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April 12, 2012
Mastitis call an inflammation which develops in a mammary gland. Most often such inflammatory process is shown at the woman who gave birth to the child recently. Generally the infection gets into a mammary gland through cracks which appeared on nipples as a result of breastfeeding. However, mastitis symptoms sometimes appear at the woman in the period before childbirth.
Mastitis which symptoms sometimes develop at the sick woman very promptly is an acute illness. It is carried to nonspecific pathology.
In a puerperal period mastitis is generally initially shown laktostazy. At such state the patient already has all signs of development of inflammatory process, body temperature increases. But at the same time attack of microorganisms did not happen yet. Most often manifestations of a laktostaz take place in verkhnenaruzhny part of a mammary gland, is closer to a zone of armpits. On site the laktostaz can be defined a painful segment, at the same time skin over it often reddens.
In view of the fact that the risk of hit to canals of an infection is highest after childbirth, mastitis is shown at the woman in the course of establishing feeding by a breast. Streptococci, staphylococcus, an enterobakteriya most often act as causative agents of this disease. In more exceptional cases the illness is provoked by gonokokk, pneumococci, a number of anaerobic bacteria. Microorganisms get to segments and channels of a mammary gland, and as a result of their influence mastitis develops. Symptoms of a disease are most often shown under the influence of staphylococcus. The illness constitutes danger in view of high probability of suppuration of a mammary gland that as a result it is fraught with need of a surgery.
Often drafts, overcooling, acceptance of too cold shower become premises to development of mastitis also.
Thus, as the reasons of mastitis it is necessary to define infection through cracks in nipples, development laktostaz (a state at which there is a high formation of milk in an organism of the woman, problems with its normal outflow and, as a result, its delay). Also provocative factor is the general decrease in immunity.
Types of mastitis
Acute mastitis can be subdivided into several different forms. At serous mastitis at the woman overall health considerably worsens, body temperature increases, in a mammary gland the milk delay is observed.
At infiltrative mastitis in a mammary gland of the patient of the woman there is an infiltrate over which skin considerably reddens. This education can turn into an abscess later. Purulent inflammatory process is characteristic of purulent mastitis. Body temperature at the same time increases up to especially high marks – to forty and more degrees. If at the woman the abscessing mastitis develops, then in a breast there is an abscess which is a limited suppurative focus. At a gathered breast purulent inflammatory process extends on tissues of a mammary gland, and at gangrenous mastitis in a breast there are necroses.
Mastitis can proceed both in acute, and in a chronic form. At the woman who got sick with mastitis symptoms of a disease are initially observed similar to signs of a laktostaz. The mammary gland is considerably condensed, skin around it reddens. The woman suffers from strong pain, at her temperature strongly increases, the fever is observed.
In process progressing of mastitis the breast becomes more in sizes, on a mammary gland painfully to touch skin, it to become is to the touch hotter. Directly in the thickness of a mammary gland at mastitis abscess can develop. To the woman sick with mastitis, it is very difficult to nurse the child, often in her milk it is possible to find pus and blood.
At inspection the doctor finds other symptoms of mastitis of a mammary gland. So, thickness of an integument of a sore breast much more, than thickness of the same site on other mammary gland. At the same time the accurate differentiation of elements of a mammary gland disappears. In a mammary gland expansion of absorbent vessels is found. Constant nagging pains and noticeable discomfort in a breast considerably worsen the general condition of the woman.
Upon transition of mastitis to the abscessing phase there is an emergence of the delimited abscess. At formation of abscess reddening is observed, skin strains, the strong tension of skin in certain cases takes place.
At granulematozny mastitis (other name — idiopathic plazmotsitarny mastitis) clinical displays of a disease can be different. So, at the woman also the small consolidation in a breast having local character can be observed and the expressed hypostasis at which there is gland infiltration in general is bright. This disease arises generally at women is more senior than thirty years. It is directly connected with childbirth and feeding of the child in the past. In certain cases at this form of mastitis retraction of a nipple is observed, besides, lymph nodes in regional zones can increase.
Diagnosis of mastitis
"Mastitis" can establish the diagnosis both the specialist mammologist, and the surgeon. Diagnosis is carried out rather simply: for this purpose the doctor carries out poll sick and detailed survey. To exclude existence of purulent mastitis, carrying out ultrasonic research is possible.
Complications of mastitis
There are several possible complications of mastitis at women. The women who already had mastitis earlier can get sick with recurrent mastitis over time. The risk of repeated development of a disease at them increases both during the current chest feeding, and at the following pregnancies.
Breast abscess is also widespread complication of this illness – it is shown approximately at ten percent of women who had mastitis. In this case without surgery it will not be possible to cure an illness.
Also after earlier postponed mastitis the organism of the woman becomes more susceptible to manifestation of a mastopathy, in particular its nodal form.
Treatment of mastitis
First of all, women have to realize accurately that if they show mastitis, treatment of this illness should be begun at once. Than earlier to resort to adequate therapy, especially treatment will be successful.
Laktostaz at the feeding woman arises mainly owing to a bad drainage of milk in a mammary gland. The similar phenomenon can take place, as owing to some features of channels (sometimes they are especially twisting and narrow), and in view of a way of feeding. So, the child can decant better when feeding those segments which are located about its mandible. Therefore in the first days and weeks after the birth of the kid insistently advise young mothers very carefully to decant a breast after feeding is finished. At women with laktostazy such decantation is the main measure of decrease in risk of developing of mastitis.
If at the woman body temperature sharply rises, exceeding at the same time a mark of 38,5 degrees, and there is a suspicion on the fact that at the patient mastitis develops, treatment of this disease, first of all, provides the actions directed to immediate decrease in body temperature. At sharp and strong increase of temperature the negative effect of this phenomenon considerably exceeds its positive influence.
At treatment of mastitis an important point is selection of antibiotics. It is necessary to choose drug which minimum will influence an organism of young mother in general and at the same time will render the maximum effect at fight against a contagium.
If the causative agent of mastitis is staphylococcus that happens most often, then for treatment of an illness often appoint the drugs Cefalexin, Amoxiclav, flukloksatsillin, ciprofloxacin, clindamycin and others.
The course of treatment antibiotics proceeds from ten to fourteen days. Doctors insistently advise not to interrupt a course of treatment even if the condition of the patient considerably improved. In parallel with antibiotics to the woman treatment by the immunomodulators which are promoting elimination of inflammatory process and at the same time strengthening immunity is appointed.
Antibacterial therapy is carried out also outwardly, rubbing to places of defeat of ointment with antiinflammatory action. In the course of treatment of mastitis also hot compresses stimulating strengthening of a blood-groove in an inflammation zone that promotes fight against an infection are locally applied. To the woman who got sick with mastitis it is strongly recommended to use a lot of liquid.
If at the patient the purulent form of mastitis develops, treatment in this case assumes carrying out surgical intervention. If adequate therapy at development of mastitis is absent, then opening of an abscess happens to the milk canal. At purulent mastitis the general condition of the woman very heavy, there is a high probability of manifestation of many complications as infectious, so noninfectious character. Besides, after purulent mastitis on a breast there are scars and hems because of which the mammary gland is deformed and its initial attractiveness is lost.
Therefore in most cases surgical treatment is carried out immediately. After operation the general condition of the patient quickly improves.
Besides, at mastitis also other types of therapy are often appointed. It can be administration of drugs with antiinflammatory action, physiotherapeutic methods, cooling of a mammary gland.
Quite often at development of mastitis in the woman the attending physician can advise her to take measures for full suppression of a lactation. Similar approach is reasonable at long lack of improvement of a state in the course of adequate treatment of mastitis. If all means for treatment of this illness are picked correctly up, then the health of the patient has to become better no more than for three days. In the absence of recovery signs for the fourth or fifth days after an initiation of treatment the doctor can advise to suppress a lactation and to resort to other schemes of therapy of mastitis.
Also premises to full refusal of a lactation is development in the woman of purulent mastitis, especially thus if the repeated case of an illness takes place.
Development of purulent mastitis – very strong threat both for mother, and for the kid. Repeated display of mastitis during feeding testifies to vulnerability of a breast to attack of microbes during breastfeeding. If in this case to stop a lactation, then a condition of the woman quickly to improve and at the same time there will be no risk of negative impact on the kid.
To stop feeding doctors a breast insistently advise also in case of display of mastitis in the lower part of a mammary gland. In this place laktostaz and mastitis develops seldom and testifies to too high sensitivity of a mammary gland to influence of an infection after the delivery.
Suppression of a lactation as a method of treatment of mastitis is applied at heavy standing of the woman which can arise also against other diseases. Weight of a state decreases at the breastfeeding termination.
At mastitis it is possible to try to facilitate a condition of the patient by means of some folk remedies. It is possible to put a leaf of cabbage which helps to reduce pain to the breast affected with mastitis and to remove redness of skin. It is necessary to rumple previously cabbage leaf a little that from it juice acted. The cabbage sheet needs to be attached to the washed-up breast for the whole day and to press it a bra.
For achievement of the warming effect it is possible to put honey flat cake which, besides helps to remove an inflammation to a breast. For its preparation it is necessary to mix two parts of wheat flour with one part of honey from a buckwheat or a linden. Well peremesiv dough, it is necessary to shake it in thin flat cake and to put to a breast for the night, having wound it with a warm scarf. In the morning the breast needs to be washed and wiped dry.
For removal of an inflammation it is possible to prepare broth which, besides, has soothingly impact on an organism. The St. John's Wort grass, leaves of a nettle and a plantain, a valerian root enters grass infusion. Collecting herbs needs to be filled in with boiled water, to draw and drink two tablespoons after acceptance of food.
It is the most important that the woman at any displays of mastitis at once saw a doctor, remembering gravity of an illness and probability that she can do harm, both to health of mother, and a condition of the child, having provoked very serious complications.
Prevention of mastitis
To avoid developing of mastitis, the woman without fail has to prepare nipples for feeding of the child. If young mother notices emergence of cracks on nipples, then it is required to treat them immediately. It is not less important to carry out the prevention methods directed to allowing stagnation of milk in mammary glands. For this purpose continuous decantation of the remains of milk practices after feeding was ended.
Also important preventive measures in this case is observance of all rules of hygiene when feeding the kid: mother has to wash hands and nipples, it is obligatory to watch putting the kid to a breast it is correct. In this case it is important that the baby during feeding completely took a nipple and space around a nipple.
Specialists advise women who nurse the child to wear a special bra for nursing mothers which optimum supports a breast.