MKB 10 lactation mastitis. Lactational mastitis

Inflammation in the mammary gland due to milk stagnation. A factor predisposing to the development of mastitis is nipple cracks.

Laser therapy for lactation mastitis is carried out to eliminate lactostasis and local inflammation. The tactics of treatment are determined by the form of the disease: with serous mastitis, direct laser irradiation of the breast is permissible; in the presence of purulent complications, accompanied by intoxication, fever and the presence of pus in the milk expressed from the affected mammary gland - direct laser irradiation is recommended to delimit the purulent process, which facilitates subsequent surgical intervention in the required volume.

In this case, the main therapeutic measures provide for a parallel effect on the immunocompetent organs and zones: the projection zone of the thymus, blood irradiation according to the supravenous technique in the projection of the ulnar and axillary vessels, axillary lymph nodes on the affected side.

As the acute inflammatory phenomena decrease: symptoms of intoxication, the temperature drops to normal or subfebrile values, and the tension in the mammary gland decreases, direct laser irradiation of the affected mammary gland is permissible: first in the peripheral regions, and in subsequent sessions - in the projection of the inflammation focus.

It should be recalled that during the entire period of the disease, milk from the affected mammary gland is expressed and the child is not given, and when antibiotic therapy is performed, the child is transferred to artificial feeding during the entire period of taking antibiotics. In both types of mastitis, treatment is supplemented by irradiation of the receptor zones positioned in the projection of the outer surface of the forearm, the dorsum of the hand, the outer and front surface of the lower leg, the anterior chest wall, paravertebral zones of the spine in the projection Th1-Th7, and the collar zone.

It should be emphasized that laser irradiation of the breast has a positive effect on the quality of milk and cannot be considered as a reason for restrictions on feeding the baby.

Irradiation modes of treatment areas in the treatment of lactational mastitis

Figure: 116. Zones of radiation in the treatment of lactational mastitis. Legend: pos. "1" - projection of the axillary neurovascular bundle, pos. "2" - ulnar vessels, pos. "3" - thymus projection, pos. "4" - the mammary gland, the estimated area of \u200b\u200blactostasis, pos. "5" - the zone of segmental innervation of the breast.

The duration of the course of treatment is determined by positive dynamics. A regularity was noted: the earlier the treatment with the laser therapy method is started, the shorter the course duration. Treatment from the first day of illness determines the duration of the course within 3 procedures. At the beginning of the course of treatment on the 3rd day and later, the duration of the course is 8-10 procedures or more.

Each woman has individual anatomical features of the breast, but its internal structure is the same for everyone. Inside, each breast has a glandular tissue, divided into 15-20 large lobes. Each of them is divided into even smaller ones, which pass into the ducts directed to the nipples. If conditions are created in a nursing woman that prevent milk from leaving the ducts, lactostasis may develop.

Lactostasis - milk retention in the excretory ducts of a woman's breast during lactation. Improper feeding techniques, incomplete emptying of the breast, hypothermia and other factors can cause the problem. Most often primiparous women suffer from lactostasis. The disease itself is not dangerous for a woman or a child. If left untreated, the disease can cause serious complications such as mastitis or purulent inflammation.

Development reasons

Stagnation of milk in the mammary gland, as a rule, occurs in women during the first 10 days after childbirth.

Violation of the outflow of milk from the breast through the ducts can occur for the following reasons:

• non-compliance with feeding techniques;
• incomplete emptying of the glands with active milk secretion;
• infrequent feedings;
• poor breastfeeding by the baby due to his health condition (for example, central nervous system problems, prematurity);
• early weaning of the baby from the breast (the child must let her go when he feels full);
• the transition from breastfeeding to artificial feeding;
• not drinking enough liquid by a woman;
• increased milk viscosity;
• a lot of animal fats in the diet;
• wearing squeezing underwear;
• the habit of sleeping on your stomach;
• abnormal structure of the nipples, narrowness of the ducts.

If lactostasis occurs in a woman a month after childbirth and later, its causes may be:

• chest trauma;
• hypothermia;
• stress;
• overwork;
• persistent imbalance of hormones.

Lactostasis code according to ICD 10 - O92.7.

Symptoms of the disease and its difference from mastitis

If lactostasis is suspected, it is necessary to begin therapeutic measures as soon as possible. Otherwise, complications may arise, one of which is. These two conditions share some of the same symptoms. But still, there are differences between them.

Signs of lactostasis:

• breast enlargement, asymmetry of the glands;
• soreness in the chest;
• feeling of fullness;
• the presence of compaction and tubercles when probing the gland;
• in the area of \u200b\u200bthe problem area, skin color is not changed;
• violation of milk outflow.

After a few days, with prolonged stagnation of milk, non-infectious mastitis may develop - persistent inflammation in the crowded glands.

Mastitis is complemented by severe symptoms that are absent in lactostasis:

• redness of the skin around the problem area of \u200b\u200bthe breast;
• increase in local and general temperature;
• violation of general well-being (lethargy, weakness, muscle pain);
• enlarged lymph nodes;
• when expressing milk, relief does not come (unlike lactostasis).

Important! After a while, without proper treatment, bacteria can enter the lobules and ducts of the glands and cause infectious inflammation. Bacteria begin to multiply actively, provoking the development of a purulent process. A woman develops purulent-serous discharge from the nipples, the temperature rises, and there are signs of severe intoxication of the body.

General rules and methods of treatment

The approach to the elimination of lactostasis in a nursing woman should be complex. First of all, you need to free the clogged ducts from milk stagnation. You can cope with the problem without the use of drugs. Treatment for lactostasis may include special massage, regular pumping of milk, proper feeding techniques, and other methods.

Breast massage

A woman can do massage for lactostasis on her own. But in order not to harm yourself, you need to follow it according to certain rules. All movements must be careful not to injure the glands.

Movement when kneading the chest should be smooth, stroking. Move your hands to the nipple from the outside of the chest. If pain is felt, massage is performed at the same time as pumping.

Before the massage, it is important to wash your hands with soap, apply baby oil to the gland to facilitate movements.

Massage technique:

• Press on the chest, massage the chest in a circle for 4 seconds. Move slowly in a spiral towards the nipple.
• Lean forward, shake your chest. This will allow the milk to fall down the ducts.
• Clamp the nipple between 2 fingers and gently pull it back, twist it slightly.
• You can finish the massage with a warm shower, directing a stream of water under a slight pressure to each breast.

With increased sensitivity of the mammary glands, massage should not be done.

Expressing milk

First, stimulation of oxytocin synthesis is needed. To do this, you need to take a warm shower, massage your back along the spinal column in the thoracic region, drink warm tea and calm down. It is best to express milk by hand.

Put the gland on 4 fingers. Place your thumb and forefinger on the edge of the halo. Press rhythmically on the chest. Guide the fingers towards the side of the chest. Change the position of the fingers, moving in a circle of the halo.

Do not squeeze the tissue of the gland or squeeze them strongly. A woman can crush lobules of an organ with milk and aggravate the course of the disease. On average, the process of expressing milk should take 30-60 minutes. After the procedure, you can attach the baby to the breast.

Compresses

As an additional treatment, you can apply therapeutic compresses to the problem breasts:

• Beat off a fresh cabbage leaf so that juice stands out from it. Apply a cabbage leaf with lactostasis to a sore breast.
• Make a tortilla with wheat flour and honey. Apply to the gland for 15-20 minutes. Cannot be used by women who are allergic to honey.
• Apply low-fat cold cottage cheese to the sore spot.

On the page, read information about the methods of treatment and removal of breast fibroadenoma.

Ointments

With lactostasis, it is allowed to apply medicinal ointments to eliminate unpleasant symptoms:

• Arnica;
• Traumeel;
• Malavit.

You can not use Vishnevsky ointment, as well as warming agents based on camphor or alcohol.

Preventive measures

To avoid the development of lactostasis, nursing women are advised to:

• correctly apply the baby to the breast;
• completely and timely empty the breast from milk;
• do not give the child a second breast while milk is in the first;
• wear a special nursing bra that is free of bones and does not compress the breast;
• sleep on your side, not on your stomach;
• rest more;
• drink more fluids;
• do not overcool the chest;
• avoid injury to the glands;
• before each feeding, the breast must be washed;
• use special inserts for milk leaks;
• promptly get rid of cracked nipples in order to prevent infection;
• avoid stress.

If a nursing woman suspects the development of lactostasis, it is necessary to eliminate the problem as soon as possible. The sooner you begin to fight stagnation of milk in the breast, the faster you can restore its functionality and prevent the transition of lactostasis to mastitis. Lactation is a period that requires a woman's special attention to her breasts. It is important to prepare in advance for this moment, learn how to properly attach the baby to the breast, monitor the cleanliness and timely emptying of the glands from milk.

Video about the reasons for the development and features of the treatment of lactostasis in nursing women:

Not many people know that today there is the so-called International Statistical Classification (ICD) of all diseases familiar to mankind and numerous problems directly related to human health.

In English, this classification is called the International Statistical Classification (or ISC) of Diseases and Related Health Problems.

According to this classification, each disease, each pathological or physiological state is assigned a certain code, through which scientists, doctors and simply curious ordinary people can find out basic information about a particular ailment in an accessible and understandable form.

But nevertheless, many have questions, why such a classification is needed, how to use it, and where is a place in it for such a state as lactostasis? Let's sort it out in order.

What code should be used to find the classification information about lactostasis?

The international classification system includes class XV, which contains information about pregnancy, childbirth and the postpartum period. This class includes almost all aspects that can be directly or even indirectly related to the life periods mentioned in the title.

Naturally, lactostasis can be attributed precisely to this class. Further, the disease code should report information about the block in which the basic data about the disease of interest to us are located. Consider Block O85-O92.

The name of this block is "Complications associated mainly with the standard postpartum period." So, most authors try to include the stagnation of milk we are looking for (or lactostasis, stagnation of milk) and other, non-infectious conditions within the limits of this definition.

It should be noted that according to the tenth International Classification of Diseases, it is customary for physicians to distinguish between the following main variants of lactation disorders (ICD code 10 from O91 to O92):

• The numbers O91 mean lactational mastitis.
• Nipple cracks are encrypted in the numbers O92.1.
• The value of O92.2 includes other, not specified lactation disorders.
• Code O92.3 speaks of primary agalactia.
• The numbers O92.4 imply a state of hypogalactia.
• In the numbers O92.5, agalactia is disclosed, either secondary, or arising according to medical indications.
• Under the numbers O92.6 is hidden such a diagnosis as postpartum galactorrhea (translated from Greek - milk outflow).
• And finally, the numbers O92.7 mean lactostasis, or polygalactia, etc.

In the descriptions of stagnation of breast milk, one can find information that the general condition of women with lactostasis may worsen slightly. Body temperature readings, standard clinical urine and blood tests may remain completely normal.

Most often, with the development of milk stagnation, there are two main signs of an acute inflammatory process: firstly, hyperemia, and secondly, hyperthermia. Nevertheless, in a number of cases, acute forms of milk stagnation can be accompanied by severe fever, with a significant increase in body temperature.

It is important for women to understand that it is almost impossible to differentiate acute stagnation of milk from the initial forms of mastitis on their own, and this means that even reading medical literature, and being a very literate person, it is impossible to refuse timely consultation with a doctor.

However, let us return to the classification of lactostasis. Why do doctors still prefer to use a certain ICD 10, and not the usual book description of the disease? The answer is found by itself when you understand what the previously mentioned classification is.

The essence of the international classification of diseases

ICD 10 is a kind of registration document that is standardly used as the leading statistical and classification framework in world health. The document is carefully reviewed and revised every ten years by the staff of the World Health Organization.

The value of this document lies in ensuring that the unity of various (in different countries) methodological approaches to the treatment and analysis of diseases. Today, in the world medical community, the classification document of its Tenth revision is in force (actually from here and ICD-10).

This classification document allows you to systematically register data, easily analyze information received from different countries, not to get confused in interpretations and to compare data on the number of deaths or morbidity with one or another ailment (lactostasis in particular) in different countries.

ICD 10 was able to become a single international diagnostic classification to meet universal epidemiological and statistical purposes. Through this classification, it has become much easier to analyze the general health situation in different population groups.

Thanks to this document, physicians have the opportunity to count both the frequency and prevalence of certain diseases and, most importantly, to note the relationship of disease states with various external factors found in a particular country.

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How can you identify them?

• nervousness, disturbed sleep and appetite;
• allergies (watery eyes, rashes, runny nose);
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• frequent colds, sore throat, nasal congestion;
• joint and muscle pain;
• chronic fatigue (you get tired quickly, no matter what you do);
• dark circles, bags under the eyes.

A properly adjusted process allows you to raise a baby strong, healthy and at the same time brings great joy to the mother. But if in the process of natural feeding a young mother has problems, this can negatively affect the well-established feeding scheme. One of these troubles can be lactostasis - stagnation of milk in the breast. This condition is one of the complications of breastfeeding. It can develop in a young mother, regardless of which one she had.

The MCB-10 code for this condition is O92.7.0. The duration of lactostasis is different, and this condition can be repeated periodically throughout the entire period of breastfeeding. The disease causes very unpleasant sensations and soreness in a woman. Any forum for young mothers contains many messages in which women describe this condition as quite unpleasant and causing suffering.

If the correct treatment is not provided in a timely manner, lactostasis can become complicated, which, in turn, will lead to the termination of breastfeeding. Therefore, it is very important that a woman is examined by a doctor in a timely manner and helps to cope with the problem. How to behave if lactostasis develops, and which specialist will help to overcome the problem, will be discussed in this article.

Pathogenesis

The lactation function in a young mother is formed from the second to the tenth day after the birth of the child. The female mammary gland consists of 15-25 acini (lobules). Milk is synthesized in them. The acini and nipples are connected by ducts. If for some time a certain acinus is not released from milk or the duct is squeezed, as a result, a milk plug is formed, which prevents the release of gland products. As a result, stagnation occurs in one or more segments of the gland.

A similar violation is noted if milk production is too active, ahead of the process of its elimination. In this case, primary lactostasis develops.

The accumulating capacity of the gland is regulated by the neurohumoral system. While the gland is filled with milk, the tone of the epithelial cells of the duct walls decreases. As a result, milk can accumulate in large quantities and the pressure does not rise. But if the formation of the accumulative and excretory functions is slower than the formation of the secretory function, milk accumulates, which provokes stagnation.

The tissue of the gland in those places where stagnation is formed, infiltrates and swells, because of which it becomes denser. Soreness appears. As the milk is partially absorbed back, fever develops. Due to the increased pressure in the lobules, milk production slows down, which threatens the lactation process. Therefore, with prolonged lactostasis, lactation may stop. On specialized sites you can find photos of lactostasis.

Classification

Depending on the area of \u200b\u200bthe lesion, the following types of lactostasis are determined:

• Unilateral - the outflow of milk is disturbed from one breast.
• Double-sided - the outflow of milk is disturbed from both glands.

For the reasons that provoked this condition, lactostasis is divided into the following types:

• caused by the peculiarities of the anatomical structure;
• caused by the influence of external factors;
• arising from the impossibility of breastfeeding.

Also, lactostasis is divided into primary and secondary:

• primary - develops at the stage of lactation formation;
• secondary - occurs against the background of an inflammatory process.

Causes of lactostasis

The production of breast milk and its passage through the ducts are determined by hormones and. The body produces these hormones. If the baby lays on the breast irregularly, or he picks up the breast incorrectly, the pituitary gland receives distorted information. As a result, an insufficient amount of hormones is released, the lactation function decreases, and milk stagnates in the ducts.

When listing the reasons that can provoke the development of lactostasis, the following factors should be noted:

• Features of the structure of the mammary glands. If the breast is very large and sagging, the milk ducts are not completely emptied and congestion forms. Also, in some women, the breast ducts are too narrow.
• Abnormal structure of the nipple. If the nipple is weak and very flat, it is difficult for the baby to grasp and suckle, so the breast is not emptied enough.
• ... With fibrocystic mastopathy, dense fibrous tissue grows in the affected mammary gland, compressing the ducts.
• Bruised or traumatized chest, swelling, changes after surgery. As a result, the morphology and functions of the flow-lobular system are disturbed.
• Too active milk production with a weak appetite of the baby. As a rule, this process is getting better within two weeks after the birth of the child.
• Pinching. A bra that is too tight can impair milk flow. Also, lactostasis can be provoked by physical pinching of the breast due to sleeping on the stomach, improper holding of the breast with the fingers during feeding.
• Strong milk viscosity, developing due to stress, fatigue, dehydration.
• Feeding your baby too long.
• Improper attachment to the breast of the baby. As a result, he does not completely suck milk from the breast.
• Refusal of the baby from the breast, premature weaning or premature feeding.
• Hypothermia of the mammary glands. As a result, the ducts narrow, and the outflow is impeded.
• The appearance of cracks in the nipples and areola. Because of this, the feeding process is disrupted.
• Too strong physical or psycho-emotional overwork.
• Additional expression of milk. Expressing milk too often can increase milk production, leading to stagnation.

Symptoms

With stagnation in the breast, the following symptoms of lactostasis develop in a nursing mother:

• body temperature rises;
• chest pain, as well as an unpleasant feeling of fullness and heaviness;
• lumps in the mammary gland;
• redness of the skin on the chest, in the area where stagnation appeared;
• the appearance of pain during feeding, which decreases as the breast becomes free of milk.

Sometimes symptoms appear without the development of a lump. After a while, the stagnation zone may shift and increase.

It is important to consider that the signs of milk stagnation in a nursing mother may be different. Very often, when the temperature rises due to stagnation, antipyretic drugs do not work. But if the signs of lactostasis in a nursing mother are accompanied by temperatures up to 39 degrees and above, this condition is quite dangerous. It can provoke purulent-inflammatory processes. Therefore, in this case, you must consult a doctor. After all, if lactostasis develops in a nursing mother, the symptoms and treatment should be determined by a specialist in order to prevent the development of serious complications.

There is often confusion between the concepts of "lactostasis" and "mastitis". The difference between these diagnoses is that lactostasis is stagnation of milk, provoked by a blockage of the duct. Mastitis is an inflammatory process of breast tissue, which is a consequence of prolonged lactostasis. And since these conditions are difficult to distinguish on their own, if alarming symptoms appear, it is better to consult a doctor who will help find the answer to the question of how to distinguish mastitis from lactostasis.

Analyzes and diagnostics

The diagnostic process for the symptoms described above begins with a physical examination. The specialist conducts palpation of the mammary glands, conducts a survey, collects a general history. The following laboratory and instrumental research methods are also used:

• general and biochemical blood test;
• analysis of urine;
• bacteriological examination of milk;
• ultrasound examination of the mammary glands;
• puncture breast with histological and cytological examination of the material.

Differential diagnosis with early mastitis is important.

Treatment of lactostasis in a nursing mother

Treatment of lactostasis in nursing mothers should, first of all, be aimed at ensuring maximum emptying of the mammary gland. But if the symptoms seriously worsen a woman's life, and there is a prolonged stagnation of milk in a nursing mother, the doctor will tell you what to do after confirming the diagnosis.

Those who are looking for an answer to the question of what to do with stagnant milk need to realize: treatment only with folk methods of this condition is categorically not recommended. It is especially important to consult a specialist when it comes to those who have lactation for the first time. The wrong approach to treatment can lead to a decrease in the amount of milk. A complete cessation of lactation is also likely. Therefore, it is necessary to follow the recommendations on how to remove stagnant milk very accurately.

The doctors

Medicines

Only a doctor can tell what to do and how to treat lactostasis with medication, since a nursing mother needs to find safe means.

• To relieve soreness and fever, safe non-steroidal anti-inflammatory drugs are prescribed, for example. For pain relief, or can be used.
• During the period of lactostasis, drugs are used that reduce milk production. Prescribe drugs , , .
• With pronounced stagnation, it is prescribed sublingually. Sometimes it is administered intramuscularly once.
• used only when absolutely necessary and as directed by a doctor.
• For local treatment, compresses can be used - vaseline and camphor oil, butadione ointment., magnesia sulfate, arnica ointment (the last remedy must be used very carefully, as it can cause local reactions). It is necessary to use any ointment for lactostasis, applying it to the surface of the mammary gland very carefully. Reviews indicate that several such procedures help reduce the severity of unpleasant symptoms.

Procedures and operations

Treatment of lactostasis at home should be carried out in a comprehensive manner, according to the scheme prescribed by the doctor. At home, it is important not only to take the necessary medications, but also to change the regime, as well as the frequency of feeding the child.

If the treatment of lactostasis at home at a temperature involves the use of drugs, then at the first signs of stagnation, you can avoid the aggravation of the situation by establishing the correct regimen and method of breastfeeding. How to prevent complications of this condition?

• Correct feeding. First of all, you need to feed the baby on demand, doing it every 1.5-2 hours. It is imperative to carry out feedings at night. Each time the baby is fed, both breasts should be given alternately. Sometimes changing the posture while breastfeeding helps to get rid of stagnation. The posture when the mother feeds the baby from under her arm helps to free the breast from stagnant milk.
• Expression. You can express milk with a breast pump, before doing a small breast massage or putting a warm heating pad on for a while. A warm shower can help. But it is not recommended to warm up the breasts too much. You need to express milk until the woman feels comfortable. You shouldn't do it "to the last drop." Straining of lactostasis at home can be done without a breast pump. But for those for whom the question of how to sort out stagnation is relevant, it is important to apply the correct technique for its implementation. It is recommended that you take a pill 30 minutes before removing milk stagnation in a nursing mother. Expressing directly is carried out as follows: the right mammary gland must be grasped with the right hand so that the chest is in the palm of your hand, the thumb is on top. With your free hand, you can simultaneously massage the area where the seal has formed. You need to do massage movements from the periphery to the center of the chest. However, pumping should be done very carefully, as very rough movements can lead to injury and, as a result, to the development of mastitis. It is important to note that some breastfeeding counselors have round-the-clock counseling available online or by phone. They can give you tips on how to properly pump. Sometimes, when expressing during lactostasis, inclusions in the form of so-called "milk grains" can be noted in milk. Therefore, the woman has the question of how to break the lumps of milk during stagnation. In fact, there is nothing wrong with that, because milk is a rather fatty product that should fully provide the child with useful substances.
• Breast massage for lactostasis. To massage the mammary glands in nursing mothers, you must first familiarize yourself with its technique. To do this, you should watch a video of breast massage with stagnant milk. Massage should be carried out before straightening stagnation with your hands at home. It is important that all movements are smooth and gentle. They should be directed from the base of the mammary glands to the nipples. You need to massage the breast carefully, but still doing it, despite the pain. It is recommended to watch a video on how to properly straighten milk stagnation with your hands at home in order to perform massage movements effectively. In the process of massage, the lobules, where stagnation is localized, are well defined by touch - they are denser and harder. Having found them, it is necessary to carry out the massage especially carefully. But if soreness in places of stagnation persists even after massage with straining, you should definitely consult a doctor so that he can urgently treat lactostasis at home or prescribe hospital procedures, since the condition may subsequently worsen. Sometimes a woman needs to take urgent medications or perform procedures that only a doctor can prescribe.
• Compresses for lactostasis. A short heat compress is recommended before expressing and massaging. As for whether an alcohol compress should be carried out, this method is not recommended, since an alcohol or vodka compress can stimulate the bacterial flora and even affect the hormonal regulation of lactation. Recommended for 15 minutes before feeding. putting a cold compress on your chest will ease the pain. For compresses, ointments are used, as well as some folk remedies. One of the most popular is the cabbage leaf for lactostasis. Cabbage leaf compress can be used as an adjunct to relieve acute symptoms. Cabbage effectively relieves puffiness and pain, which is confirmed by the reviews of many women. How to apply a cabbage leaf with lactostasis? This should be done after feeding the baby and pumping. The sheet should be at room temperature. Initially, it needs to be washed well, dried and hard parts removed. Next, the sheet is gently beaten with a hammer or the blunt side of a knife until the juice appears. After that, it is immediately applied to the problem area, covered with a clean cloth on top. The film is not used for this. You should wear an old bra on top. As for how much to keep such a compress, 2-3 hours is quite enough. After removing the compress, you need to gently rinse your chest. Used for compresses and other products, such as honey cake. It is made from honey and rye flour (equal proportions) and applied to the breast for 20 minutes. However, such a remedy can only be used in the absence of beekeeping products.
• Treatment of lactostasis with ultrasound. In the process of treating stagnation, ultrasound is used for massage. As a rule, 3-4 procedures are carried out. Using a physiotherapy device with a sensor, the specialist performs a massage in the area of \u200b\u200bthe seal. After that, the milk is immediately expressed.
• Physiotherapy. As an additional treatment, the use of magnetotherapy, light therapy is recommended. At home, a physiological corrector device can be used.

When applying any of the methods of home treatment, it is necessary to remember that it is advisable to use them only if the woman feels normal. If the temperature lasts 2-3 days during lactostasis, what to do should be decided only by the doctor after the examination. Regardless of how long the temperature lasts, you cannot independently decide how to bring it down with medication. Adequate assistance with lactostasis will be provided in the antenatal clinic.

Alcohol compress for lactostasis

If a woman needs help with lactostasis at home, first aid is provided on specialized sites. The specialists cooperating with them provide round-the-clock assistance, answering questions from young mothers. There is also a hotline where you can contact for answers.

Treatment with folk remedies

In addition to the methods already described above using cabbage leaf and honey cake, other folk methods are also suitable as auxiliary means. But they can only be used as additional treatments.

• Chamomile. Prepare an infusion of 2 tbsp. l. chamomile and 1 tbsp. boiling water. After 2 hours, moisten the gauze in the infusion and apply to the chest for 15 minutes. To carry out such compresses three times a day.
• Baked onion. Apply a warm, freshly baked onion to the site of inflammation for half an hour.
• Eucalyptus. Pour 1 tbsp of eucalyptus leaf. water, boil for 15 minutes. Infuse the broth for a day, treat the breast with it before feeding.
• Honey and butter. Mix a teaspoon of honey and sunflower oil, heat to a warm temperature and put the mixture on cheesecloth. Put it on your chest and cover with plastic wrap. Put a warm scarf on top. Keep for about an hour.
• Compresses from potatoes and beets. Grate fresh potatoes or beets and apply a compress over the seal. Cover with foil, keep for about an hour.

Prophylaxis

All breastfeeding mothers should follow some important rules. Prevention will help prevent breast congestion.

• Breastfeeding mothers need to drink more fluids to keep the milk from getting too viscous.
• During feeding, you need to change positions. You cannot constantly feed the baby while lying down, since in this position the breast is pressed against the body and is not always emptied normally.
• The baby needs to be fed on demand, without lifting him from the breast, until he is satisfied.
• It is necessary to develop the breasts by doing preventive massage.
• Do not wear very tight and tight clothing.
• You should not sleep on your stomach.
• Cracks in the nipples and areola should be immediately treated with drugs.
• Avoid hypothermia and chest injuries.
• Buy the most comfortable and comfortable bras.
• When the first signs of lactostasis appear, it is imperative to take the necessary measures to eliminate them.

Diet

With lactostasis, you should follow the diet recommended for nursing mothers. It is very important to follow the correct drinking regime, consuming enough fluids. The diet should include beets, dried fruits, baked apples.

Consequences and complications

In the absence of proper treatment, mastitis, an inflammation of the breast tissue, can become a complication of lactostasis. With this condition, the woman's soreness increases, a severe fever develops, blood or pus may appear in the milk.

Prolonged lactostasis can subsequently lead to the manifestation breast abscess.

Forecast

With the correct approach to treatment, the prognosis is favorable.

List of sources

• Winter T., Helsing E. Breastfeeding. How to Ensure Success: A Practical Guide for Health Professionals / WHO. - Copenhagen: WHO, 1997.100 p.
• Murashko A.V., Dragun I.E., Konovodova E.N. Postpartum mastitis // Attending physician. - 2007. - No. 4 - S. 59-62.
• Basics of Newborn Care and Breastfeeding. - Part I / WHO. - WHO, 1997 .-- 178 p.

Mastitis (breast) - inflammation of the breast. Periductal mastitis (plasmacytic mastitis, subareolar abscess) is an inflammation of additional glands in the areola area. Mastitis of newborns - mastitis that occurs in the first days of life as a result of infection of hyperplastic glandular elements.

Code for the international classification of diseases ICD-10:

• O91.2
• P39.0
• P83.4

Classification. Downstream .. Acute: serous, purulent, phlegmonous, gangrenous, abscessing .. Chronic: purulent, non-purulent. By localization: subareolar, intramammary, retromammary, diffuse (panmastitis).
Etiology ... Lactation (occurs in the postpartum period; see breastfeeding). Bacterial (streptococci, staphylococci, pneumococci, gonococci, often in combination with other coccal flora, Escherichia coli, Proteus). Carcinomatous.

Causes

Risk factors ... Lactation period: violation of the outflow of milk through the milk ducts, cracks in the nipples and areola, improper care of the nipples, violations of personal hygiene. Purulent diseases of the skin of the mammary gland. SD. Rheumatoid arthritis. Silicone / paraffin breast implants. Reception of GC. Removal of a breast tumor followed by X-ray therapy. Long-term smoking experience.

Symptoms (signs)

Clinical picture
. Acute serous mastitis (may progress with the development of purulent mastitis) .. Sudden onset .. Fever (up to 39-40 ° C) .. Severe pain in the mammary gland .. The gland is enlarged, tense, the skin over the focus is hyperemic, on palpation - painful infiltration with indistinct borders .. Regional lymphadenitis.
. Acute suppurative abscessing mastitis .. Fever, chills .. Pain in the gland .. Mammary gland: reddening of the skin over the lesion, sharp pain on palpation, softening of the infiltrate in the center with the presence of fluctuations .. Regional lymphadenitis.
. Acute purulent phlegmonous mastitis .. Severe general condition, fever .. The mammary gland is sharply enlarged, painful, pasty, infiltration without sharp boundaries occupies almost the entire gland, the skin over the infiltration is hyperemic, has a bluish tinge .. Lymphangitis, regional lymphadenitis.

Diagnostics

Treatment

TREATMENT
Conservative therapy ... Isolation of mother and child from other women in labor and newborns. A bandage or bra to support the breast. Dry heat to the affected mammary gland. Expression of milk from the affected gland in order to reduce its engorgement. Termination of breastfeeding with the development of purulent mastitis. If expression is not possible and there is a need to suppress lactation, drugs that suppress the formation of prolactin are used - cabergoline 0.25 mg 2 r / day for two days, bromocriptine 0.005 g 2 r / day for 4-8 days. Antimicrobial therapy with continued breastfeeding - semi-synthetic penicillins, cephalosporins: cephalexin 500 mg 2 r / day, cefaclor 250 mg 3 r / day, amoxicillin + clavulanic acid 250 mg 3 r / day; if anaerobic microflora is suspected, clindamycin 300 mg 3 r / day (in case of refusal to feed, you can use any antibiotics). NSAIDs. In case of stopping feeding - a solution of dimethyl sulfoxide at a dilution of 1: 5, topically.

Surgery ... Fine needle aspiration of contents. If the punctures are ineffective, the abscess is opened and drained with careful separation of all the bridges. Surgical incisions .. For subareolar abscess - along the edge of the areola area .. Intramammary abscess - radial .. Retromammary - along the submammary fold. With a small size of the focus of fungal or tuberculous etiology, chronic abscess - it is possible to excision it with the adjacent altered tissues. With the progression of the process with the development of panmastitis - removal of the gland (simple mastectomy).

Complications. Formation of a fistula. Subpectoral phlegmon. Sepsis.
The course and prognosis are favorable. Full recovery occurs within 8-10 days with adequate drainage.
Prophylaxis ... Thorough care of the mammary glands. Compliance with feeding hygiene. Using emollient creams. Expressing milk.

ICD-10. O91.2 Non-suppurative mastitis associated with childbirth. P39.0 Neonatal infectious mastitis N61 Inflammatory diseases of the breast. P83.4 Swelling of mammary glands of newborn