When pus comes from the chest. Mastitis during breastfeeding: symptoms, causes, treatment

A disease in which inflammation occurs in mammary glands ah, it's called mastitis. Most mothers whose children were breastfed are familiar with this disease firsthand. Characteristic features diseases are strong painful sensations in the breast, its sudden change in size and redness, discomfort during feeding, elevated temperature and others.

Mastitis occurs in several stages. If at the first symptoms of the disease it was not applied effective treatment, it can go into a more dangerous purulent stage, with the threat of complications.

Causes of mastitis

Can a woman’s erroneous actions cause mastitis during breastfeeding? The reasons for the development and progression of the disease are very different.

The main culprits are causing disease, are streptococci, Staphylococcus aureus and other bacteria that enter the female body.

Pathogens can penetrate the mammary glands:

• through ducts, cracks, wounds on the chest, which are a suitable environment for this;
• through the circulatory system if a woman is sick with other chronic infectious diseases.

In a normal state, a woman’s body is able to independently cope with a small number of bacteria, but after childbirth the immune system is weakened and cannot resist pathogenic microbes.

In addition, a woman’s ignorance of hygiene standards during feeding may be involved in the appearance of this disease. Another reason why mastitis occurs during breastfeeding is lactostasis.

Signs of lactostasis

The disease can develop due to stagnation in the ducts due to improper feeding from the breast or long breaks between feedings. The milk environment is a favorable environment for the growth of bacilli.
Characteristic signs of lactostasis are:

• nodular lumps in the mammary gland that resolve after massage;
• chest pain;
• uneven, intermittent flow of milk from the ducts where the disease develops.

The problem must be eliminated by initial stage, since untreated lactostasis develops into mastitis after a few days.

Indirect reasons that may contribute to the development of the disease include:

• various defects of the nipple (it can be retracted or divided into lobes), the child cannot grasp it correctly during feeding, thereby injuring it;
• mastopathy;
• pathologies of pregnancy, birth injuries and others.

Types of mastitis

Mastitis is divided into two main types:

1. Non-lactation is a disease that develops regardless of breastfeeding. The reasons for its occurrence are various injuries caused to the mammary gland and hormonal problems.
2. Lactational - occurring during the postpartum period.

What are the stages of mastitis in a nursing mother? The signs are characteristic for each stage. The following stages of the disease are distinguished:

• Serous - initial. Characterized by an increase in temperature up to 38 degrees, with chills, weakness, headache, breast enlargement and redness, hyperemia, aching pain, which intensifies when touching and feeding the child.
• Infiltrative is the second stage into which serous mastitis develops if it is not treated or treated incorrectly. Characterized by formation and fever.
• Purulent. This stage is characterized by a critical body temperature of 39-40 degrees, sleep disturbance, severe headache, inflammation into burning pain in the chest from the slightest touch.

Diagnostics

If the above symptoms appear, you should immediately seek medical help. When a specialist examines the breast and palpates it, he diagnoses the problem. A blood test can confirm whether mastitis has developed and the presence of inflammation in the body. Bacteriological culture of milk will determine which microbes caused the disease and their resistance to antibiotics. Also, to diagnose the disease, they can conduct ultrasonography. An ultrasound photo will help to more accurately determine at what stage of mastitis during breastfeeding.

Mastitis and breastfeeding

If the mother has begun the superficial stage of mastitis, there is no inflammatory process yet, but only redness is observed, slight pain, and no drug treatment is used, you can feed the baby with a second, healthy breast. Milk is expressed from the problematic gland, but under no circumstances is it given to the child, so as not to infect him.

In later stages of the disease, it is necessary to urgently stop feeding, since the pus that can form in the breast can spread to the healthy mammary gland, as well as the bacteria that caused this disease.

Throughout treatment, milk must be expressed. This, firstly, will help maintain lactation, and secondly, the healing process will go much faster.

Principles of mastitis treatment

Depending on the form of the disease, as well as how long ago mastitis developed during breastfeeding, they use different ways fight the disease.
The principles of treatment are:

• Relieving pain.
• Termination of the inflammatory process.
• Stopping the proliferation of bacteria that caused the disease.

Treatment methods

In the first stages (serous and infiltrative mastitis in a nursing mother), treatment is carried out using conservative traditional methods. In case of a purulent stage, surgery cannot be avoided.

1. Incoming milk must be expressed approximately every three hours or as needed to prevent it from stagnating and, accordingly, the proliferation of bacteria.
2. To reduce pain, local anesthesia is used, for example, ice can also be applied.
3. In case of prolonged unsuccessful treatment, a woman’s serious condition, the development of various kinds of complications and other reasons, it is necessary to reduce the amount of milk secreted or temporarily stop the process with the help of special medicines, which should be used only as prescribed by a doctor.
4. After complete recovery, feeding can be established again.
5. To cleanse the mother's body of toxic substances, droppers with saline solutions and glucose are used. Drugs are also added to boost a woman’s immunity.

Use of antibiotics

If mastitis progresses during breastfeeding, treatment will not be possible without taking a course of antibiotics. After the milk has been cultured to determine sensitivity to antibiotics, a suitable drug will be prescribed. The following groups of medications are most often used in therapy:

• penicillin;
• aminoglycoside;
• cephalosporin.

Treatment can be carried out in the form of intramuscular or intravenous injections, or the use of tablets is also possible. The average course is from a week to ten days.

When treating purulent mastitis, one cannot do without breast surgery and antibiotic therapy.

After recovery and cessation of medication, a repeat bacterial culture of the milk is performed. If tests do not show the presence of infection in it, lactation can be resumed.

Traditional methods of treatment

Very often from relatives and friends you can hear recommendations on the use of traditional methods of treating a disease such as mastitis in nursing. There are many recipes, the use of which, according to healers, is a panacea for this disease. It cannot be categorically stated that the use of bran compresses, application of burdock, coltsfoot leaves, cabbage, onion cakes with honey, ointments from plantain seeds and many other remedies to the source of inflammation is ineffective. All these methods can and should be used, but only in combination with drug treatment and always under the supervision of a doctor.

Considering that most often mastitis occurs due to bacteria, herbs and other natural components are not able to kill the infection that has entered the body, antibiotics can do this. But they can alleviate the mother’s condition, reduce pain and other unpleasant symptoms, reduce the level of lactation, and improve milk flow.

In addition, any self-medication if mastitis occurs during breastfeeding is unacceptable. To avoid a more severe purulent form or complications in the form of sepsis, you must immediately seek help from specialists.

Disease prevention

There is no doubt that it is easier to prevent a disease from occurring than to treat it later. When breastfeeding, in most cases it will protect the mother from developing the disease. It is enough to follow a few very simple rules, and feeding your baby with breast milk will be problem-free and will bring only pleasure.

1. In the first weeks, it is necessary to express correctly and regularly after feedings, since much more milk arrives than is necessary for a very small eater, and its remains can cause stagnation and an inflammatory process.
2. When applying to the breast, it is necessary to monitor how the baby clasps the nipple and change its position during feeding so that the milk is sucked out from the farthest ducts.
3. Monitor the appearance of wounds and microcracks on the nipples, and promptly treat them with various ointments. It is in this case that they will be good traditional methods, for example, carrot juice has wonderful healing properties.
4. Purity - main factor in disease prevention. A clean body, underwear, a washed and ironed bra is the necessary minimum of measures to protect against the spread of disease from the outside. In this matter, the main thing is not to overdo it. There is also no need to wash your breasts with soap after each application, so as not to dry out the skin around the nipple and cause irritation. A regular daily shower and periodic rinsing of the glands before feeding will be sufficient.

Summing up, I would like to once again draw attention to the fact that one should not take such an ailment as mastitis during breastfeeding lightly. Its treatment must begin immediately, after the appearance of the first signs, which only at first glance may not indicate something serious.

Self-medication without seeking medical help is unacceptable, because only after a blood test and milk culture can be prescribed correct and effective treatment, which can soon return you to the ranks of nursing mothers.

The main function of the female breast is to feed the newborn baby with milk. Throughout life, the mammary glands undergo various changes due to the action of hormones. However, sometimes there may be a discharge from the nipples that does not resemble breast milk. Why does pus appear from the nipple? What are possible reasons this phenomenon?

Exudate flowing from the breast can be of a different nature. It is not always purulent. The accumulation and discharge of pus is a pathological change. In this case, the mammary glands are affected by the inflammatory process. It is usually accompanied by swelling, hyperemia, and breast tenderness. Since inflammation is caused by pathogenic microorganisms, the exudate released is different unpleasant smell and has a grayish tint. A viscous yellow secretion indicates a purulent nature.

Another pathological phenomenon is galactorrhea. This is the medical term for the spontaneous release of light fluid from the nipples outside of breastfeeding. Teenagers are also susceptible to this pathology.

The disease is caused by:

• Various hormonal imbalances
• Climax
• Previous abortions
• Taking oral contraceptives

Liquid from the nipples appears with mastopathy and ectasia of the milk duct. In such situations, the secretion does not reabsorb; the fluid formed in the breast comes out through the nipple tubules.

Normally, a woman's breasts produce colostrum and breast milk. In the last stages of pregnancy future mom often notices yellowish fluid from the chest. The woman's body is preparing to feed the newborn with milk. After childbirth, milk fluid may be released from the milk ducts between feedings of the baby with pressure and spontaneously.

Discharge of pus

The main causes of purulent discharge:

• Mastitis
• Benign tumor
• Deformation of milk ducts
• Damage to nipple tissue
• Papilloma inside the duct
• Proliferation of glandular tissue in mastopathy
• Infection of breast tissue
• Furuncle
• Tumor

New growths may appear inside the thoracic ducts, causing tissue deformation and suppuration. Purulent discharge from the mammary glands appears when pressure is applied during palpation for benign and malignant tumors. Infection of the milk ducts and glandular tissue can occur due to piercings or improper expression of breast milk while feeding the baby. Cracks in the nipples allow infection to penetrate deep into the breast. Photos show what the pathology looks like.

Discharge causing anxiety

The formation of a non-purulent secretion also indicates pathology and requires close attention. You should be concerned if the following are observed from the nipple when pressed:

• Whitish exudate not associated with pregnancy
• Green or yellow viscous secretion
• Dark brown or black discharge
• Cloudy liquid
• Blood impurities

Secretion formation is caused pathological changes in the chest, proliferation of fibrous tissue. Thick secretion indicates inflammation of the ductal structures. Pathology is often diagnosed after forty years. The discharge may not have any impurities or lumps, be light or cloudy, transparent, thick, viscous. It is necessary to pay attention to their consistency - sticky exudate indicates the development of a benign tumor.

Sometimes exudate appears with increased production of prolactin and galactorrhea. The appearance of secretion may also indicate a tumor, ovarian or kidney disease. Bloody issues indicate rupture of blood vessels in the ducts. They appear during the oncological process.

The secretion can occur involuntarily or when pressing on the nipple. Liquid oozes from one or two nipples. The pathology is sometimes accompanied by enlarged lymph nodes in the armpits.

Possible causes of purulent discharge

The accumulation of pus in the mammary gland is a sign of tissue infection.

Leads to suppuration:

• Mastitis
• Abscess
• Large intraductal papilloma
• Infection of tissue by pathogenic microorganisms

The pathology is usually accompanied by fever, chills, and thirst. Purulent discharge may have a greenish tint. This is often observed in various forms of mastitis. When the disease occurs, the infection penetrates through the nipple into the milk ducts. Recent surgery on the gland can lead to infection.

Malignant and benign tumors damage glandular tissues and change the structure of the milk ducts. As a result, exudate begins to be produced, filled with leukocytes, fatty compounds, albumin and other impurities.

What to do if you have nipple discharge

The nipple may ooze clear fluid, fester, and bleed. In such cases, it is important to contact a mammologist and undergo a series of studies. After a thorough examination by a doctor, the necessary diagnostic procedures and tests are prescribed. Seeing a doctor will allow you to detect the disease in a timely manner and prevent the development of complications. Timely treatment guarantees a favorable medical prognosis.

Elimination of pathology depends on the nature of the disease. The inflammatory process in the milk ducts and glandular tissue is eliminated with the help of antiseptic and antibacterial drugs. In some cases, the use of hormonal agents is required. For infection, various anti-inflammatory medications and the use of local ointments are prescribed. If there is a boil and an abscess, the lesion is opened by a surgeon and removed.

What can the color of the discharge indicate?

The color of the exudate indicates the nature of the pathology. By the shade of the liquid, the doctor can determine what process is occurring in the affected breast.

Possible shades of discharge may look like this:

• Yellowish, green - development of mastopathy, mastitis, inflammation
• Dark green thick exudate – suppuration of a ductal cyst
• Brown – milk duct ectasia
• Watery-transparent - oncological process
• Blood impurities - cancer, papilloma inside the duct
• White - inflammatory processes of various etiologies.

A thick, sticky green mass indicates inflammation of the ducts in the breast. With galactorrhea, the discharge is whitish or has a yellow tint. Only a thorough diagnosis of the mammary glands will help to establish an accurate diagnosis.

Examination of discharge from the nipples of a woman

Among the diagnostic methods used to clarify the diagnosis are:

• Mammography
• Ductography
• Blood tests

Examination of glandular tissue and milk ducts using ultrasound is the most popular and affordable method. In some cases, under ultrasound guidance, the doctor may puncture the gland to take a puncture for histological analysis of the biomaterial.

Ductography and mammography are x-ray studies of glandular tissue and ducts. The method reveals the condition of the milk ducts, the presence of tumors and cysts.

Also for diagnosis it is necessary to perform a test for prolactin and thyroid-stimulating hormones thyroid gland. If you suspect cancer, it is important to histological examination allocated secret. If the color of the skin of the mammary glands changes, a biopsy of the areola particles is performed.

To prevent pathology, a woman should pay enough attention to the hygiene of the mammary glands. The expectant mother is obliged to take care of her health during and after breastfeeding.

It is important to prevent infection of the nipple and the development of cancer. It is important to correct irregularities in the monthly cycle and the balance of hormones, and promptly treat gynecological diseases of the appendages and uterus.

Discharge of pus from the nipple is not only extremely unpleasant, but also a very dangerous symptom that should alert you and force you to immediately consult a doctor. And to know what to expect, find out the possible reasons for this phenomenon.

First, it is worth noting that pus is an exudate resulting from purulent or serous inflammation of tissue. This liquid has a viscous consistency, a yellowish or grayish tint, and often an unpleasant odor. It consists of leukocytes, cholesterol, globulins, fats, albumins, particles of skin and soft tissue, DNA impurities, as well as enzymes and waste products of inflammatory agents - pathogenic microorganisms.

Considering what was written above, we can conclude that pus does not form in the chest just like that; its accumulation and release is preceded by an inflammatory process. And in most cases, pathological changes occurring in the tissues of the mammary glands do not go unnoticed and provoke a number of other symptoms:

• swelling
• hyperemia
• distension
• discomfort
• soreness
• redness
• engorgement
• burning

Pus can be released from the nipples only when exposed to them (for example, when pressed) or flow freely if its amount is significant.

Non-purulent discharge that may cause concern

The discharge is not always purulent, although sometimes in consistency and shade it actually resembles pathological exudate. But if the leakage of fluid from the nipples is not accompanied by severe and obvious inflammation, and there are no other symptoms, then most likely it is not pus.

Possible situations in which fluid similar to pus may be released from the nipples:

• Pregnancy. In the second half of the breast, colostrum begins to form, which the expectant mother may notice on her underwear. Its discharge does not cause concern, and the liquid itself has a fairly thick consistency and a yellowish-transparent color.
• Lactation. Leakage of milk between feedings is completely normal and should not be a cause for concern.
• If the discharge is very scanty and extremely rare, almost transparent or slightly yellowish, has no odor and is released when you press on the nipples, then this can also be considered a variant of the norm. In the mammary glands, even outside the lactation period, a small amount of a special secretion is secreted, which can come out through the milky tubules. The volume of discharge may increase with overheating, with intense physical activity, as a result of stimulation of the mammary glands or after certain procedures.
• Galactorrhea is the spontaneous release of milk outside the period of breastfeeding. Normally, it can be released for some time after the end of lactation, but, as a rule, no longer than 6-12 months (in some cases 1.5-2 years). If a woman has not breastfed for a long time, and especially has never breastfed, then galactorrhea is caused by hormonal disorders, namely an increase in the level of prolactin, which is responsible for lactation. An increase in its amount in the body can be a consequence of an abortion or miscarriage, taking oral contraceptives and other hormonal drugs, diseases of the thyroid gland, adrenal glands or pituitary gland, liver failure (this organ ensures the utilization of hormones), certain gynecological or oncological diseases.
• Mastopathy. With such a common disease, discharge from the nipples can also be observed, but in most cases it is not purulent in nature.
• Ectasia of the milk ducts is their pathological expansion, most often developing in women over forty-five years of age. With this pathology, the resulting secretion does not dissolve in the chest, as in the normal state of the ducts, but rushes along them to the tubules located in the nipples and comes out. In some cases, deviation requires medical intervention.

Possible causes of purulent discharge

Suppuration of the nipples can be caused by the following conditions, pathologies and diseases:

• Mastitis is an inflammatory disease. In most cases, it develops during the lactation period due to damage to the skin as a result of improper attachment or insufficient emptying of the breast. With this disease, the discharge is accompanied by pain, hyperemia, severe swelling, bloating, an increase in the size of the mammary gland, as well as an increase in body temperature and clearly palpable lumps.
• Intraductal papillomas. These are wart-like neoplasms located on the walls of the ducts and, accordingly, deform them. In some cases, with papillomas, purulent discharge from the nipples is observed. And upon palpation, compactions can be detected.
• Malignant or benign neoplasms, especially those located inside the milk ducts and deforming them. Pus can be released when tumors are of significant size, so during examination they will probably be clearly palpable.
• Damage and further infection of nipple tissue. This area can be damaged as a result of rough stimulation, invasive procedures (including piercing), non-compliance with pumping technique (especially manual pumping), and injuries.
• Cracks in the nipples occur due to improper attachment during lactation and become a kind of entrance gate for various pathogenic microorganisms, such as streptococci, Pseudomonas aeruginosa, Staphylococcus aureus, and enterobacteria. Their activity causes inflammation and, as a result, the release of pus.
• Mastopathy can lead to the formation of pus if tissues growing pathologically in the breast irritate and deform the milk ducts, damaging their walls. With this disease, a number of other symptoms are observed: engorgement of the mammary glands, compactions in them, discomfort, changes in shape and size, pain.
• Recent breast surgery. If tissue infection occurs during or after them, this can cause suppuration.
• Boils or carbuncles. If they are located on the nipples, which, although rare, does happen, then pus from the cavity can exit through the milky tubules if it does not find another way out. Such neoplasms look like red ulcers rising above the skin, very painful under mechanical influence.

What to do

If you notice the discharge of pus from the mammary gland, then this is clearly an alarming sign that requires immediate consultation with a doctor. A mammologist will conduct a thorough examination and prescribe a series of diagnostic procedures: ductography, x-ray, mammography, ultrasound, blood tests. Based on the results obtained, a diagnosis will be made.

Treatment depends on the reasons that caused the suppuration. To relieve inflammation, antiseptics and anti-inflammatory drugs may be recommended. For bacterial infections, antibiotics are prescribed. Sometimes an appointment is required hormonal drugs. And to open the abscesses and remove tumors localized in the chest, surgical intervention will be required.

Pus discharged from the nipples - unpleasant symptom, which should alert any woman who cares about her health and force her to visit a doctor.

“If it turns out to be mastitis, what will happen to lactation?” – I asked with tears in my eyes. “In my experience, there were several cases when girls managed to maintain lactation. You can try,” answered the lactation consultant, “unfortunately, you called too late, if only a couple of days earlier...”

On the way to the hospital, I tried to analyze everything that happened this week after giving birth to understand where I made a mistake. May be the cause of steel inflammation inverted nipples and the cracks that appeared on them, through which the infection entered? Or there was stagnation of milk due to an uncomfortable position during feeding - due to the episiotomy, I couldn’t even roll over on the bed, let alone use different positions. Probably, after the first flush, it was necessary to immediately express milk, but at the courses they said not to express on the first day, and at the maternity hospital the staff were not at all interested in breastfeeding. Well, why didn’t I immediately call a consultant, I listened to the optimistic advice of my friends.

I looked at the baby, who was fast asleep in my arms, and I felt very ashamed in front of him - after all, having several honors diplomas, a successful career, rich life experience, I so seriously let him and myself down in the very first week of our life together.

The consultant, having learned the results of the ultrasound, advised me to make a puncture, remove the pus and return home to be near the child and go to the clinic for dressings. She said that you can and should express milk from both breasts every 2-3 hours, but very carefully from the sore breast. And buy the formula for your child during treatment.

At the regional hospital, the surgeon categorically stated that I needed hospitalization for 10 days, general anesthesia for the operation would be, since novocaine could cause complications and the inflammation in the chest would go further. He didn’t even discuss the issue of feeding. In his opinion, this topic needs to be closed: purulent mastitis is a direct indication for cessation of lactation. I had to write a refusal to be hospitalized and go to another hospital.

The surgeon on duty at the district hospital, without looking at the ultrasound form, accurately determined the diagnosis and, after listening to my intention to feed and be near the child, did not insist on hospitalization. The operation lasted about 10 minutes, I lay on the couch, turned away, and confusedly asked questions about scars, antibiotics and lactation. The doctor allowed me to carefully express milk. “2:1 in favor of lactation,” I thought. A bandage was applied to the chest. Unpleasant and creepy. Somehow keeping herself under control, she returned to the car, where her husband was waiting with the child in his arms.

The first night it was very scary to even remove the bandage from my breast, let alone pump.

The wounds were open, and when pressure was applied, milk, blood, and pus oozed out of them. The temperature rose and I shivered. In the morning at the clinic while I was changing the dressing, I again asked a question to the new doctor, wanting to hear more opinions: is it possible to express or am I harming myself, as the surgeon from the regional hospital said. I heard a third answer in favor of pumping.

It was not possible to sleep at all: I had to feed the baby, then pump. It was also not possible to use a breast pump. It was painful and to no avail - the milk didn’t come out, not a drop! And on the sore breast there were scars, just where the breast pump attached. I pumped by hand for 20 minutes each breast. There was very little milk, so little that no dishes were needed - a few cotton pads were enough. It was chilling again.

But it turned out that this was not the most difficult and terrible thing. In the morning we were unable to wake up the baby for the next feeding. He slept... and did not wake up. In panic they called an ambulance. The baby was taken to the intensive care unit and we were sent home. They said he would definitely spend a week in intensive care. For the first time in our lives, my husband and I felt a feeling of deep and unbearable anxiety for the life of our child. We didn’t even know what to talk about - we drove in silence and hardly spoke at home, only occasionally “everything will be fine, he’s under the supervision of doctors.” I cried constantly. In the evening we were told by phone that the baby had lost a lot of weight, there was a suspicion of infection and in the morning he would be given all the necessary tests, but in the meantime they started injecting him with antibiotics.

“Lost weight. There wasn't enough milk. “It’s my fault,” was running through my head all day long. Because of clever books about the benefits of breastfeeding, I turned into a self-confident fanatic and believed that if a baby sucks for a long time and does not cry, it means he is full - but he sucked for so long because he did not have enough milk, and probably fell asleep hungry and exhausted. We didn't even offer him supplementary food. And during the courses they said: “You can’t have enough milk, you can’t have enough intelligence.” This means that the lack of milk is also my fault... The lactation consultant herself called us several times to find out how we were doing and persistently persuaded me not to blame myself and not to talk about the past, but to focus on what needs and can be done for the future. Only a week later I found out that the baby had pneumonia, and the weight loss was probably not only due to lack of milk.

On the third night, the temperature rose again, the chest turned red, and in the morning I had to go to the doctor on duty for an emergency dressing. And again a harsh tone. He didn’t even bother to change the bandage - he said that the wound had festered, that pumping in my situation was simply ridiculous, and he didn’t understand how they could allow me to do this. I was told the word “abscess”, the meaning of which I only later read on the Internet, and was ordered to urgently go for hospitalization to the hospital where the operation was performed. The surgeon was surprised at my return to the hospital, examined the wounds and said that she didn’t see anything wrong with them, the pus should and would come out as the wound healed, and while the child was in the hospital, she suggested that I go to the hospital.

I remember that week like a bad dream, although I really didn’t have enough sleep then. Every two hours I started pumping. It was difficult to even call it pumping: rare drops of milk oozed from my breasts, which I blotted with cotton pads. Several times during the night I turned on the bright light in the room and, like a sleepwalker, pressed my chest from the periphery to the center. It felt like torture. And for what? There was no guarantee that the milk would appear - I couldn’t even express 5 ml - or that the baby would latch onto the breast after such a long break, but with unyielding stubbornness I continued to express... every two hours... from the periphery to the center. In the morning – painful dressings. I wanted to sleep, but there was no time to sleep. I often cried and was afraid that due to stress the milk would disappear completely. The women in the ward supported me. But none of them believed in me, none of them ever said “you can do it!”, They said “don’t worry, I raised all three of my children on formula and nothing!” On the third night in the hospital, pus began to be expressed from the sore breast - a lot and directly from the nipple. There were three surgeons in the resident’s room at once, when I once again asked, with a trembling voice: “What should I do?” “Pump. Your baby will need this,” they said. I am very grateful to these doctors.

A week later from surgery, I immediately moved to the children's hospital when the child was transferred from intensive care to the children's department. She took him in her arms and did not let him go. They even scolded me and didn’t allow me to sleep with him at night, I nodded and still took the baby to my bed. He still didn’t weigh much, he was spitting up almost all the formula, but I still couldn’t feed him, and there was nothing to feed him. Now I think that in those days I was also saved by the fact that I did not understand how much milk there should be. I thought that once even a drop was expressed, it meant there was milk and I had to express it. But others, with such a meager amount, simply stop feeding and switch to formula. In the hospital, it was not possible to express by the hour, because the baby was crying, I constantly carried him in my arms, sang, talked... and expressed only when he fell asleep. Sometimes after four hours, sometimes after six. I couldn't sleep at all. I had to feed with formula at set hours. And the baby wanted to eat out of schedule. He was too weak to endure hunger. Half an hour to an hour before the mixture he began to cry a lot, got tired and fell asleep hungry...

They brought a mixture that had already spoiled by the time he woke up. I had to start another fight - for supplementary feeding on demand! For me, “feeding by the clock” is still some kind of cruel myth. A week later, when the antibiotics ran out, I asked the doctors to do a milk culture and expressed a desire to start breastfeeding. The head of the children's department said that there is no point in doing bacterial culture - even if staphylococcus is detected there, you still need to feed. This was strange for me, I did a test, staphylococcus actually showed up, but several more doctors confirmed the possibility and necessity of feeding, and I decided to start.

I really wanted the baby to latch on, but I knew that after two weeks of tube and bottle feeding it wouldn’t be easy. I was also confused by the fact that the baby was underweight and did not digest food well, so I could not not give formula and ignore the crying. The first time, to my great surprise, the baby immediately latched onto the breast, but due to the inverted nipples, he could not hold it and burst into wild crying. I calmed him down and offered my breast again - the baby was crying a lot. She gave me a bottle. I was upset, but I understood that not all at once. However, the next day the baby easily latched onto the breast again and - oh, miracle! – began to suck. “Because breasts were the first thing he saw in the maternity hospital. It’s more priority for him than the bottle, so he took it,” our pediatrician explained to me the reason for the miracle two months later. The second week we spent with my son in the hospital, I put him to my breast before bottle feeding for 10-20 minutes. After feeding, I continued to express a little using a breast pump (the wounds had almost healed), but only 5–10 ml was gained.

For the entire second month, I fed the baby on demand - first the breast, then the bottle... There was still very little milk, and my husband and I no longer really believed that it would appear. I even mentally set some conditions for myself: “If things don’t improve in three weeks, I’ll stop lactation.” I drank everything I could drink - Lactogon, Lactovit, some homeopathic granules, brewed dill with nettle, added condensed milk to tea, but most importantly - I applied it: day and night, always on demand. And by the beginning of the third month, the child gradually began to refuse the bottle. I checked my breasts - milk was already flowing in a good stream. I was happy and checked the baby’s weight every day, then after two days, then after a week...

Everything is fine. Since the third month, I have been breastfeeding my son only. We are now almost six months old. The baby is gaining weight according to “outpatient” standards, is cheerful and cheerful.
I prefer not to remember what happened. But I’m a little proud that I was able to overcome this, although, of course, I still blame myself for the fact that this happened at all. Well, at some stage I didn’t have enough intelligence to prevent all this in time - I had to correct it with willpower. But the most important thing is that I am truly happy in those moments when the baby looks for the breast, finds it and sucks, with such ecstasy and so sweetly. It was worth it. And indeed, there is probably never enough milk - there is not enough willpower or sincere desire.

Expert opinion

The situation in which Julia found herself was certainly very difficult and alarming for her. It should be noted that postpartum mastitis not that rare; on average they occur in 3–10?% of women. This condition is very painful for a woman: the nursing mother’s well-being suffers, her temperature rises, and weakness is noted. Changes in the affected breast can vary from mild local redness and moderate pain to a pronounced change in the color of the affected area, severe hardening and unbearable pain.

Added to all the negative aspects listed above is the fact that the woman is forced to somehow resolve the issue of feeding the child. Often you have to stop breastfeeding during treatment. There are often cases when, unfortunately, various reasons, it is not possible to return to breastfeeding the baby, and the baby remains on artificial nutrition with formula milk. This is exactly what the consultant to whom Julia turned for help mentioned.

Julia began her story by mentioning the need to consult a surgeon. That's right, mastitis is a surgical pathology, and the mammary glands should be examined by a surgeon if there is any suspicion of mastitis. But this does not mean that any case of mastitis will necessarily require surgery. More drastic measures (for example, such as the “puncture” mentioned by Yulia) are needed in the case of purulent mastitis, when an abscess forms in the gland and the pus from the cavity must be removed for recovery to occur.

I think that we should not blame the lack of pumping against the background of a flow of milk for what happened. The information that Yulia received during the course was absolutely correct - milk flow does not require pumping. True, there is one condition - if the child actively sucks on both mammary glands. Considering what Yulia wrote - inverted nipples, pain during feeding, uncomfortable positions that prevent the baby from optimally attaching to the breast during feeding, and most importantly, the lack of practical assistance from medical staff in teaching proper latching - you can a large share likelihood to assume that the release of the mammary glands against the background of milk flow was ineffective. Stagnation of milk and possible infection through microcracks in the nipple - these factors may well be sufficient for the development of mastitis. So it's not lack of pumping that's to blame. Proper attachment to the breast with frequent feedings could prevent the development of mastitis in this case.

I agree with the opinion of the lactation consultant and those surgeons who recommended expressing milk from the affected breast. Lactation does not stop with the development of mastitis; accordingly, milk must still be removed from the gland. If one can agree with the ban on feeding a baby in the case of purulent mastitis (there is no need for a child to receive infected milk, and even with an antibiotic, which is necessarily prescribed for a purulent process), then the ban on pumping is absolutely illogical. Gently expressing by hand or with a breast pump promotes faster healing and helps you return to breastfeeding after recovery, because lactation will continue.

The lactation consultant is also right regarding the temporary transfer of the baby to adapted milk formulas. You should not even feed your baby from a healthy breast during treatment of purulent mastitis - the baby, along with the milk, will receive medications that are not harmless to his health.

But regarding the need to hospitalize a patient with mastitis in a hospital, it is difficult to say unequivocally. The tactics in each individual case are determined by the surgeon consulting the woman. Not in all cases is outpatient treatment (without going to the hospital) acceptable, as was the case with Yulia. It is difficult to comment on the situation with the treatment of mastitis. I assume that the pain when pumping prevented Yulia from removing milk from her breast more effectively. Perhaps this was the reason that the process was somewhat delayed. Swelling of the breast tissue, inevitable with mastitis, also prevents good milk flow. Well done that she survived everything! It must be admitted that not every woman could maintain lactation so persistently. Moreover, surrounded by such contradictory opinions of doctors!

When the swelling of the gland became less pronounced and the inflammation decreased, the purulent cavity in the chest began to drain well (empty). This explains the “flow of pus” from the breast that Yulia mentioned when pumping.

Without knowing all the details, it is difficult to guess why the child’s illness began exactly as Yulia describes it. Severe intoxication (the effect of bacterial toxins on the body), severe weakness against the background of current pneumonia, dehydration (lack of fluid in the body due to a deficiency in its supply) could be the reason that the baby “did not wake up in the morning.” I admit that, most likely, there were some alarming signs on the eve of the illness that would have allowed the parents to suspect something was wrong in the baby’s condition. But Julia had her own serious problem at this moment, therefore, perhaps, she and her husband simply could not see any nuances regarding the child’s health.

You shouldn’t immediately blame “fanaticism” regarding breastfeeding for all the troubles during lactation. And where would we be in this matter without a certain amount of healthy fanaticism?! All lactation consultants know very well that success depends on a woman’s positive attitude towards breastfeeding and confidence in her abilities. Hence the phrase often used by consultants - “milk is formed not in the mammary glands, but in the head”; The more confident a woman is, the more successful she will be in breastfeeding. That's why the lactation consultant was concerned when she called Julia after what happened to her and her baby. Under no circumstances should we allow my mother to begin blaming herself for what happened. Otherwise, I would have to forget about lactation.

Answering Yulin’s question about supplementary feeding, I would like to note that you should not rush to offer it to your baby immediately after birth. The prolonged sucking that Yulia mentions is quite normal in healthy children. Judging by the baby’s behavior, as a rule, it is clear that he is not getting enough – the baby is restless, wakes up quickly, is nervous at the breast, and sucks out little milk. And such a child will not urinate a lot (less than 6 diapers will be wet per day). If these signs were not present, there is no reason to say that the baby was malnourished.

After Yulia’s child began to recover, she began feeding him formula milk, first by the hour, and then, observing the child’s anxiety, she thought about feeding him formula not “on a schedule,” but on demand. Of course, rules for feeding formula by the hour exist for healthy children. But even they often show signs of hunger and require feeding before the due hour. It is difficult to say why Yulia had to prove something in the hospital and “fight for formula feeding on demand.” A sick child lives according to a special schedule, and if he wants to eat earlier, why should he be forced to do so? So, in demanding additional feeding for the baby, the mother was absolutely right. I think that the reason for the refusal was not the callousness or inattention of the staff, but the fact that each hospital has its own established daily routine, which specifies the time for preparing and distributing milk formula. Deviations from this routine are not very convenient for medical workers, although to their credit, most of them try to adapt to the needs of each individual child.

In refusing to bacteriologically culture milk for staphylococcus, the doctors were absolutely right. Since the presence of this microbe in the breast milk of a nursing mother is allowed, this is not a reason to refuse breastfeeding. Hence, there is little point in sowing milk in this situation.

Children in the first months of life have a very good sucking reflex. Yulia's child was successfully fed from the breast for some time after his birth (before his illness). The baby managed to get a positive experience of breastfeeding. In my opinion, it was this, as well as Yulia’s exemplary perseverance, that contributed to the child’s rapid return to breastfeeding after a period of formula feeding.

Frequently applying the baby to the mother's breast often turns out to be more effective than any other methods for increasing lactation. When a baby sucks at the breast, the level of the hormones prolactin and oxytocin, which are responsible for the production and release of milk, increases in the mother’s body. That is, breastfeeding itself helps maintain and stimulate lactation. Other measures, including lactogonic drugs (including homeopathic ones), various teas and herbal decoctions, are not as effective as frequent feeding of the baby to the breast.

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Purulent mastitis is a complication of mastitis caused by infection, when the causative agent of the disease enters the breast tissue through cracks in the nipples or from foci of chronic inflammation in the mother’s body.

At purulent mastitis the diseased gland needs to be expressed regularly, and you can continue to feed the baby from a healthy breast, but provided that the mother has been prescribed antibiotics that are compatible with breastfeeding.

Treatment of breast abscess is carried out only in a hospital. Doctors have low-traumatic methods for removing an abscess; contact highly qualified mammologists.

Continuing breastfeeding is possible even in cases where breast surgery could not be avoided.

What causes purulent mastitis?

Purulent mastitis is a scourge that all nursing mothers fear, but very few actually encounter it. The main causes of purulent mastitis are a simultaneous decrease in a woman’s immunity and the entry of a pathogen (staphylococcus or streptococcus) into the breast tissue, as well as poor milk flow from the breast.

Purulent mastitis usually occurs as a consequence of mastitis caused by infection. If during treatment with antibiotics there is no improvement, and the lump in the breast becomes softer, more mobile, but does not disappear, and feeding continues to be sharply painful, you need to do an ultrasound of the mammary gland and contact a breast surgeon.

With purulent mastitis, pus may be released from the breast: if you express milk onto cotton wool, its veins will be clearly visible. However, with an abscess, pus may not be released, so an ultrasound and consultation with a mammologist are the most reliable ways to determine what is happening to the breast.

As a rule, such an unpleasant development of events is more common in those nursing mothers who had purulent-septic inflammation during childbirth and have foci of inflammatory chronic diseases. Also at risk of purulent mastitis are women with changes in breast tissue (mastopathy, breast injuries) and those who have already encountered this problem during a previous history of feeding.

If lactostasis can be mistaken for mastitis, then purulent mastitis is difficult to confuse with lactostasis. Firstly, the first one almost never starts in one day. It takes time for the abscess to mature - at least 3-4 days.

The abscess will be very painful, hot to the touch, the skin over it turns red, and it becomes painful to move your hand. Sometimes it happens that the skin over the abscess, on the contrary, becomes very pale. Purulent mastitis can resolve without fever; this circumstance makes it difficult to make a diagnosis, and women do not receive the necessary medical help on time.

How to reduce the risk of developing purulent mastitis?

Try to avoid lactostasis. It has been proven that feeding a baby according to a schedule increases the risk of lactostasis and mastitis, so in the first months of lactation you should not limit the time of feeding. It is also advisable not to use pacifiers and nipples, because they form the baby’s habit of sucking incorrectly, which makes it difficult for milk to flow out of the breast and often leads to cracked nipples. And cracks are “entry gates” for infections.

Proper attachment, frequent feedings, clean underwear made from natural materials without pits, frequent washing of hands and breasts once a day are sufficient measures to protect against mastitis. If a woman followed all these rules, but could not avoid problems, she urgently needs help. immune system. To do this, you need to give the young mother the opportunity to get enough sleep, reduce any stress and take care of a diet rich in vitamins, especially vitamin E.

To prevent mastitis caused by infection from taking on its menacing purulent form, be sure to follow the rules for its treatment. Cannot be used alcohol compresses, and resort to the help of any warming agents for a short time.

If there is an infection in the chest, heat will encourage its development. You can only warm your breasts for a few minutes before feeding to improve milk flow. After feeding, it is better to apply cold to it in order to relieve swelling.

Do not squeeze out the seals, do not rub them, do not knead them! If it turns out that such a lump is not a milk lobule filled with stagnant milk, but an abscess, the infection can spread throughout the entire mammary gland. Until a diagnosis is made, you can stroke and gently finger the lump while breastfeeding.

Don't stop feeding! Only if there is a significant amount of pus in the milk, express the sore breast every 3 hours with a powerful breast pump or using a hot bottle and pour out this milk. Healthy breasts can be fed without restrictions. Even if you are prescribed antibiotics, continue breastfeeding, of course, monitoring your baby's reaction to the drugs.

How is purulent mastitis treated?

It is important to remember that delay in treating purulent mastitis leads to more serious interventions, delayed recovery and the risk of recurrence of the disease.

If pus is found in the milk, but there is no abscess in the breast, the doctor will prescribe antibiotics and medications that help relieve pain and inflammation. It is very important throughout the treatment of mastitis to empty the breasts on time and not allow them to become engorged.

The better the flow of milk is established, the faster the woman’s body will cope with the disease. The pus that is in the ducts of the breast, with proper treatment and good emptying of the breast, usually comes out quite quickly, and the breast completely restores its function within a week.

If a single abscess is found in it, the doctor can remove the pus with a special needle under ultrasound control. Then the young mother is necessarily prescribed antibiotics and a repeat ultrasound.

In more complex cases of the development of purulent mastitis, surgical opening of the abscess and installation of drainage may be required. This operation is performed in a hospital and always under general anesthesia.