Swelling of the milk ducts

The swelling of the mammary ducts is caused by bacterial infection of the mammary ducts, which can lead to inflammation in the mammary ducts. It mainly occurs in breastfeeding mothers. Because the milk is not completely discharged, it will affect the renewal of milk and then cause symptoms of mastitis. It is more common in the early stages of breastfeeding. It is also related to our breastfeeding method. Incorrect breastfeeding posture can cause nipple rupture, thereby causing infection.

Acute mastitis is an acute suppurative infection of the breast, an inflammation of the connective tissue in and around the mammary ducts. It often occurs in postpartum and lactating women, especially primiparas. Acute mastitis occurs in primiparas in 50% of cases, and the ratio of primiparas to multiparas is 2.4:1. It can occur at any time during lactation, but is most common 3 to 4 weeks after delivery, so it is also called puerperal mastitis.

Causes

Puerperal mastitis is a common disease in the puerperium, often secondary to nipple fissures, excessive breast fullness, and milk duct obstruction.

1. Cracked nipples

It is usually caused by incorrect breastfeeding posture, the baby not sucking the nipple and most of the areola in the mouth, and breastfeeding on one side for too long.

2. Blocked milk ducts

It is common in secondary milk stasis, and its main causes are incomplete breast suction, irregular and frequent breastfeeding and local pressure on the breast. Milk stasis is also common in people with nipple hypoplasia (such as inverted nipples), which affects breastfeeding. In addition, the breast milk of primiparas contains more exfoliated epithelial cells, which are more likely to cause blockage of the mammary ducts and aggravate milk congestion.

3. Bacterial invasion

The main pathogen of acute mastitis is Staphylococcus aureus, and Streptococcus is less common.

(1) Bacteria can directly invade through the milk ducts, which are prone to infection due to milk congestion and retention. Because retained milk is easy to decompose, the decomposition products are acidic, which not only irritates the mammary ducts but also serves as a good culture medium for bacterial reproduction.

(2) Bacteria can enter the nipple through small wounds or cracks, invade the breast interstitium through the lymphatic vessels and form cellulitis.

(3) Pathogens that infect other parts of the mother’s body during the postpartum period can circulate through the blood and cause breast infection.

(4) Another route of infection is that pathogens in the infant's body (such as oral and nasopharyngeal infections) directly invade the mammary lobules along the mammary ducts during breastfeeding, grow and multiply in the stagnant milk, and cause breast infection.

4. Milk stasis

(1) First-time mothers have no experience in breastfeeding and have a lot of milk. Babies often cannot suck out all the milk, causing excess milk to accumulate in the glandular lobules, which is conducive to the growth and reproduction of bacteria. The breast milk of primiparas contains relatively more exfoliated epithelial cells, which can easily cause blockage of the mammary ducts and aggravate milk congestion. The accumulation of milk promotes acute inflammation.

(2) If a primipara does not clean her nipples regularly during pregnancy, the epithelium will become fragile. If the baby sucks for too long, the nipple epidermis will become soft and prone to cracking. When cracking occurs, the baby's sucking will cause severe pain to the mother, affecting adequate breastfeeding. The breasts will not be easily emptied, and milk will easily accumulate. In addition, if the nipples are underdeveloped, short, flat, small, or inverted, milk is more likely to accumulate.