There is a pus spot on the nipple during breastfeeding

We all know that lactation is a very important period, especially women's breast health, which directly affects the feeding of the child. The breasts are prone to problems during the lactation period. Some women find thick spots on their nipples, which may indicate mastitis. The condition should be diagnosed promptly and treated actively to avoid affecting the child. Now let’s take a look at the specific circumstances of 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.

treat

Acute mastitis should be treated as early as possible. Early mastitis is mainly characterized by milk stasis inflammation, which has not yet formed into pus, and can be treated with ultrashort wave therapy. If the fever is high, it can be treated with infusion, penicillin, and cephalosporin antibiotics. It is recommended not to breastfeed while taking antibiotics.

When acute mastitis reaches the stage of abscess formation, timely incision and drainage are required. The size and position of the incision should be based on the principle of ensuring smooth drainage of pus. Because breast abscesses are often multi-chambered, it is necessary to use fingers to separate the connective tissue partitions of multiple abscess cavities so that drainage can be unobstructed. Abscesses deep in the breast are mainly characterized by high fever and chills. The local redness and swelling are not obvious, and there is no fluctuation. A puncture and pus extraction test can be done first, and then an incision can be made after the presence of pus is confirmed. It is best not to wait for breast abscess to rupture on its own, because the abscess cavities are often multiple or occur one after another, and the spontaneous rupture cannot be drained completely. Generally speaking, as long as the pus is drained and the fever subsides, suppurative mastitis will enter the wound healing period. The dressing will be changed every other day, and the wound will usually heal within a month.