gangrene, the entire gland must be removed. After the intervention, a course of antibiotics is indicated.

Recommendations

Breast mastitis requires immediate action and adequate treatment. To achieve a speedy recovery and not harm your health, you need to adhere to the following recommendations:

1. Treatment of mastitis should be trusted only to qualified specialists. Independent actions can lead to negative consequences and the transition of the disease to a more complex stage.
2. To achieve effective results, you cannot ignore the recommendations of your doctor.
3. When identifying the first signs of mastitis, you need to refrain from thermal procedures and regularly express milk.

Only professional treatment of mastitis will help get rid of the inflammatory process and avoid its reappearance.

Complication after purulent mastitis

It is impossible to answer unequivocally what the probability of reoperation is for purulent mastitis. It all depends on the overall picture, the degree of tissue damage, and the patient’s compliance with the doctor’s recommendations during the recovery period.

In total, there are two types of complications.

1. Complications associated with the disease itself. In some cases, phlegmon or gangrene of the mammary glands may develop, which provoke blood poisoning (sepsis).
2. Postoperative complications:

• cosmetic defect;
• after surgery, a milk fistula may form, which most often does not interfere with feeding and closes a month after the patient recovers;
• the postoperative wound may fester - a recurrence of purulent mastitis occurs;
• a healed surgical injury deforms the mammary gland and increases the likelihood of developing mastitis during the next pregnancy.

Purulent mastitis after surgery requires careful care and daily dressings.

Prevention

It is almost impossible to completely exclude the possibility of the disease. However, you can reduce it to a minimum. To do this, it is enough to carry out a number of preventive measures:

1. It is necessary to breastfeed regularly, as well as express the remaining milk after each procedure.
2. When feeding, you need to properly attach the baby to the breast. The baby should be able to grasp the entire areola. This prevents damage to the delicate skin of the nipples.
3. Timely treatment of inflammatory processes occurring in the body also reduces the chances of mastitis.
4. Before and after each feeding, you need to prepare your breasts. The nipples are washed with warm water and then gently wiped with a clean towel.

Preventive measures also include self-examination of the mammary glands and regular visits to a specialist.

Is it possible to continue breastfeeding with mastitis?

With mastitis, the infection does not get into the milk, and it cannot harm the baby. And although breastfeeding with mastitis can be painful for mom, try not to stop breastfeeding. The more often the baby suckles at the breast where congestion has occurred, the faster it will be eliminated. You also need to continue feeding to strengthen the baby’s immunity, since breast milk has antibacterial properties.

Rarely, but sometimes breastfeeding with lactation mastitis can be too painful. Then try placing your baby on the healthy breast, and place a cloth or small towel under the breast with mastitis to absorb the dripping milk. Perhaps, after the sore breast is partially emptied, the pressure will decrease and feeding from it will not be so painful. You can also try expressing milk and feeding your baby or saving it for the future.

The discomfort of mastitis can be frustrating and discourage breastfeeding. But with timely treatment, the symptoms of mastitis quickly disappear, and mother and baby can again enjoy the benefits and process of breastfeeding.

Lactation mastitis

usually begins with lactostasis - characterized by high body temperature with a relatively satisfactory general condition, the presence of a painful compaction in the gland tissue, slight redness of the skin over the compaction. If lactostasis is not resolved within 3-5 days, it turns into purulent mastitis, because Inevitable infection of the stagnant milk occurs through the milk ducts.

The temperature becomes normal in the morning, and in the evening it rises to 37.5 - 37.8 degrees. The compaction in the gland increases, becomes more painful, and the redness over it increases. Inflammation of regional lymph nodes in the axillary region is possible. Ultrasound helps clarify the diagnosis.

Three reasons for treating mastitis at the Miracle Doctor clinic

• Providing assistance at any stage You can contact us at any stage of the inflammatory process. But, of course, this should be done as early as possible.
• Functional safety Cessation of lactation due to mastitis is extremely undesirable for a newborn. The child should receive everything necessary for normal growth and development through mother's milk. Our treatment is aimed at preserving the breasts for full feeding.
• Prevention After treatment, our specialists will give you recommendations on how to avoid recurrences of mastitis in the future.