What is mastitis?

Mastitis is a common disease in the female breast area. Suffering from mastitis is very harmful to the health of female breasts and can easily cause some other complications. Mastitis can easily lead to breast pain or breast swelling, leading to a decrease in the body's immunity, etc. It needs to be treated in time. It is especially easy to suffer from mastitis during breastfeeding, so more attention should be paid to prevention.

What is mastitis?

Mastitis is a common disease among women. Depending on the cause, it can be divided into acute suppurative mastitis, paraareolar fistula, plasma cell mastitis, etc. Here we will discuss the most common acute suppurative mastitis. Acute suppurative mastitis often occurs during the lactation period, especially within 1 to 2 months after delivery in primiparas, so it is also called acute lactation or puerperal suppurative mastitis, and is called "mast abscess" in traditional Chinese medicine. The incidence of acute mastitis in primiparas is as high as 2% to 4%, which is twice as high as that in multiparas. Milk stasis is caused by bacterial infection, which presents as acute inflammation with symptoms of redness, swelling, heat, pain, chills and high fever. In the early stage, it can be treated by manual milk discharge and Chinese medicine. After suppuration, incision and drainage are required. After the onset of the disease, not only will the mother herself suffer extreme pain, but she will also be unable to continue breastfeeding, which will affect the health of the baby. Therefore, prevention should be started from the late pregnancy and postpartum care should be done well. Acute mastitis can be prevented.

Causes

Milk stasis is the prelude and basis of bacterial infection. If there is too much milk and milk discharge is not smooth, the milk may accumulate and form lumps. Stagnant milk is the best breeding ground for bacteria. Milk stasis is mostly caused by insufficient breastfeeding experience or improper methods. The pathogenic bacteria are mostly Staphylococcus aureus, and a few are hemolytic Streptococci. They invade the mammary gland through damaged nipple skin or milk ducts, multiply in large numbers, and destroy the mammary gland tissue, forming multilocular abscesses. When the nipple is underdeveloped, inverted, inverted or split, the mammary ducts are blocked from draining milk, causing congestion. Breastfeeding for too long, or the child falling asleep with the breast in his mouth, can cause erosion on the nipple surface or the child bites the nipple, allowing bacteria to enter through the hole; or due to a cold or pharyngitis, bacteria may travel through the blood into the stagnant milk and multiply in large numbers, causing suppuration.

Postpartum women are weak in physical condition and have reduced immunity. They are wrapped too tightly, sweat a lot, and are not cleaned enough, resulting in local moisture in the breasts, which also provide a breeding ground for the growth and reproduction of bacteria. Trauma to the breasts such as squeezing and impact during lactation can also easily induce mastitis.

Clinical manifestations

The clinical manifestations of acute mastitis can be divided into three stages or phases.

Stage 1: milk stasis and lump stage or redness and swelling stage. The main symptom is sudden swelling, hardness, and pain in a certain part of the breast, usually the upper outer or upper inner quadrant, with unclear boundaries and obvious tenderness. At this stage, the inflammation inside the breast is at the cellulitis stage and no abscess has yet formed. The color of the breast skin is normal, slightly red, or slightly warm. Sudden high fever, chills, pain, swelling, local bright redness, which quickly turns to pus and ruptures, often accompanied by chest tightness, headache, loss of appetite, etc. If the nipples are cracked, you will feel a pain like a needle prick in the nipples when breastfeeding, and one or two small pus spots or very small cracks may be seen on the surface of the nipples.

Stage 2: abscess formation stage. If the cellulitis stage fails to dissipate in time, the inflammation will continue to develop, tissue necrosis, and abscess formation are inevitable. The lump gradually grows larger and harder, and the pain becomes more severe, often throbbing or even persistent, and the local skin of the breast becomes red and burning. The patient has a persistent high fever, thirst, nausea and anorexia, and swollen lymph nodes in the ipsilateral axillary. After 2 to 3 days of redness, swelling, heat and pain, the center of the lump gradually becomes soft and fluctuating, the center becomes red, swollen and shiny, the skin becomes thinner, and large areas of surrounding skin become bright red. Pus will be sucked out during the puncture. At this stage, the abscess has formed and the opportunity for conservative treatment has passed.

Stage three: late stage of abscess ulceration. When an abscess matures, it may rupture on its own or be drained surgically. If the drainage is unobstructed, the local swelling and pain will be reduced, the body temperature will return to normal, and after changing the dressing, the wound will gradually heal in about a month. If the pus does not drain smoothly after ulceration, the swelling does not go away, the pain does not decrease, and the fever does not subside, it means that the drainage is not smooth. If it is not healed for a long time, it will turn into chronic mastitis and form a milk fistula, that is, milk and pus will flow out mixedly.