The illness of the feeding mothers of
Mastitis, or an inflammation of a mammary gland, is a diagnosis which, unfortunately, is made quite often to the woman after the delivery. With an onset of the illness of young mother there are natural questions: whether this disease how it is treated and whether it is possible to continue breastfeeding at mastitis is dangerous?
of the Stage of a disease on infected and not infected. Entrance gate for development of the infected mastitis most often are cracks of nipples. Besides, activators can get into a mammary gland with blood current from the centers of a chronic infection in kidneys, almonds, gaymorovy bosoms, carious teeth.
not infected mastitis. Most often it is a consequence of not cured laktostaz. The disease is characterized by sudden rise in temperature to 38 - 40 ° With, sometimes with a fever. As a rule, owing to obstruction of the dairy courses milk outflow is broken. The woman feels severe pain in a mammary gland. At a palpation in one of its segments sharply painful consolidation (infiltrate) with hypostasis and reddening of skin in the field is found, temperature over area of an inflammation increases. Unlike a laktostaz, the general signs of inflammatory process join: a headache, the general weakness, an indisposition, dryness in a mouth. In the general blood test the quantity of leukocytes, but generally - at the expense of mature forms moderately increases, SOE raises. At bacterial research of milk activators do not come to light. If symptoms of not infected mastitis remain heavy, there are two and more days, hit in an infection breast is possible, and then the disease develops into the infected mastitis.
the Infected mastitis. the Clinical picture is characterized by fever to 40 ° With with big razmakha (i.e. with sharp falling and temperature increase from 37 to 40 - 41 ° C), oznobam. The general state worsens considerably, noted dryness of integuments, mucous, weakness, an indisposition, a headache increases. The mammary gland is increased, reddening of skin with a cyanotic shade is observed. The venous network is well expressed, in hard cases drawing of the inflamed lymphatic vessels appears. Infiltrate with a clear boundary and morbidity is probed. Axillary lymph nodes increase, they are painful at a palpation. There are signs of inflammatory process in clinical blood test (the quantity of leukocytes, especially unripe forms increases, SOE raises, in biochemical blood test the amount of protein decreases, specific markers of an inflammation - laktoferrin, C - jet protein appear). The pathogenic (pathogenic) microflora at bacteriological crops of milk comes to light. Besides, from a mammary gland pus can be emitted.
On the clinical course and stages of a disease are allocated by serous, infiltrative and purulent mastitis.
Serous mastitis. It is an initial stage of the developing mastitis. In this stage in the corked dairy segment there is inflammatory hypostasis, the segment becomes intense and sharply painful, temperature, as a rule, to 38 - 38,5 ° increases; With, skin over the struck segment is moderately hyperemic (red), is edematous. During this period breastfeeding is allowed (if temperature does not exceed 38 ° Ń). In the absence of treatment within 1 - 2 days mastitis passes into the following stage.
Infiltrative mastitis. Inflammatory liquid begins to impregnate all fabric of a segment of a mammary gland, can spread to the neighboring areas. Intoxication symptoms (a headache, weakness) accrue, the condition of the woman, body temperature higher than 38 ° worsens; With, fever has resistant character. The mammary gland increases in a size, the struck segment reddens, gets a cyanotic shade, is very strained and painful. This form of mastitis it is desirable to treat in a surgical hospital. At a positive effect from treatment there is a rassasyvaniye of infiltrate and restoration of outflow of milk, there comes recovery. However at the inefficient, late begun treatment transition to the following stage of mastitis is possible.
Purulent mastitis. the Available infiltrate begins to be defined more distinctly, then there is its softening (suppuration). Suppuration is followed by further deterioration in a condition of the woman, intoxication amplifies, temperature increases to 40 ° With, sharp temperature drops within a day with tremendous oznoba are characteristic. At a puncture of a segment or when pressing from a nipple pus is emitted. In this case surgical intervention - opening of an abscess and its drainage is required. The lactation is suppressed in this situation by means of special hormonal preparations. Treatment of purulent mastitis is carried out only in a hospital.
the General principles of treatment of mastitis consist of carrying out the actions improving outflow of milk, antibacterial therapy, application of dezintoksikatsionny and symptomatic means. It is possible to feed the child only at not infected mastitis in its initial stage. In each case the issue of a possibility of breastfeeding is resolved individually, and the principle same, as at a laktostaza here. Decantations need to be carried out by means of a milk pump, but not manually as the last can provoke distribution of an inflammation and an infection to the next sites of a mammary gland. In the absence of effect of treatment the risk of accession of an infection and hit of pus in milk within a day increases. The issue of a possibility of feeding by a breast is resolved only by the doctor. If feeding by a breast is authorized, then antibiotics which do not make an adverse effect on the kid are appointed, at infiltrative and especially purulent mastitis, as a rule, appoint two antibacterial preparations from different groups. At temperature increase and for removal of pain appoint paracetamol, for faster restoration of electrolytic balance carry out intravenous administration of salt solutions, glucose, blood substitutes. At serous mastitis for acceleration of a rassasyvaniye carrying out not thermal physiotherapeutic procedures on area of the center (Ural federal district, ultrasound, a magnetotherapy) is possible. At suppuration treatment surgical - opening of an abscess in combination with application of antibiotics.
the Most widespread mistake in such cases is use of various compresses, warmings up, dense greasing by potassium permanganate. All this leads to a bigger distribution of inflammatory process due to activization of proteolytic enzymes of gland, leukocytes and the joining bacterial infection. At influence of heat vessels extend, permeability of a vascular wall amplifies, products of disintegration and an inflammation easily get into nearby sites. All compresses are thermal procedures therefore their use at mastitis is absolutely inadmissible. In practice such ukutyvaniye promote “ripening“ of an abscess - to transition from an infiltrative stage in purulent. The first urgent aid at the beginning inflammation of a mammary gland is local cooling of a painful site by certain rules. Ice is put to a sick site fractionally within a day (for 40 - 60 minutes with 10 - 15 - minute intervals). It is known that this approach is fair at any inflammatory process (infiltrate, appendicitis, pancreatitis etc.) . Application of cold in this case reduces and limits an inflammation zone, renders analgesic effect, causes an angiospasm, removes hypostasis, promotes reduction of development and improvement of outflow of milk, inflammatory liquid. At a liquid congestion in a limited zone of gland (it can be milk, inflammatory exudate, pus) it needs to be removed by aspiration with a milk pump or the sterile syringe. The doctor has to do the last manipulation. The correct application of cold and some other procedures under supervision of the expert, as a rule, allows to avoid the expressed suppuration, abscess and the subsequent operation of opening of an abscess.
At suspicion on emergence of signs of a laktostaz and at suspicion on mastitis needs to see a doctor (the surgeon, the mammologist) immediately. It will allow to begin in due time medical actions, to prevent possible complications and to keep breastfeeding. It is necessary to remember that there is no clear temporary boundary of transition of a laktostaz to mastitis. Self-treatment is in this situation inadmissible. Before arrival of the doctor the woman can try to decant a breast. At a temperature over 38 ° With it is possible to take a paracetamol pill. It is necessary to decant a healthy breast during the entire period of treatment each three hours and if the doctor allowed - to feed with it the child.