Symptoms of acute mastitis, most common during lactation

Acute mastitis is the most common disease in women during breastfeeding, especially for first-time mothers. If it is simple acute mastitis, the patient will experience breast pain and high skin temperature. Timely anti-inflammatory treatment will be enough. If it is purulent mastitis, breastfeeding should be stopped.

1. Symptoms and Signs

1. Acute simple mastitis

In the early stages, the breasts are swollen and painful, with high skin temperature and tenderness. Due to milk stagnation and poor venous and lymphatic return, hard nodules with unclear boundaries appear in the local breasts. If this stage is handled correctly, the inflammation can dissipate.

2. In acute suppurative mastitis, the local skin is red, swollen, hot, and painful, with obvious nodules and increased tenderness. The patient has symptoms of systemic poisoning such as chills, high fever, headache, weakness, and rapid pulse. Ipsilateral axillary lymph nodes are swollen and painful.

3. Abscess formation stage

Acute mastitis becomes localized, forming an acute breast abscess. At this time, the mass fluctuates, and the fluctuation of superficial abscesses is relatively obvious. The abscess can burst outward or inward into the milk duct, draining pus from the nipple. When the abscess breaks into the loose tissue in front of the pectoralis major muscle behind the breast, a retromammary abscess is formed. Breastfeeding should be prohibited at this time

2. Pathological causes

1. Bacterial invasion

The pathogenic bacteria of this disease are mostly Staphylococcus aureus, and a few are Streptococci. Bacteria enter through the cracks in the nipple skin or the chapped areola, spread along the lymphatic vessels to the fat and fibrous tissue between the mammary lobules and the glandular lobules, causing acute suppurative cellulitis of the breast. In a few cases, postpartum infection complications occur in other parts of the body, and the bacteria spread to the breast through the blood circulation, causing illness (Figure 1).

2. Milk stasis

Breast milk facilitates the growth of invading bacteria. The causes of milk stasis include: ① The nipples are too small or inverted and are not corrected in time before birth, making it difficult for the baby to suck milk or even unable to breastfeed. ② Excessive milk and incomplete emptying. The mother does not understand the secretion of milk, and the excess milk cannot be discharged in time and is retained in the breast. ③ Blockage of the milk ducts makes it difficult to discharge milk. Inflammation, tumors and external compression of the milk ducts themselves can all affect normal breastfeeding.

3. Cracked nipples

After delivery, if the mother fails to master the correct breastfeeding technique, or the baby's sucking is abnormal, or if irritants such as soap or ethanol desiccant are used excessively on the nipples, or if the baby's oral motor function is disordered, nipple fissures may occur, allowing bacteria to invade through the small cracks in the nipple and reach the subcutaneous and interlobular tissues through the lymphatic vessels to cause infection. When the nipples are cracked, breastfeeding is painful and the milk cannot be fully sucked out, causing milk stasis and creating conditions for the reproduction of invading bacteria.