Serous mastitis

Serous mastitis is a pathology that often brings a lot of unpleasant sensations and disrupts the normal process of breastfeeding. This is due to the fact that mastitis often develops in nursing mothers due to the peculiarities of the feeding process. The prevalence of serous mastitis is high and the main task is to prevent the development of a purulent process with further complications. Therefore, knowledge of the causes and main symptoms will allow you to contact a doctor in a timely manner and prevent such consequences.

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Epidemiology

The epidemiology of serous mastitis is such that every second nursing mother encounters this pathology. Therefore, more than 90% of cases of diseases have a lactation genesis. About 50% of cases of serous mastitis occur with complications in the form of infection and the formation of a purulent process, which indicates an incorrect treatment tactic or its untimeliness. This must be taken into account in order to avoid such high rates of complications, because then not only the mother suffers, but also the child, who must be weaned during this period.

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Causes serous mastitis

Knowing the main causes of serous mastitis development allows not only to prevent the development of this process, but also to better treat the disease in the early stages, affecting all links of pathogenesis. Mastitis is an inflammation of the mammary gland, which is diffuse in nature, that is, both the parenchyma and milk ducts become inflamed. The word "serous" means that the process is favorable, that is, the inflammation is not purulent. In this case, the inflammatory infiltrate does not consist of many leukocytes, as in purulent mastitis, but of lymph and intercellular fluid. This indicates that it is possible to prevent the formation of pus by timely intervention in the process.

A common cause of serous mastitis is improper care of the gland. A woman learns this process in the maternity hospital, so you need to listen and remember the main points. There is no need to wash the gland before and after each feeding, but it is enough to just wipe the nipple with a drop of milk. At the same time, you do not need to rub the nipple hard to avoid cracks. As for hygiene procedures, a morning shower is enough, and there is no need to specially wash the gland. Minimal interventions are the key to successful feeding. It is very important that the child covers the entire nipple during feeding, does not pull it, but eats calmly. At the same time, cracks do not form so often, which is the main reason for the development of serous mastitis. The pathogenesis of serous mastitis is a violation of the normal outflow of milk, which in turn leads to its stagnation. Breast milk is an excellent nutrient medium for various microorganisms, including bacteria. Therefore, only in case of milk stagnation, the processes of absorption and secretion of lactic acids and other components are disrupted, which leads to a disruption of the process of cellular filtration. At the same time, the process of formation and movement of intercellular fluid is also disrupted - this serous fluid penetrates into the tissue of the mammary gland, forming an infiltrate. The process of lymph outflow is also disrupted, which then leads to even greater changes and thus inflammation of the gland tissue with serous contents occurs. If any amount of opportunistic bacteria gets into this serous infiltrate, then progression of the inflammatory process with the formation of purulent mastitis is possible. But in this case, a mandatory condition is damage to the skin, which is an entry gate for infectious agents. That is why it is so important to avoid cracked nipples.

But it is also necessary to talk about the reasons for the development of serous mastitis in non-nursing mothers, because this also happens. At the same time, any woman can feel all the symptoms of this disease, not being pregnant or in the case of postpartum mastitis. Then the most common cause of serous mastitis in a woman who does not have other risk factors can be surgery or any intervention on the mammary gland. Very often, young women who have not yet experienced the joy of motherhood resort to plastic surgery to increase the size of their breasts. In this case, they are warned about the possible complications of such a procedure, one of which is mastitis. This happens because the anatomy of the milk ducts is disrupted due to their compression by the implant, and this contributes to the development of artificial lactostasis. Therefore, a process such as mastitis can very often develop.

We should not forget about other external causes of serous mastitis, because any operation entails the possibility of infection.

It is important to know about the causes and risk factors for the development of serous mastitis not only in order to select adequate treatment, but also in order to prevent this disease.

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Risk factors

It is also important to know the risk factors for serous mastitis in order to avoid them. Among these factors, lactostasis is in first place – milk stagnation in the mammary gland of a nursing mother. After childbirth, a woman begins to secrete milk to feed the child, which is normally regulated by sex hormones. At the same time, the mammary gland produces the amount of milk that the child needs. But with various disorders, including improper feeding and care of the mammary gland, the process of normal lactation can be disrupted, which leads to the development of serous mastitis. Therefore, the main cause of serous mastitis can be called violations of the process of feeding and breast care. Therefore, it is very important to put the newborn baby to the breast without night breaks, on demand. This contributes to the normal formation of the lactation process, because at night, hormones are released that affect the milk ducts. This allows you to establish a normal lactation process during the first month of the child's life, and in the future to avoid various problems.

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Symptoms serous mastitis

To understand the symptoms of this disease, first, it is necessary to find out the processes that occur in the gland tissue itself. The infiltrate that forms in the mammary gland can be localized or can spread throughout the tissue. Accordingly, there are two main types of mastitis - localized and diffuse, which also differ in symptoms.

Also, in some cases, there may be a staged spread of the process. In this case, the following stages are distinguished:

1. local - at this stage the process occupies only a small area of the gland;
2. widespread stage – characterized by infiltration of the entire gland;
3. complicated stage – when any complications appear.

The first signs of serous mastitis can be easily suspected when pain occurs for the first time during feeding and the child's dissatisfaction with the milk consumed is visible. At the same time, the infiltrate that forms compresses the milk ducts and the process of milk outflow is disrupted - therefore, when the child sucks the breast, he does not get enough. This makes him put in even more effort, which causes pain in the chest during feeding. The severity of pain can be of different nature, but in most cases it is the first sign of such a pathology. Then the lactation process becomes even more complicated, since lactostasis worsens the outflow of not only milk, but also the outflow of lymph, and the entire process of blood circulation in the gland. Therefore, the process of infiltrate resorption is complicated. Along with these symptoms, others appear. First of all, a feeling of heaviness and engorgement appears, which causes pain and discomfort. One gland increases in size and this also causes discomfort, but there are no systemic manifestations or local inflammatory reactions in the form of redness of the gland or an increase in body temperature.

There may be other symptoms - drops of clear non-inflammatory fluid are released from the nipple before feeding or between feedings - this is the serous secretion that is the substrate of the disease. At the same time, there are no purulent or bloody discharges - which indicates serous mastitis. Therefore, the main symptoms of serous mastitis are in the subjective sensations of the woman, which is important to understand at this stage for conducting and differential diagnostics.

Further, as the disease progresses, when the serous secretion spreads to the entire gland, then it increases even more and the process of lactostasis is more pronounced. In this case, not only is the feeding process complicated, but it is also difficult for a woman to even express milk. If such a process develops over the course of one week, then this is acute serous mastitis. Chronic process is rare, since due to the disruption of feeding at this stage, women treat acute inflammation, not allowing it to become chronic.

Serous lactational mastitis is the most common, as the process itself is a risk factor for the disease. Therefore, the symptoms listed above are associated with lactational mastitis. At the same time, the treatment of such mastitis has some peculiarities. Non-lactational serous mastitis occurs precisely as a result of surgical interventions. At the same time, the lactation process is in no way associated with mastitis. The symptoms are also similar, but the first sign may be the release of serous secretion from the nipple. This should alert the woman and force her to take action.

It is necessary to know the main symptoms of mastitis in order to contact a doctor in time at the initial stage and avoid the unpleasant process of surgical treatment of pathologies that have already arisen against this background.

Complications and consequences

Complications that most often occur with serous mastitis are purulent inflammation with the formation of purulent mastitis or abscess. This occurs due to the lack of adequate treatment of the serous process, in which pathogenic microorganisms enter the infiltrate and cause an immune reaction with the formation of a purulent process. If such a process is limited by a capsule, then we are talking about an abscess, which is a serious complication and requires surgical treatment.

The consequence of untimely and inadequate treatment of serous mastitis may be phlegmon of the mammary gland - this is a diffuse inflammation with destruction of glandular tissue. All these complications are also dangerous because during the period of treatment of the purulent process the child should not be breastfed. This greatly affects the health of the baby, since this is the main nutrition for its normal development.

Also, one of the consequences of improper treatment of serous mastitis may be the formation of cysts or galactocele. These structures are formed due to the expansion of milk ducts, their distal parts, which is accompanied by the accumulation of fluid in them. Such cysts are potentially dangerous, since they may become purulent or cause complications when feeding future children.

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Diagnostics serous mastitis

Diagnosis of serous mastitis should be timely - and this is the main thing that a nursing mother should remember in order to maintain normal lactation. Therefore, if any symptoms appear or if you have any questions, you need to contact a doctor. You can even call a regular pediatrician on the phone, who will be able to tell you whether the problems with feeding are related to normal physiological reasons or these are symptoms of a disease. And only in the latter case should you contact a specialist.

Diagnosis of serous mastitis should begin with collecting the patient's complaints and clarifying the nature of feeding. It is necessary to find out whether lactation was normal from the first days, and whether there was a problem with milk stagnation before. It is necessary to pay attention to a possible increase in body temperature. Then it is necessary to conduct an external examination and palpation of the mammary gland. With serous mastitis, you can see a seal and a painful infiltrate in the thickness of the gland, but the area is not red. If you press lightly on the gland, then a clear liquid may be released from the nipple. Such changes indicate a benign process.

The tests that are necessary for the diagnosis of serous mastitis consist mainly in the exclusion of other pathologies and are general clinical. For diagnosis, it is necessary to pass a general blood test, urine test, and blood sugar level. There should be no changes in the general blood test; when mastitis becomes purulent, then we can talk about some changes. Other tests should also not differ from the norm.

Instrumental diagnostics of serous mastitis is used more often for the purpose of differential diagnostics or in long-term treatment of the acute process. In this case, the main diagnostic method is ultrasound examination. This method uses ultrasound, which normally penetrates evenly through all layers of the mammary gland. If there is milk stagnation, infiltrate or serous fluid in the interstitial tissue, this will be visualized on the monitor in the form of different echo signals. Such ultrasound diagnostics allows you to accurately determine the size and location of mastitis, and also makes it possible to determine the presence of a capsule. Also, using this diagnostic method, you can monitor the effectiveness of treatment.

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Differential diagnosis

Differential diagnostics of mastitis is very important, since the treatment tactics for its different forms differ. The main pathologies with which differential diagnostics of serous mastitis should be carried out are purulent mastitis and abscess. Purulent mastitis is accompanied by severe pain in the breast, its redness, and the release of pus from the nipple. Whereas with serous mastitis, these symptoms are absent. Also, with purulent mastitis, there are systemic manifestations in the form of hyperthermia, headache, muscle pain and other manifestations of intoxication syndrome.

An abscess of the mammary gland has similar clinical manifestations to serous mastitis, since this process is limited by a capsule and there may not be redness with purulent discharge. At the same time, as with a serous process, there is engorgement and an increase in the area in volume without redness. The only distinctive feature of an abscess is fluctuation during palpation, so it is very important to carefully examine the gland. If there are doubts during a visual examination, then the diagnosis can be confirmed using ultrasound.

Timely diagnostics and thorough differential diagnostics allow for a correct diagnosis and treatment.

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Treatment serous mastitis

The main principles of treating serous mastitis are to normalize milk flow, which reduces swelling and improves blood circulation and lymph flow from the area. This allows the serous fluid inside the gland to be absorbed, and the problem resolves itself. In this case, non-drug treatment methods are used, and drugs can only be used symptomatically or for prevention purposes.

First of all, it is necessary to emphasize that if mastitis is serous in nature, and the woman does not take antibacterial agents, then breastfeeding should be continued, because it improves milk flow and accelerates recovery.

Treatment of serous mastitis should begin with proper milk expression. To do this, you can simply express with light massaging movements along the ducts in a radial direction to the nipple, or you need to use a breast pump. After all, it is necessary not only to improve the outflow of milk through the milk ducts, but to eliminate the milk that has stagnated and can be a source of further infection. The use of such a breast pump should be correct, according to the instructions. Elimination of milk stagnation reduces swelling and allows the serous fluid to be absorbed and excreted with the lymph outflow faster. Massage is very helpful in the treatment of serous mastitis. The advantage of this method of treatment is not only its effectiveness, but also the possibility of treatment at home. Massage in this case relaxes the muscle fibers of the milk ducts, stimulates their contraction, and thus the contraction of these fibers improves and milk is better released from the milk ducts, and then lactation itself improves. In this case, compacted areas in the breast can be massaged and the outflow of milk from these areas can be normalized. Massage also improves blood circulation and lymph drainage from the breast, which in turn relieves swelling in serous mastitis. The result of this method depends on the correct implementation of all components of the massage and subsequent milk expression. For correct execution, massage movements should be gentle and light to avoid pain and injury. The technique for this procedure involves stroking, rubbing, kneading with gentle, smooth movements. With the fingers of both hands, you need to perform massage movements from the top to the nipple. Next, you need to stroke around the gland in the direction of the armpits - to the places of lymph drainage. After such a massage, you must express milk and you can put a warm heating pad on the chest, which relaxes muscle fibers and improves blood circulation. The massage course should be carried out during the week twice a day. After several procedures, the effect will be noticeable in the form of a decrease in the size of the gland and the removal of serous infiltrate.

Medicines used for serous mastitis are mainly aimed at local symptomatic action. Systemic administration of medications for serous mastitis is not required. Compresses from ointments and tinctures are used for treatment. The main medicines used for treatment are:

1. No-shpa is a drug that has a myotropic antispasmodic property, which is realized by acting on the muscle fibers of arterial vessels, and this also leads to their expansion and pressure reduction. In serous mastitis, the drug is used as a combination treatment as a compress to improve milk flow and reduce the severity of symptoms. This is how the analgesic effect of no-shpa is realized for chest pain and engorgement. An additional effect of the drug is its tocolytic effect, which allows it to be used even in the first days of the postpartum period. Side effects of the drug can manifest themselves in dyspeptic phenomena - nausea, abdominal pain, stool disorders. In susceptible people, the drug can cause allergic reactions of varying degrees from simple rashes to severe edema. A sharp expansion of blood vessels can cause a decrease in blood pressure and bradycardia. Dilation of peripheral blood vessels of the skin can manifest itself in hyperemia and excessive work of the sweat glands. The method of using no-shpa and the doses used depend on the severity of symptoms and the need for a quick pain-relieving effect. The dosage of tablets is 10, 20, 40 milligrams. Solution in ampoules 2% in a volume of 2 milliliters. For complex treatment, it is recommended to use no-shpa intramuscularly or in tablet form for severe pain syndrome, as well as in the form of compresses for local treatment. To do this, take several ampoules of no-shpa, dilute in a glass, then moisten a gauze cloth folded in several layers, and apply to the compacted areas of the chest. Dry gauze and film can be applied on top. It is better to wear loose underwear so that there is no strong compression. Such compresses should be done several times a day.
2. Malavit is a natural medicine that contains many components - sage, mint, chamomile, yarrow, peony, calamus, calendula, oak bark, birch, pine, fir and cedar resin, as well as glycerin and other oils. Due to this composition, the drug has an anti-edematous, anti-inflammatory effect, relieves itching and pain. The drug is available in the form of a solution for external use, so to treat serous mastitis, it is necessary to use the drug as a compress. For such a compress, you need to take 50 milliliters of Malavit solution and you can add Dimexide to it, then make a gauze pad and soak it in the solution. It is better to do such a compress several times a day or alternate its use with compresses from no-shpa.
3. Progestogel is a hormonal drug consisting of progesterone, a natural hormone. Due to the form of release, this product is convenient to use in the form of a gel to treat such pathologies, especially if mastitis is lactational. Progesterone penetrates the breast tissue and reduces vascular permeability, relieves swelling and normalizes the mitotic activity of milk duct cells. Progestogel is not absorbed into the systemic bloodstream and does not cause side effects, but slight redness or itching in the area of application is possible. Dosage and method of use of the drug - a small drop of gel should be rubbed on the mammary gland, using this treatment twice a day. Precautions - cannot be used for more than two weeks, as local complications are possible due to the composition of the drug.
4. Menovazin is an ointment that contains alcohol, menthol, anesthesin and novocaine, which is why the drug has an analgesic effect. Menthol also dilates blood vessels and improves blood circulation in the gland. How to use the drug: apply a small amount of ointment to the chest with massaging movements. Side effects are possible in the form of redness at the site of application of the ointment, which is caused by the presence of menthol. If the itching sensation is severe, wash off the ointment. Precautions: do not use the drug if you are allergic to novocaine.

Vitamins for the treatment of serous mastitis can be used in complex therapy, especially if the diet of a nursing mother does not provide all the nutrients. In this case, it is recommended to use complex vitamins in combination with microelements - Vitrum, Supradin, Undevit, Kvadevit.

Physiotherapeutic treatment of serous mastitis has a very good healing effect due to its active influence on the vessels and parenchyma of the gland. The main effect of such procedures is to improve lymph drainage and blood circulation, which relieves swelling, pain and inflammation. Many techniques can be used, but only if there is no purulent inflammation. Electrophoresis is a method by which drugs penetrate the skin with ions under the influence of voltage. In this case, you can use Magnesia, Dimexide, Malavit and other antiseptics and anti-inflammatory drugs. This accelerates their effect and improves the action of these drugs. You can also use infrasound and magnetotherapy with a high-intensity pulse wave.

Traditional treatment of serous mastitis

Traditional treatment of serous mastitis is used very often, since this process can be cured by such means without the help of antibacterial drugs. For this purpose, compresses from herbal infusions and medicinal products are used, which, together with proper milk expression, are very effective. The main traditional recipes are as follows:

1. Cabbage compresses are known for their pronounced effect on any swelling, including swelling of the mammary gland caused by serous mastitis. Cabbage leaf restores local blood circulation and normalizes the function of milk secretion, which is very important in the treatment of mastitis. To prepare a compress, take a cabbage leaf from the middle of the head, rinse it in warm water and put it on the chest, fixing it on top with underwear. It is better to do such a compress at night. In the morning, you need to express milk.
2. Honey is a product known for its multifaceted healing effect, which helps improve the filtration and absorption of serous fluid from the interstitial tissue of the mammary gland. It can be used as a compress in combination with other drugs, such as papaverine, magnesium sulfate or other ointments. For the compress, take honey in a semi-solid state, make a small cake out of it and apply it to the chest. Such a compress should be covered with cling film on top, which improves the warming effect. The duration of therapy is at least two hours a day.
3. An alcohol compress is known for its warming properties, but only if there are no contraindications in the form of purulent inflammation. To prepare such a compress, you need to take alcohol, soak a gauze cloth in it, you can also add aloe juice, and apply as a compress. But you should not forget about the possible harm of such a compress for the child, so before feeding you need to wash your breasts.

Herbal treatment of serous mastitis is also very effective, as herbs can be used as a compress, as well as medicinal infusions or ointments.

1. Arnica is a plant that has a very good effect when used correctly and systematically. This plant has an anti-edematous, antispasmodic, desensitizing effect. The drug also activates the processes of infiltrate resorption, stimulating the secretion of milk through the ducts, and thus improves blood circulation, thereby reducing the heaviness in the gland and swelling. As a compress, you need to use a tincture, for which you boil the herb in hot water. Treatment should be carried out in the morning and evening, by applying a compress to the affected areas.
2. Yarrow - has many useful fatty acids that can penetrate the skin and normalize lactation processes with relaxation of milk ducts. To prepare a compress, you need to steam the herb and make a compress from the infusion. You can take it internally in parallel with the use of honey.
3. St. John's wort - used for its antispasmodic effect, as well as its ability to reduce pressure in blood vessels and improve blood flow from the area of inflammatory tissue. To prepare a compress, you need to infuse St. John's wort leaves in a small amount of water and apply several times throughout the day.

Homeopathy can also be widely used in the treatment of serous mastitis as a local remedy.

1. Mucosa compositum is a homeopathic remedy of inorganic origin. This remedy improves local blood circulation in the mammary gland, and is especially effective for nipple cracks and breast pain. The dosage of the drug at the beginning of treatment is five homeopathic granules three times a day, then after two weeks the dose should be reduced to three granules per day. Side effects are possible in the form of nagging pain or discomfort in the lower abdomen, which goes away after a few days. Precautions - the drug should not be used in case of a purulent process in the gland.
2. Echinacea is a homeopathic remedy of natural plant origin. This plant is primarily a systemic remedy for improving lactation, since the plant stimulates active secretion of milk. The method of using the drug is using a homeopathic solution in ampoules, dissolving them in clean water. In case of lactostasis, it is dosed at half a teaspoon twice a day. Side effects can be in the form of increased pressure, tachycardia, insomnia. Often there are stool disorders in the form of diarrhea. Precautions - in the presence of arterial hypertension, take with caution, under the control of blood pressure - if it rises, you need to reduce the dose or stop taking the drug.
3. Merculis is a single-component drug that has a very pronounced antispasmodic effect due to the relaxation of cells in muscle fibers. For the treatment of lactostasis, it is recommended to use an ointment, which is especially effective in cases of severe swelling and a feeling of heaviness in the chest.

Surgical treatment of serous mastitis can be used only when complications develop. If we are talking about infection and the development of purulent mastitis and abscess, then surgical treatment must be used. In this case, the purulent focus is opened, drained and active antibacterial therapy is performed. In other cases, when serous mastitis has a benign course, then surgical intervention is not required.

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Prevention

Prevention of serous mastitis is very simple, so knowing the basic rules of proper feeding and breast care, you can easily prevent any complication. The main preventive measures are as follows:

• You need to feed your baby according to his needs, without paying attention to night breaks, and put him to the breast at least every three hours during the first month;
• Proper breast care is very important between and before feedings. You should not wash or rub the nipple vigorously every time - this is a risk factor for cracks. You need to wipe the nipple with a drop of milk before each meal. A morning shower is enough and there is no need to wash the gland with soap or other means every time.
• Adequate sleep and normal nutrition for a nursing mother are very important for normal milk production and the prevention of mastitis.

Forecast

The prognosis for recovery from serous mastitis is favorable with timely treatment measures.

Serous mastitis is a non-purulent inflammation of the mammary gland, which disrupts the normal process of feeding the child and causes discomfort. The disease itself is not as serious as possible complications, which develop quickly if left untreated. Therefore, it is important to pay attention to any symptoms associated with chest pain, discomfort or disruption of normal feeding, as this affects the health of your baby first and foremost.