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Prejudice about mastitis.


Liliya Kazakova, pediatrician, consultant on breastfeeding. 1. Very often, nursing mothers call mastitis lactostasis. What does lactostasis look like? Painful tuberosity and often redness of the skin over the tubercle. The occurrence of such a tuberosity or compaction is associated with the blockage of one of the ducts with a supposedly fat droplet and a violation of the outflow of milk from the lobe of the gland. Sometimes lactostasis is accompanied by fever, chills. The main cause of lactostasis is poor drainage of all or part of the breast. Poor drainage is most often associated with the fact that the child is feeding in the same position. For example, in a standard sitting position, the axillary lobe, the largest and with convoluted ducts, is emptied worse than anyone (the areas closest to the child’s lower jaw are best emptied - in this case, the lower central ones, and the upper lateral ones - the worst). The simplest action for the prevention of stagnation of milk in the axillary lobes is to sometimes apply the baby “from under the arm” - the mother, for example, sits (you can also lie down), the baby lies on the pillow with his head near his chest, and the ass and legs are behind the mother’s back , the baby lies on his side, at hand. Very often, in the event of stagnation under the arm, it is enough to attach the child several times in a row in this position and it dissolves perfectly. The location of lactostasis from above “in the center” is typical for cases when the mother holds the breast with “scissors” during feeding - the nipple between the index and middle fingers, the index finger is pressed into the chest. (So ​​the breast can neither be supported nor served, but in most maternity hospitals it is advised to give breasts in this way. In some preparation courses for childbirth, they literally advise the following: “Hold your chest like a cigarette.”). The chest should be supported with the whole hand - the thumb is on top, the rest is under the chest. In the vast majority of cases, the breast does not need to support all feeding at all. Very often there are recommendations to constantly wear a bra so that it supports the chest higher and then it would be filled evenly from above and below, they even offer to sleep in a bra. All this is called the prevention of lactostasis. But by nature, the female breast is designed so that it accumulates more milk in the lower lobes, and it is the lower lobes of the gland that are best emptied from any position. So why do we need a uniform accumulation of milk in all parts of the gland? Probably so that it would be more convenient for lactostasis to form at the top ... If the bra is worn, it should be free, it’s convenient when pissing "holey", milk leaks and you need to use pads ... Lactostasis practically does not occur with properly organized breastfeeding, when there is no accumulation of large servings of milk for feeding, and the mother is able to feed the baby from various positions. Lactostasis is a mysterious thing, sometimes it occurs from scratch and, with active sucking of a child, the affected breast disappears within 1-2 days without special measures. (And mother begins to say that a cabbage leaf helped her. If she comes across a mother who does not understand at all what is happening to her, and when she begins to develop lactostasis, she stops applying the baby to her sore chest and generally stops touching her, she no cabbage leaf helps, then a catastrophe usually happens.) If lactostasis begins to ripen in the chest, a child should be applied to it as often as possible. Sometimes it is necessary to express the breasts BEFORE feeding and attach the actively wanting to suck the baby to the sis, in which one lactostasis remains ... Sometimes it is necessary to massage the segment with lactostasis and expressing it (contact specialists at the place of residence ...) The severity of the situation does not depend on the degree of pain breast, and the woman’s ability to decant with such soreness. It is pain that does not allow the mother to carry out effective decantation. Therefore, it is better to resort to the help of a specialist who can cope with this complication in 30 minutes. Most mothers are afraid to express and massage this area because it seems to them that something might burst there. Something may burst if massage and decantation are carried out as follows: put sisu on a stone and hit it with a hammer from above. 2. Women often call mastitis a physiological phenomenon - the arrival of milk.
The arrival of transitional milk most often occurs 3-4 days after birth and may be accompanied by breast edema, soreness and fever. (In this case, the so-called breast temperature rises: when measuring temperature at three points (for example, under the arm, in the mouth and groin), the highest temperature will be under the arm, the difference with other points may be a degree or more.) The arrival of mature milk usually happens 10-18 days after the birth and can also be accompanied by swelling of the mammary gland, soreness, fever. In this situation, it is necessary to continue to feed the baby on demand, and also apply on demand of the mother. If a mother has painful sensations, a “stone chest”, then she can stretch her breasts to a feeling of relief about a day after the arrival of milk. You need to wait about a day due to the fact that a substance that minimizes excessive lactation appears in a full breast after about a day. If you express the breast before this time, the amount of milk will come, and hyperlactation with all the accompanying troubles can start to start, the main one being the need for regular expressions. It should be noted that with the joint stay of the mother and the child, feeding on demand and correctly applying the big problems with the arrival of milk is not observed. In the case of a separate stay of the mother and the child, engorgement with severe edema, redness of the entire mammary gland, and difficulty in the outflow of milk is quite common. In the presence of abrasions or cracks in the nipples, such engorgement can result in mastitis. To cope with engorgement, it is necessary to establish decantation within 2-3 days, as well as frequent and prolonged sucking of the baby's breast. This is the case when feeding at the request of the mother is extremely important. But sometimes the baby cannot grab the chest well and suck the milk because the areola becomes hard. In this case, before breastfeeding, it is necessary to express the breast so that the baby can successfully grab it and start sucking. 3. Real mastitis is an infected inflammation of the breast tissue. Most often develops against the background of engorgement or lactostasis. If milk is not removed in a timely manner with lactostasis, inflammatory changes in the breast tissue begin, which occur against the background of swelling and changes in blood circulation in the lobe of the gland with lactostasis. This condition is often called uninfected or serous mastitis. If a woman has abrasions or cracks in the nipples, a rapid infection of the inflammatory focus occurs. It should be noted that the infection can get there not only from cracks, but also from any other focus of a chronic infection in a woman’s body (for example: carious tooth, chronic tonsillitis, pyelonephritis, etc.) With mastitis, the well-being worsens, the general body temperature rises, part of the chest becomes red and hot, painful when touched. The treatment of mastitis is carried out according to the same principles as the treatment of lactostasis. It is necessary to free a fraction of the milk by expressing, massaging and applying the baby. With mastitis, feeding a child is not prohibited, but necessary, since no one better than a child can empty the lobes of the breast. With mastitis, antibiotic therapy is necessary. There are many modern antibiotics that are compatible with breastfeeding. If a doctor prescribes antibiotics, it is necessary to inform him of this, because very often, doctors do not consider it necessary to continue breastfeeding against the background of antibiotic therapy and do not bother with the selection of treatment compatible with breastfeeding. 4. Breast abscess - a condition that develops against the background of mastitis in the absence of treatment. With an abscess, in the place of the formerly lactostasis, a cavity is formed, filled with purulent contents. An abscess, as a rule, is opened into the milky duct and its treatment consists in regular expressing of a sick breast and conducting a course of antibacterial therapy. With an abscess, while pus is secreted from the duct, feeding the baby is recommended to continue only from a healthy breast. In preparing the material used the book “Counseling on breastfeeding”, author Zh.V. Tsaregradskaya.
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Prejudice about mastitis.

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