Mastitis is an acute purulent infection of the mammary glands, a common condition in the puerperium and one of the causes of postpartum fever, most commonly in breastfeeding women, especially first-time mothers. It can occur at any time during breastfeeding and is most common at the beginning of breastfeeding.
The etiology of mastitis includes the following two aspects.
1. Stagnation of milk: Stagnation of milk facilitates the growth and reproduction of invading bacteria. The causes are.
(1) small or invaginated nipples, which prevent breastfeeding, failure of pregnant women to correct invaginated nipples in time before delivery, and difficulties for infants when suckling.
(2) Excessive milk, incomplete emptying, the mother did not empty the excess milk in the breast in time.
(3) The milk ducts are inaccessible, the milk ducts themselves are inflamed, tumors and external compression, and the fibers shed by the bra can also block the milk ducts.
2, the invasion of bacteria nipple invasion when the infant suckling difficulties, easy to cause the nipple around the breakage, is the main way of bacteria along the lymphatic vessels invasion caused by infection. In addition, the baby often sleeps with the nipple, but also can make the infant oral inflammation directly invade and spread to the milk ducts, and then spread to the interstitial mammary glands to cause purulent infection. The causative agent is commonly Staphylococcus aureus.
The danger of mastitis is greater, the beginning of the disease is often high fever, chills and other symptoms of systemic toxicity, the affected side of the breast volume increases, local hardening, skin redness, pressure and throbbing pain. If there is local tenderness within a short period of time, it means that an abscess has formed and needs to be drained by incision. The axillary lymph nodes on the affected side are often enlarged and the white blood cell count is elevated.
The clinical manifestations of abscesses are related to the depth of their location; in shallow locations, there is localized redness and swelling and elevation in the early stages, while in deep abscesses the local manifestations are often not obvious in the early stages, with local pain and systemic symptoms predominating. Abscesses can be single or multiple; they can be formed sequentially or simultaneously; sometimes they break down by themselves or drain through the nipple, or they can invade the lax tissue in the posterior mammary space and form posterior mammary abscesses.
Patients with severe mastitis may have high fever, chills, significant breast swelling and pain, localized skin redness and swelling, hard nodes and pressure pain, and enlarged and painful axillary lymph nodes on the affected side. The inflammation softens within a few days, forming a breast abscess with fluctuating sensation, and the abscess is deep with redness of the skin and a less pronounced fluctuating sensation. After the pus has broken out, the pus drains freely, and the swelling and pain can be reduced and healed. Acute mastitis is often accompanied by enlarged lymph nodes in the affected axilla with tenderness; the total white blood cell count and neutrophil count increase.
The abscess may penetrate the loose connective tissue in front of the pectoralis major fascia and form a post-breast abscess; or the milk may overflow from the incision and form a milk leak; or even septic sepsis may occur.
Treatment of mastitis.
1. Antibiotics such as penicillin, benzylpenicillin, erythromycin and gentamicin can be used to treat mastitis. The local hard nodes can be dressed with Chinese herbal medicine, such as gold, early mastitis if timely treatment can be cured.
2, early inflammation can continue to breastfeed, emptying milk to prevent milk stagnation. If the infection is serious, you can feed the healthy side of the breast and suck up the residual milk with a breast pump after feeding. The affected breast should wait until the abscess is cut open and the pus is drained before breastfeeding.
3. If an abscess has formed, a surgeon should be called to cut and drain the abscess in time.
Prevention of mastitis.
1. For women with nipple entrapment, correct it by pulling the nipple outward with your fingers after washing every day.
The first thing you need to do is to use a breast pump to suck up all the milk after giving birth.
3. Do not let the baby sleep with the nipple in his mouth, and do not nurse for too long.
4.Prevent nipple rupture and master the correct breastfeeding posture.
5.Once you have a ruptured nipple, you can squeeze out a small amount of milk and apply it to the nipple after breastfeeding, if the situation is serious you need to go to the hospital.
Prevention
The prevention of mastitis is more important than the treatment. The first thing you need to do is to keep both nipples clean during pregnancy and breastfeeding, and if you have nipple inversion, you should gently squeeze out the nipple and clean it. Before and after breastfeeding, you can wash your nipples with 3% boric acid water. If the nipple is damaged or cracked, you should breastfeed temporarily and use a breast pump to suck out the milk and wait for the wound to heal before breastfeeding.