Lactostasis or already mastitis
Lactostasis is stagnation of milk in the duct without infection. A dense painful area appears, but the general condition suffers little, the temperature is normal or slightly elevated, and after complete emptying of the gland it becomes noticeably easier.
With mastitis, stagnation is accompanied by an infection, most often staphylococcus, penetrating through the cracks of the nipple. The temperature rises above 38 °C, chills and aches appear, the skin over the lump turns red and becomes hot, and pumping does not bring relief. This is a fundamental difference: lactostasis is treated by emptying the gland, mastitis requires a doctor.
Stages and why it is important not to be late
- Серозная стадия: отёк и болезненность, температура повышена, гноя ещё нет. Лечится консервативно.
- Инфильтративная стадия: формируется плотный болезненный участок с чёткими границами, температура высокая. More можно обойтись без операции.
- Гнойная стадия (абсцесс): в толще железы образуется полость с гноем. Антибиотики сами по себе её не устраняют — необходимо вскрытие и дренирование.
The transition from the second stage to the third often takes less than two days. Therefore, an attempt to “endure”, warm up or express the problem usually ends with surgery being required instead of pills.
What not to do
- Warm up the gland, apply hot compresses, go to the bathhouse - heat accelerates suppuration
- Kneading and “breaking” the seal with force - this injures the tissue and spreads infection
- Make alcohol and vodka compresses - they suppress milk secretion
- Starting antibiotics on your own without examination and without taking into account compatibility with feeding
- Abruptly stopping feeding and bandaging the breasts increases congestion
Treatment
In the early stages, the basis of treatment is regular and complete emptying of the gland, proper attachment of the child, treatment of cracked nipples and antibiotics compatible with breastfeeding. Additionally, painkillers and cold are applied to the affected area between feedings.
When an abscess is formed, an opening and drainage is performed: the cavity with pus is emptied, washed and the drainage is left for several days. A short hospital stay is usually required. After surgery, treatment continues with antibiotics, and lactation in most cases can be maintained.
Mastitis outside lactation
Inflammation of the mammary gland in a non-breastfeeding woman is less common and requires special attention. It may be associated with smoking, diabetes, nipple piercing, or a cyst with suppuration. But there is another reason that must be excluded: the edematous-infiltrative form of breast cancer is very similar in appearance to mastitis - the same redness, swelling, induration.
Therefore, for “mastitis” outside the feeding period, as well as for mastitis that does not respond to treatment within a few days, an ultrasound is necessarily performed and the issue of a biopsy is decided.
Prevention
- Correct latching on the breast by a child from the first days is the main prevention of cracks
- Feeding on demand and complete emptying of the gland, no long breaks
- Timely treatment of cracked nipples
- Gradually rather than abruptly ending breastfeeding
- Hygiene without drying out the skin: soap is not necessary with every feeding
- See a doctor if there is a lump that does not go away within 24 hours
