Symptoms and treatment of lactostasis in a nursing mother. All about the symptoms and treatment of lactostasis Lactostasis symptoms treatment

Lactostasis is a stoppage of movement through the ducts (stagnation) of breast milk, usually occurring in the first weeks of feeding a newborn. Primiparas are more likely to suffer from this pathological condition. The disease usually occurs between the first three days and six weeks of breastfeeding. The consequences of lactostasis are the multiplication in an excellent nutrient medium of microbes that have entered through the cracks of the nipples into the gland, and the formation of purulent inflammation.

How to distinguish lactostasis from mastitis? The first is a non-inflammatory condition, with no signs of inflammation. When there is redness of the skin of the gland, its swelling, severe pain and induration, an increase in local temperature in the area of induration of the relatively healthy gland, deterioration in general well-being. Mastitis requires immediate medical attention.

Causes and mechanism of development

The causes of lactostasis are primarily associated with the wrong way of feeding the child. This is facilitated by cracked nipples that appear in the first days of feeding. They are painful, disrupt feeding technique and make pumping difficult.

When breastfeeding is irregular or sucking is impaired, nerve impulses from the nipples and breast tissue carry incorrect information to the pituitary gland, a region of the brain. As a result, prolactin production in the pituitary gland decreases. This hormone regulates milk synthesis. Under its influence, oxytocin is also produced, which contracts the muscles of the uterus and stimulates the contraction of the milk ducts. As a result of a lack of prolactin and oxytocin, the lactation function of the ducts decreases, and acute stagnation of milk occurs.

Factors provoking the disease:

hypothermia, breast contusion;
emotional stress;
flat nipple shape;
constant pumping;
structural features of the gland (narrow ducts, too thick milk);
prematurity or illness of the child;
sleeping on your stomach;
using an inappropriate, tight, “pre-pregnancy” bra;
premature supplementary feeding with artificial formula or refusal of breastfeeding without taking measures to stop lactation.

Prevention of lactostasis during breastfeeding

It consists of training women in preparation courses for childbirth, the availability of available daily telephone consultation upon the patient’s request (“breastfeeding hotline”), and the proper organization of assistance to women who have given birth in the pediatric area.

A woman should also educate herself: read specialized literature, watch educational videos, listen to the advice of more experienced relatives and friends.

How to feed a child correctly to prevent the development of lactostasis?

put the baby to the breast as early as possible, if possible immediately after birth;
feed in a position that is comfortable for mother and baby;
make sure that it completely covers not only the nipple, but also the areola;
help the baby a little, holding the gland from below so that it is comfortable for him to suck, but without squeezing the ducts with your fingers;
don’t be afraid to learn yourself and teach your baby to latch on to the breast, sometimes this doesn’t happen on the first try;
feed the child “on demand” until he has formed his own feeding schedule;
in the first weeks, allow the baby to breastfeed as much as he wants;
apply to a different breast at each feeding;
to feed the baby at night, it is advisable to arrange it in such a way that you can easily move the baby’s crib to the mother’s bed during feeding.

Clinical picture

At the very beginning of the disease, a woman notices that milk began to be released worse, in a thinner stream, intermittently. The child’s behavior also changes: he does not eat enough, is capricious, and gets tired quickly. Usually a day or two after this, the clinical picture of lactostasis develops.

Symptoms of lactostasis in a nursing mother: severe engorgement of the gland occurs, it thickens, and becomes painful. More often the gland is affected on one side, less often on both. When pumping, patients experience pain, a feeling of fullness, and weak milk flow. Sometimes there is pain in the armpits. It is associated with an increase in additional lobes of the mammary glands, located slightly to the side of the main mass of secretory tissue.

Usually, a compacted area in the form of a “ball” or “cake” is felt in the gland. The skin over it may turn slightly red and a venous pattern becomes visible. Such a zone can appear in different parts of the gland and changes its size and position.

Often, signs of lactostasis in a nursing mother include an increase in body temperature. People often call it milk. It does not exceed 38˚ and lasts no longer than a day. If the fever is higher or longer and is accompanied by a deterioration in the woman’s condition, it is possible that lactostasis has already given way to mastitis.

With lactostasis, the woman’s general condition does not suffer. She has no weakness, weakness, sleep and appetite are not disturbed. She is able to care for her child.

Treatment of lactostasis

To treat this condition, two main tasks must be performed: to free the mammary glands from stagnant milk and to establish its normal secretion.

What you can do yourself

The correct feeding regimen should be established, sometimes completing it by expressing the remaining milk. You can use a breast pump for this. Both mechanical and automatic devices are suitable.

How often to express during lactostasis? This should be done no more than three times a day, emptying the corresponding mammary gland. It is not necessary to express milk at the end of each feeding if the woman does not feel an urgent need for it. If your breasts are full of milk, it is better to express a little of it before feeding. There is no need to pump at night. Read about how to strain lactostasis in our article below.

There is no need to limit drinking. Sage, hop cones, infusion of walnut leaves, and garlic (up to 5 grams per day) help reduce the formation of milk. But we should not forget that unusual plant products can slightly change the taste of milk, and the baby will refuse to eat it.

Such a common remedy as cabbage leaf can provide significant help to a woman with lactostasis. Firstly, a dense sheet warms up the tissue and improves its blood supply. Secondly, the active substances released by the plant have a decongestant, analgesic, and vasodilator effect. Before use, it is recommended to cut off the veins of the leaf, this will help the juice to be absorbed faster. It is best to apply cabbage leaf after feeding the baby. It can be placed directly into the bra cup, after washing and drying. This sheet should be changed after two hours; there are no contraindications for its use.

Remedies such as alcohol compress and camphor oil, as well as any other heating methods are not currently recommended, as they can cause mastitis or completely stop the formation of milk.

Traumeel gel has virtually no contraindications - a product based on herbal ingredients. It helps relieve swelling, pain and inflammation, improves the functioning of the milk ducts. For lactostasis, the medicine is applied to the skin of the gland twice a day; it is not harmful to the mother and child. In this case, a compress is not needed, the gel is simply applied to washed skin.

How to reduce the temperature that occurs during lactostasis without harming the baby? It is acceptable to use drugs such as Paracetamol or Nurofen. You cannot take Aspirin, non-steroidal anti-inflammatory drugs, Analgin.

Treatment of lactostasis at home is based on the use of folk remedies, tested by generations of Russian women, and on modern devices. It consists of three principles:

feed more often from the affected breast, while placing the baby so that his nose and chin “look” in the affected direction;
massage the affected gland;
Express milk infrequently, it is better in small quantities before feeding; after lactostasis is cured, additional pumping should be stopped.

One of the necessary conditions for improving well-being is an elevated position of the gland. It is better for a woman to use special nursing bras that support the breasts and distribute pressure on wide straps. If the breast hangs freely, excellent conditions are created for milk stagnation.

“cradle” - the mother sits and holds the baby in her arms, as if in a cradle;
feeding from under the arm: the baby lies on the side of the mother, facing her chest, while the additional lobules located closer to the axillary areas are well emptied;
“face to face”: the ideal position for feeding during lactostasis, since both glands are in the most favorable position from a physiological point of view.

You need to find several comfortable positions and alternate them.

1. Baby on mom
2. Overhang

1. Lying on your hand
2. From under the hand

1. Cradle
2. Cross cradle

The so-called straining of lactostasis is used when simple methods do not help; carried out before feeding the baby, at least every two hours:

first, leaning over the bathtub, you need to warm up the gland well with warm water from the shower, while simultaneously performing a chest massage; this can be done using a heating pad or a simple bottle of hot water;
massage should be carried out in a spiral, starting from the periphery and moving towards the center; it should not be kneading and cause pain;
feed the baby from the “sick” gland in one of the positions listed above;
gently massage the breast from the edges to the nipple, carefully feel the place where the lump remains, express milk or use a breast pump (it is better to express no more than three times a day so as not to cause excessive milk production);
Apply a bottle of cold water, a damp cloth or a plastic bag with ice, wrapped in a terry towel, to the site of the former seal for 15-20 minutes;
The baby should be fed twice from the affected gland, then once from the healthy gland, and again twice from the sick gland; you can offer him the breast even more often than he asks for. Of course, if the baby is not hungry, he will refuse to suckle, but you still need to try to breastfeed more often.

How can a doctor help?

What to do if home remedies for lactostasis do not help? Which doctor should I contact? Usually, a visiting nurse or pediatrician who visits the mother and child and monitors the breastfeeding process helps solve such problems. If home methods are ineffective, your doctor may prescribe physical therapy or medications.

Physiotherapeutic methods are safe for women and children, painless and very helpful in restoring lactation. Usually ultrasound, electrophoresis of medicinal substances, ultra-high frequencies (UHF), darsonval are used. These procedures can begin in the maternity hospital if a problem with feeding arose immediately.

For treatment at home, you can purchase an electrophoresis device at the Medtekhnika store. You can use Dimexide, Troxevasin and other drugs that improve blood circulation, but only after consulting with your supervising doctor.

To improve the emptying of the gland, Oxytocin is prescribed intramuscularly before feeding or pumping. To prevent this drug from causing painful contractions of the uterus, No-shpa is also administered intramuscularly half an hour before the injection.

To increase the volume of water, thereby reducing the amount of fluid in the body, diuretics (Furosemide, Hydrochlorothiazide) are prescribed.

To reduce milk production, Dostinex or Parlodel are prescribed. They are prescribed literally for one or two days; if taken for a longer period of time, such drugs can completely suppress the formation of milk. Also, for severe lactostasis, which many authors consider as the initial form of mastitis, penicillin antibiotics are used, which are safe for the child. They are prescribed to prevent the development of pyogenic microflora in the area of stagnation.

Features of lactostasis in men

It would seem, how can milk stagnation occur in atrophied mammary glands in men? It turns out that such cases do occur, although very rarely. They are usually associated with the release of milk under the influence of the hormone prolactin. It is secreted in men as a result of a benign or malignant tumor of the pituitary gland, a gland in the brain. In addition, sometimes milk begins to be released due to a deficiency of testosterone - the male sex hormone, lung tumors, hypothyroidism, excessive use of antidepressants, Verapamil and other drugs.

In these cases, men begin to secrete a small amount of milk. Since their glands do not have a well-developed structure, milk can stagnate inside, accompanied by the same symptoms as in women: engorgement of the gland, the formation of a painful compaction in it.

Treatment of lactostasis in men consists of treating the underlying disease. They have fewer restrictions on medicinal termination of lactation using hormonal drugs.

The birth of a child is a very important moment, especially if it is the first experience. Young mothers are under constant stress trying to provide proper care for their baby. In the first months of life, breastfeeding is an important aspect. And then some difficulties may arise for the young mother.

One of the problems may be lactostasis in a nursing mother, which leads to blockage of the milk ducts. As a result, the milk stagnates in them, the tissues swell, pain and fever appear. Lactostasis is clearly a pathology, which is classified by ICD code 10 092.7.0.
With timely treatment, lactostasis can be eliminated quite quickly, within a few days. However, if you self-medicate or ignore symptoms, lactostasis can develop into a more serious disease.

Stagnation of milk in the milk ducts can occur for several reasons.

When feeding the baby in the same position. As a result, the same ducts are released, and the rest of the milk remains. Thus, the milk duct becomes blocked.
Sleeping in the same position also contributes to the development of the disease. Milk accumulates in one part of the breast, mainly under the armpits.
Wearing tight underwear also leads to the development of milk stagnation. You should avoid tight bras or underwear with underwires that literally dig into the skin.
A young mother should not forget about replenishing fluids in the body. Drinking enough water will prevent the milk from becoming viscous. In this case, it will be difficult for the baby to suckle and the milk ducts will become clogged.
Quite often, the causes of lactostasis lie in trauma to the mammary gland. As a result of the impact, tissue swelling occurs and this prevents the normal outflow of breast milk.
A common practice among women who have given birth is pumping. But the milk that remains after feeding the baby should not be expressed. This causes a constant increase in lactation. The baby simply cannot cope with this amount of nutrition, and the remaining milk causes blockage.
Using nipples. A baby who drinks milk from a bottle using a pacifier will be reluctant to breastfeed in the future.

Previously, experts noted that the child needs to be fed once every 3 hours. The remaining milk after feeding had to be expressed. In fact, this schedule and method of feeding led to lactostasis or mastitis. To avoid such problems, it is enough to feed the baby on his demand.

At the initial stage of the disease, a nursing mother may not notice any particular deterioration in her health or other signs. However, after a few days the following signs of lactostasis appear:

pain and burning sensation in the mammary glands
feeling of discomfort while feeding the baby
mammary glands may take on a different shape
constant feeling of heaviness in the chest (stone chest)
the appearance of red spots on the chest or its complete redness
tissue swelling and swelling of the mammary glands

A fairly common symptom is temperature during lactostasis, which leads to general weakness of the body and chills. Usually, body temperature with this disease does not rise above 37.5 degrees. If the temperature continues to rise, this indicates the development of mastitis.
At this stage, it is important to know how to distinguish mastitis from lactostasis. As a rule, with mastitis, the symptoms of the disease appear more clearly and lead to a sharp deterioration in the woman’s well-being. The temperature with this disease is high. In order to understand that it is mastitis, experts advise measuring it not only in the armpits, but also in the groin and elbow bends.

When to see a doctor

Usually, stagnant processes in the milk ducts disappear within a few days. At this time, experts recommend feeding the baby more often. The baby can independently solve the problem of milk stagnation. Expressing during lactostasis immediately after feeding is not recommended.
If you do not feel better within 2-3 days, and the heaviness in your chest does not go away, then you should consult a doctor so that a simple disease does not develop into a more serious form. Using an ultrasound, the diagnosis will be determined and the correct treatment will be prescribed. If the treatment does not produce results, then they resort to laser removal of the seal.

Massage can be a good help with lactostasis. In the early stages, it will help get rid of unpleasant sensations and remove stagnation. It is best to do a massage after taking a relaxing shower. Before starting the procedure, you must wash your hands thoroughly and apply a rich cream or massage oil to your chest.
Rules for massage for lactostasis:

Place your left hand under your chest and begin to gently massage with your right. Movements should be neat and soft and done clockwise. Massaging the breasts should begin from the top and gradually reach the nipple.
Each seal must be worked out especially carefully. It is also massaged clockwise, you can knead it slightly.
The breast in the nipple area is massaged very carefully. To prevent cracks, it is better to pre-lubricate it with a thick cream.
Don't forget about armpit massage.
After finishing the massage, you need to lean forward slightly and lightly shake off your breasts several times.

It is worth paying attention that sudden movements are not allowed during massage. They should be soft and not cause pain. For greater effect, lightly tapping the seals with your knuckles is allowed.
After finishing the massage, it is recommended to immediately feed the baby or express milk. Usually, a few procedures are enough for the breasts to become soft and the lumps to disappear. If this does not happen, then you need to consult a doctor who will perform this procedure professionally and express milk from the breast.

Decanting in a medical facility

Very often we hear from young mothers about the difficulties they encounter when expressing breast milk. If you cannot do this yourself at home, the doctor will continue to strain lactostasis in the clinic. For this, special equipment is used.
Physiotherapy is also used in combination with this. It consists of exposing the area where milk stagnation and stones have occurred to ultrasonic waves. A special UHF preparation creates ultrasonic waves that promote the expansion of the milk ducts. As a result, milk does not stagnate, but is easily expressed from the breast.
Treatment of lactostasis with ultrasound will take only a few physiotherapy procedures. The full course consists of up to 10 similar procedures.

Expressing after procedures

In home treatment, the last step is to express breast milk. It is important to know how to strain milk stagnation at home. You need to express milk from breasts that are congested.
To make the process of pumping during lactostasis easier, experts recommend lightly massaging the breasts at the same time. Don't be alarmed if the milk is thick. On the contrary, this indicates that the stagnation has been resolved. After pumping, it is recommended to put the baby to the breast. This promotes complete emptying of the milk ducts.
After finishing feeding, you can apply a cooling compress to eliminate breast swelling.

Another method that is effective for stagnation of milk and a feeling like a stone in the chest is to perform physical exercises. A few simple exercises will help improve milk flow and eliminate discomfort from lactostasis in the breast.
The technique for performing the exercises is as follows.

Your arms must be bent at the elbows. In this case, the forearms rest on a support located vertically relative to the elbows. The movements are springy towards the support and back towards the chest.
The arm on the side where the lump is located is bent at the elbow and rested on a vertical support. With the other hand, carefully take the seal on the chest and slightly pull it down. Make springy movements towards the support and back.

All exercises should be done smoothly, without sudden movements. They should not cause discomfort to the body. These simple exercises can be used to prevent lactostasis during breastfeeding.

Remedies for the condition

Often, young mothers resort to traditional medicine, which can significantly alleviate the condition of lactostasis. Several generations have used cabbage juice to reduce inflammation. You can also use cabbage leaves, which must be slightly mashed before use to release the juice. In this case, you need to make sure that the juice does not get on the nipple, and this does not cause digestive problems in the child.
Potatoes have a good anti-inflammatory effect against lactostasis. It is rubbed on a fine grater and applied to the chest as a compress. Magnesia compress, honey cakes, all these remedies can reduce pain during lactostasis.
Doctors also advise paying attention to ointments of plant origin. This could be Arnica ointment or Traumeel S. If you experience severe pain, when it feels like it’s shooting in your chest, you can take painkillers. Antibiotics during feeding for the treatment of lactostasis are contraindicated.

Folk remedies

Although medicine does not recommend treatment at home, often folk remedies can bring relief and even get rid of the problem. For lactostasis, you can use camphor oil. Camphor, an oil rather than alcohol, is applied to the breasts after feeding and left there for a while.

Doctors do not recommend using alcohol compresses, which have warming properties. Milk is an ideal environment for the development of bacteria. An increase in its temperature increases their appearance many times over and leads to the appearance of purulent mastitis. Therefore, it is not recommended to use vodka compresses to treat lactostasis.

Prevention

Lactostasis in a nursing mother can be prevented by following simple rules. Prevention of lactostasis is as follows:

Regular breastfeeding of the child.
Feeding not according to time, but according to the child’s demand.
Control of feeding posture during lactostasis.
The intervals between breastfeeding should not exceed 3-4 hours.
Avoid hypothermia of the body and chest.
Wear the right underwear that does not compress your chest.
Avoid stress and nervous tension.
During breastfeeding, completely eliminate sweet, spicy, and smoked foods from your diet.

Young mothers should remember that the best preventive measure and treatment for lactostasis is regular emptying of the milk ducts in a natural way. It is better for your own child to cope with this, so when the first signs of lactostasis appear, do not transfer him to artificial feeding, but, on the contrary, put him to the breast more often.

Lactostasis is a pathological process that results in complete stagnation or retention of milk in the excretory ducts of the mammary gland of a nursing woman. If treatment is not started in a timely manner, an inflammatory process may begin, which will require surgical intervention. May cause the development of infected mastitis.

Etiology

The etiology of this pathological process is well studied. The causes of lactostasis in a nursing mother are as follows:

refusal to breastfeed a child;
improper attachment of the baby to the breast;
rare feeding;
wearing underwear that is too tight;
mechanical injuries of the mammary gland;
poor milk flow due to anatomical features;
almost constant sleep on the stomach during breastfeeding;
hypothermia;
frequent stressful situations, nervous tension, inadequate rest;
compression of some areas of the mammary glands during feeding.

Clinicians note that the development of lactostasis is more likely in those women who have large breasts. This is due to the fact that the lower parts of the mammary gland sag and the correct outflow of milk is not observed.

It should be noted that in the first week after birth, an excess of milk is normal. The process of active lactation forms 3–4 days after birth. If the pregnancy is repeated, then the process of stabilizing lactation can occur much faster - on the second day after birth.

Symptoms

Symptoms of lactostasis are well expressed. The first and most sure sign of the development of this pathological process is a feeling of discomfort and pain in the chest, for no apparent reason. In addition, you can observe the following symptoms of lactostasis:

feeling of heaviness, fullness;
local temperature increase;
with palpation, you can feel individual areas of compaction;
painful thickening of the entire mammary gland, redness;
milk is expressed in an uneven, meager stream.

In more complex clinical cases, there may be a feeling of heat, an increase in body temperature to 39 degrees. It should be noted that if the above symptoms have been observed for a long time, a general increase in temperature may indicate the onset of an inflammatory process.

Clinicians note that at the initial stage of development of this pathological process, an increase in temperature is almost never observed.

If the clinical picture does not indicate the onset of an infectious process, pain can be eliminated and the pathological process can be localized by starting proper breastfeeding. However, you should still undergo an examination by a specialized medical specialist.

Diagnostics

If the symptoms of this pathological process do not disappear within several days, you should immediately consult a doctor. Otherwise, the onset of an inflammatory process is possible, which entails the development of an infectious disease.

First of all, the doctor conducts an examination and finds out the patient’s medical history and lifestyle. The medical history and pregnancy picture are taken into account. In addition, an additional diagnostic program is carried out using instrumental and laboratory tests:

mammography.

Based on all the test results obtained and the patient’s general history, the doctor can make an accurate diagnosis and prescribe the correct treatment.

It should be noted that lactostasis in a nursing mother can also affect the health of the child, especially if treatment is carried out using antibiotics.

Treatment

There is practically no drug therapy for lactostasis. Drugs are prescribed only if an infectious process has begun. Treatment of lactostasis does not require hospitalization.

First of all, it is necessary to ensure the normal outflow of milk from the mother’s mammary glands. To expand the ducts, breast massage and warming help well with lactostasis. However, the use of alcohol compresses for lactostasis is strongly not recommended. This is due to the fact that such lotions only worsen the secretion of the hormone that is responsible for milk production.

After pumping, you should give the breast to your baby. The child will help get rid of milk stagnation in hard-to-reach places of the mammary gland. Please note that pumping milk cannot be started immediately after feeding the baby. The body will recognize this as the fact that the baby did not have enough milk, and the production process will begin even stronger.

In addition to the measures described above, a nursing mother should reduce her fluid intake. There should not be more than one liter per day.

If the painful sensation does not go away, you can use special ointments and no-shpa. No-spa will relieve pain, and a suitable ointment will remove the inflammatory process.

As for the ointment, it should be selected by the attending physician. Selecting any ointment at a pharmacy without a doctor’s recommendation is not recommended. This is due to the fact that the ointment may contain components harmful to the baby’s health.

Treatment of lactostasis should only be carried out on the recommendation of a doctor. Expressing milk is best done with the help of a medical professional or using a breast pump.

It should also be understood that when diagnosing lactostasis, treatment with folk remedies and home-made ointments is strictly not recommended. This can seriously affect the baby's health.

Possible complications

If treatment is not started in a timely manner, this process may become inflammatory. This, in turn, leads to the development of mastitis or breast abscess.

Prevention

To prevent lactostasis, the following recommendations should be followed:

regular and proper feeding of the child;
wearing comfortable underwear;
exclusion of physical activity;
proper rest and proper nutrition;
drinking the optimal amount of liquid for this period;
correct body position during sleep.

At the first signs of the development of the disease, you should seek advice from a competent medical specialist.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

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Premenstrual syndrome is a complex of painful sensations that occur ten days before the onset of menstruation. The signs and symptoms of this disorder and their combination are individual in nature. Some female representatives may experience symptoms such as headaches, sudden changes in mood, depression or tearfulness, while others may experience pain in the mammary glands, vomiting or constant pain in the lower abdomen.

One of the most pressing problems worrying women during breastfeeding is lactostasis. Lactostasis is the pathological stagnation of breast milk due to its excessive production and incomplete emptying during feeding.

In the initial stages, stagnation does not pose a threat to the life and health of a nursing mother. The danger arises in advanced forms, when there is a high risk of infection and signs of mastitis. To prevent this, it is important to prevent milk stagnation every day and recognize the first symptoms of pathology in time.

Etiology of the disease

The main mechanism for the occurrence of lactostasis is stagnation of breast milk in nursing mothers due to incomplete emptying of the mammary glands after feeding. This creates favorable conditions for the penetration and reproduction of pathogenic microorganisms and the addition of infection.

Important! During breastfeeding, the nipple areolas are inevitably damaged, which leads to cracks and microtraumas in young mothers. These skin lesions become a gateway for infection to enter the thoracic ducts. One of the ways to prevent mastitis during lactostasis and stagnation is daily treatment of skin lesions in the chest area with antiseptic solutions and special creams.

The immediate causes of lactostasis are (what should not be done):

Complete refusal of the baby or the mother herself to breastfeed, especially when the nursing mother does not express breast milk.
Irregular, unsystematized breastfeeding: skipping feedings, formula feeding in the first months of life, feeding the baby by the hour and not “on demand,” which is not recommended.
Incorrect attachment of the newborn to the breast during feeding.
Refusal of a nursing mother to express milk after each feeding, especially in the first and second months of the baby’s life, when milk consumption is less than the volume of production. This also cannot be done.

In the first month after discharge from the maternity hospital, milk production occurs in excess, since the production of hormones occurs in a chaotic, unsystematized manner. At this time, the baby consumes less milk than is produced by the mammary glands, which predisposes to the appearance of signs of lactostasis. Expressing milk after each feeding is the only way to prevent milk stagnation in nursing mothers.

Pathogenesis

Milk residues accumulate in the ducts, causing pressure to build up. The skin and subcutaneous tissue swell, a dense infiltrate appears in one of the breasts, painful on palpation. These conditions predispose the patient to infection, which makes the situation even worse.

Part of the milk is absorbed back into the bloodstream, which increases the fever and causes severe symptoms and signs of intoxication. From the moment the inflammation, swelling and rise in temperature develop, they no longer talk about lactostasis, but about the development of mastitis.

Inspection and diagnostics

Diagnosing stagnation is not difficult. The doctor makes a diagnosis only on the basis of the patient’s symptoms and complaints, as well as a thorough examination of the gland to identify signs of stagnation.

First of all, the nipple areola is examined to identify cracks and other damage, since this is the main gate of infection. The mammary gland itself is externally swollen, the skin is hyperemic. Then the doctor performs palpation: first in the upper and then in the lower quadrants. In this case, dense, painful infiltrates are detected in one or several areas.

Additional examination methods are prescribed if there are signs of developing mastitis. To do this, a woman needs to undergo a whole range of laboratory and instrumental examination methods:

A general blood test, where characteristic inflammatory changes occur, makes it possible to establish the bacterial or viral nature of the associated infection.
A general urine test to determine the degree of intoxication and the severity of the patient’s general condition.
A biochemical blood test, where attention is paid to the protein composition, after which the degree of inflammatory dysproteinemia is determined.
Ultrasound examination of the mammary glands. This is an alternative to X-ray examination - mammography, which cannot be performed on nursing mothers. Ultrasound allows you to assess the density and size of the infiltrate, and also allows you to promptly suspect the addition of complications, in particular a breast abscess. Conclusion Ultrasound is the main criterion for the severity of mastitis, by which the advisability of starting antibiotic therapy is judged.
In case of a serious condition, the patient's blood is taken for sterility for timely detection of septic complications.

What to do to prevent lactostasis

Conservative treatment is limited to preventing milk stagnation and creating an outflow in case of lactostasis.

The most effective way to prevent stagnation is timely feeding of the baby “on demand.” Many nursing mothers adhere to the “clockwise” feeding system, which is not recommended. There is no need to wake up or disturb the child in order to feed him. He will wake up on his own when he is hungry. In this case, feeding is most effective, since a hungry baby will suck more than a full one, which will prevent stagnation of excess milk in the mammary glands.

After each feeding, especially in the first month, a nursing mother needs to express milk from the breast from which the baby recently fed. This is an important procedure that is necessary to prevent lactostasis.

What to do if lactostasis has already developed

When the first symptoms of lactostasis appear, a woman should inform the gynecologist who is seeing her and receive all the necessary recommendations from him.

In the first days, “non-drug” treatment is prescribed so as not to spoil the quality of breast milk in a nursing mother. To do this, the patient is recommended to express herself daily. To facilitate the outflow of secretions from the mammary glands, before each feeding and pumping, a woman should make local warm compresses in the area of the affected gland. Warming up makes feeding easier and more efficient.

The following techniques will help warm up your chest:

Warming the chest with warm water in the shower.
Warming the chest with a towel previously soaked in warm water.
Warming compresses on the chest (for example, from cabbage leaves).

After warming up, they begin feeding the baby. If the baby has not sucked all the milk, the ducts of the mammary gland are emptied as much as possible by pumping.

Important! Since pumping during lactostasis is difficult, a special massage technique is used to help relax and expand the excretory ducts. The patient can learn more about this massage technique from the nurse or doctor at the antenatal clinic.

A nursing woman may be taken by surprise by the unexpected appearance of lactostasis. It is characterized by unpleasant symptoms: pain and swelling of the chest, chills, fever. Often young mothers are frightened by the current situation and are at a loss - should they stop feeding their baby with their milk? Should you consult a doctor? With timely and proper treatment at home, you can get rid of the disease in one or two days. You just need to know which methods are best to use.

The main dilemma of mothers with lactostasis is related to continued breastfeeding

What is lactostasis?

Lactostasis is a blockage of the mammary gland ducts. Temporary cessation of natural milk flow leads to tissue swelling. At the initial stage, this phenomenon is not dangerous, but chest pain and fever are observed. This happens because milk protein, which accumulates in the milk duct for a long time, becomes a foreign body for the body. Our immunity comes to its defense.

After three days, the disease begins to pose a health hazard. If the temperature does not subside, you should definitely consult a specialist. After 5 days, a complication of blockage of the ducts may occur: the resulting inflammation can develop into infectious mastitis.

Under no circumstances should you treat mastitis at home or with folk remedies. Treatment must be carried out under the supervision of a doctor using antibiotics.

Causes of lactostasis

The causes of lactostasis can be different:

Feeding in one position. In the same position, the child is able to release only some lobes of the breast, while in others the milk ducts become blocked, which leads to the development of a plug.
Sleep in the same position. If you lie on one side all the time, milk will accumulate only in the lobes of the breast located under the armpits.
Uncomfortable underwear. The bra can be quite tight, and the underwires can be very hard, which makes it difficult for milk to flow out.
Small amount of fluid consumed. Especially in hot weather, you need to drink a lot of liquid, otherwise the milk will become too viscous. In this case, it will be quite difficult for the baby to suck it.
Use of pacifiers and pacifiers. If your baby sucks on a pacifier or pacifier frequently, he or she will become less active at the breast.
Breast injury. When struck, swelling occurs and the patency of the glands is disrupted.
Pumping. If your baby constantly eats mother's milk, you should not express the rest. Many mothers express after feeding, thereby causing an increase in lactation. At the same time, milk production increases and the baby cannot suck everything completely. Remaining milk inevitably leads to blockage of the milk ducts.

Previously, mothers fed their babies according to a regimen: they applied the baby to one breast once every 3 hours, and it was also believed that pumping was very useful. This really had to be done, since each of the breasts was sucked by the baby no earlier than after 6 hours. With this method of feeding, the possibility of mastitis and lactostasis increases. By feeding on demand, these diseases can be avoided.

Signs of lactostasis

The initial stage of the disease is characterized by the satisfactory condition of the nursing mother. The first sign of the disease is a ball-shaped lump in the chest. You may notice bumps or redness on its surface. Stagnation of milk leads to pain and swelling in the problem area. During lactostasis, a nursing woman's breasts become stone-like, painful to touch, and unpleasant symptoms such as burning or tingling are felt. You can notice that one of the mammary glands has increased in volume.

If you do not respond to the first signs of the disease in time, then there is an increase in temperature, which is accompanied by weakness, chills or nausea. Typically, lactostasis is characterized by a temperature of no more than 37.4 degrees. If the temperature has risen higher, one can judge the development of non-infectious mastitis, which can appear due to lactostasis. This mastitis is accompanied by severe pain in the problem area and an increase in temperature above 38 ⁰C. In the event that a woman has suffered from an infectious disease or a fever and chest pain that does not go away within two days, you need to consult a doctor - perhaps an infection has developed along with blockage of the milk ducts. If this is confirmed, the nursing mother is prescribed medicinal or surgical treatment, since everything already signals infectious mastitis. Mastitis is characterized by the appearance, due to which the further spread of the infectious process occurs.

If the temperature rises above 38 degrees, this may be a sign of the development of complications

What is the difference between lactostasis and mastitis?

It is important to distinguish lactostasis from mastitis in time. Mastitis is characterized by the most pronounced symptoms of the disease and deterioration of the woman’s condition. To make sure that a high temperature is a consequence of changes in the chest, it is necessary to measure it in both armpits, as well as on the elbows and groin.

Lactostasis, as a rule, lasts for two to three days and passes. If during this time, after taking measures at home, pain, hardening of the glands and redness on the skin have not disappeared, be sure to consult a specialist. If your doctor suspects infectious mastitis, you will need to undergo specialized diagnostics and drug treatment.

Should I continue breastfeeding with lactostasis?

If you have lactostasis or non-infectious mastitis, it is not recommended to stop breastfeeding, because it is the child who will help you cope with the disease. You need to put your baby to your breast as often as possible.

Stopping natural feeding is allowed only in the event of infectious mastitis. If signs of the disease appeared no more than three days ago, you should not wean your baby from mother’s milk.

The baby is able to cope with blockage of the milk ducts more effectively than any other method. It is important to remember that with an advanced disease, it is difficult for a child to suck out milk, which is why it is recommended to first express it in a small amount.

Don't wait until your baby gets hungry - feed him more often, at least once an hour. At night, it is better to put the baby to sleep next to you, as it is necessary to put him to the breast every three hours.

Regular application will help to resolve congestion faster with the help of the baby’s efforts.

How to cure lactostasis at home?

How to treat lactostasis? To eliminate the causes of congestion in the mammary glands, there is no need to take medications. A nursing woman is quite capable of recovering from the disease at home. Breastfeeding experts advise following several methods aimed at eliminating the disease.

Choosing the right feeding position

When the disease appears, it is important to the breast so that it releases it in the place where the blockage of the milk ducts has formed. To do this, you need to choose a position where the child’s chin will look at the area of the seal. Most often, clogged milk ducts occur in the upper outer part of the breast. The following poses are suitable for releasing it:

jack pose - when mother and child lie on the bed on their sides in different directions;
soccer ball position - when the baby lies on the side of the pillow during feeding, and his legs look towards the mother’s back.

If you need to free the lower part of the chest from congestion, the baby is placed on the mother's stomach during feeding. Be vigilant and prevent lactostasis from occurring in your healthy breast.

Breast massage

During illness, in order not to injure the breasts experiencing discomfort, it is important to massage them correctly. Too active massage is harmful - it can provoke injury and the inflamed area will only increase. It is recommended to make smooth stroking and rubbing circular movements during the massage. Knead from the outer area to the nipple. This way you can free the milk duct from blockage. If there is pain, it is advisable to massage and at the same time pump in a warm shower.

Ointments

Along with folk remedies, medications can help with lactostasis. To combat the disease, you can use creams and mixtures that are approved for use during breastfeeding:

Traumeel S is a homeopathic medicine designed to relieve inflammation, pain, improve blood and lymph circulation, and restore damaged tissue. When used, the condition of blood vessels is normalized. Traumeel in the form of an ointment can be used for lactostasis and mastitis. The problem area of the mammary gland must be lubricated up to 4-5 times during the day. The drug is allowed to be used during lactation, as it has no side effects (an allergic reaction occurs very rarely).
Malavit is an ointment that you should always have at home. The finished Malavit infusion should be diluted halfway with water. A moistened cotton pad should be applied to the problem area and not removed until the next feeding.

To eliminate the disease you should not use:

Vishnevsky ointment. When applying the ointment, there is a sharp rush of blood to the smeared area, which can contribute to the development of mastitis. The ointment contains birch tar and other substances with a strong unpleasant odor that will not go away even if you wash the treated area with soap. This in turn can lead to the baby not taking the breast.
Arnica ointment. It has a local irritating effect, helps to warm tissues and improve blood circulation.
Progestogel is a hormonal ointment that leads to a decrease in lactation, which is unacceptable during breastfeeding.
Standard decongestants, bruises, and cooling ointments should never be used, as they are incompatible with this disease and can cause irreparable harm to the baby’s body.

Using Malavita allows you to quickly remove painful lumps

Therapeutic compresses

Regardless of whether the disease occurs with or without fever, you can use special compresses:

From cabbage leaf. The fresh leaf must be washed and beaten a little so that the juice appears. The compress should be applied to the problem area. The dried sheet must be removed and a new one placed. Before feeding your baby, be sure to wash the nipple, otherwise the cabbage juice may have an adverse effect on its digestion.
From cottage cheese. A cool cottage cheese cake should be placed on the inflamed area for 20 minutes.
From honey and flour. It is necessary to mix the ingredients to form a tight, homogeneous mass - a cake, and place it on the bag. Apply to the sore spot for 30 minutes.

You often hear the erroneous opinion that you need to make alcohol, vodka or camphor compresses. It is contraindicated to use such hot and alcohol-containing liquids as compresses for this disease, as well as lubricating the chest with ichthyol ointment and Vishnevsky ointment. The substances they contain can only complicate the situation. You should also not use camphor oil if you are ill - it only provides temporary relief and negatively affects the amount of milk produced in the breast. The greatest danger is the penetration of camphor or alcohol into the baby’s body through mother’s milk.

Medicines and antibiotics

For lactostasis, it is not recommended to use No-shpa, since its action is aimed at eliminating spasm, and this disease is characterized by the presence of edema, which prevents the release of milk. The viscosity of the milk may increase. Abroad, women with breastfeeding use No-shpu only in extreme cases (we recommend reading:).
It is not advisable to use antipyretic drugs, since they do not fight the causes of lactostasis, but only muffle its manifestations. If the mother has a temperature above 38 degrees and feels uncomfortable, she is allowed to take a paracetamol or ibuprofen tablet.
If you are unable to eliminate the disease on your own within two to three days, it is advisable to seek the help of specialists - a breast surgeon or gynecologist. The doctor will conduct an examination and prescribe the necessary treatment. If the temperature lasts more than three days, antibiotics are usually prescribed - amoxicillin or augmentin.

Along with medications, cabbage leaf juice effectively relieves inflammation and cools the affected area.

Additionally, it is recommended to use cold compresses. Which one you prefer is up to you. They will help relieve swelling and relieve pain. Do not reduce the number of feedings due to the compress, because the main method of combating the disease is pumping the breast.

Physiotherapy

If two days have passed and the pain and swelling have not disappeared, you should visit a doctor. The greatest effect can be achieved thanks to physiotherapy procedures that are used to combat congestion:

Ultrasound. As a rule, a positive effect occurs after the first procedure. If after two procedures the desired result is not achieved, you should not continue doing them.
Magnetic therapy, light therapy, electrical neurostimulation therapy. The Almag, Amplipulse, and Bioptron devices are considered safe to use. They do not affect the composition of the maternal product and the level of lactation. One or two sessions are enough to achieve the effect.

However, physiotherapy should be used as an additional treatment. As a separate method of combating the disease, they are ineffective.

The “Amplipulse” type device does not affect the composition of breast milk and the level of lactation

Doctor Komarovsky about lactostasis

According to Dr. Komarovsky, the most effective medicine for milk stagnation is a child who is able to dissolve the milk plug. To do this, it is important to know how the baby should be positioned. His chin should be facing the area of his chest where the plug is located:

if blockage of the milk ducts occurs in the armpit area, then the baby should be in an underarm position;
if the lump is located in the lower part of the chest, then when feeding the baby you need to sit on your knees;
if there is a lump in the middle of the chest, the child should eat lying on his side;
if the congestion is in the upper part of the chest, the baby needs to be placed with his legs away from him, and the mother needs to bend over him.

For a quick recovery, you need to give the child the affected breast as much as you like - the more often, the better. To improve the condition, a warm shower is suitable, as well as cold compresses made from cabbage leaves or low-fat cottage cheese, which should be applied to the problem area for 15-20 minutes. It is advisable to pump when there is no fever; it is recommended to do this no more than 3 times a day.

Komarovsky under no circumstances advises weaning the baby from the breast during the period of illness; this can only complicate the situation. In addition, you should not use Vishnevsky ointment or alcohol, otherwise there is a risk of purulent inflammation.

For effective resorption, the child’s chin should “look” at the area where the lump is located

Methods of breast pumping for lactostasis

Pumping for lactostasis is the main method of combating the disease. If you release the milk lobule, in which the milk ducts are blocked, then the unpleasant sensations will go away over time. The best person to cope with this task is the baby. However, if milk stagnation occurs, it will be difficult for him to do this. In this case, experts advise expressing a small amount of milk before starting to feed the baby so that it flows out more easily. In this case, choose a position in which the baby’s lower jaw will be located above the problem area of the chest. If the baby is active, it will help to completely drain it.

It is possible to eliminate milk stagnation in a nursing woman using the following pumping methods:

Manually. It is better to strain lactostasis using your hands. This will allow you to gently remove blocked milk ducts.
Breast pump (we recommend reading:). With the help of a breast pump, at first it is impossible to achieve a great effect, because in this case, “jewelry” work is required to strain a separate lump. However, after expressing by hand, it will also bring a lot of benefits.

It is better to use a breast pump after manually expressing a painful lump.

How to properly express breasts with your hands?

It is important to perform pumping in a comfortable environment and in a comfortable position. Taking a warm shower helps your milk flow more easily.

You need to grab your chest so that 4 fingers are under it and your thumb is on top. This will allow you to more effectively strain areas where milk has stagnated. Then you need to clasp the areola with your thumb and forefinger. During the disease, the milk ducts, which are susceptible to blockage, are located in the place where the tuberosity is observed. This area should be massaged. Use your fingers to press on the breast, making radial movements towards the nipple. It is advisable to knead the formed compactions with your second hand. Do not squeeze or press too hard to avoid damaging your breasts. Change the position of your fingers periodically to express milk evenly from all areas. If you pump correctly, the milk will come out in quick streams.

Due to the onset of inflammation during pumping, a woman may feel pain. Anti-inflammatory drugs in the form of injections, tablets or suppositories will help reduce pain. At the end of the process, apply a cold compress. To relieve swelling, it is advisable to put a cold towel on the area for a few minutes. If you are ill, frequent pumping is not recommended; 1-2 times a day is enough.

If after lactostasis a lump remains and pain is felt, do not worry - it will take some time for the damaged tissue to recover. There may be redness in the affected area for several days.

If you feel discomfort in your chest, try to put your baby to your breast more often. During this period, it is better to stop eating salt and limit the amount of liquid consumed per day to 1.5 liters.

Summary table: what can and cannot be done in case of milk stagnation?

What can a nursing mother do?	Necessary	Maybe	Forbidden
Place your baby to your breast frequently in a comfortable position	+ + + + +
Apply cold after each feeding and/or pumping	+ + + + +
Perform a light breast massage yourself (using your fingertips)	+ + + +
Apply Traumeel C ointment between feedings and pumping	+ + +
Express (preferably by hand, following the correct algorithm)		+ +
Take a warm shower before feeding and/or pumping (if there is no elevated body temperature or purulent inflammation)		+ +
Take antipyretics approved for breastfeeding		+
Apply cabbage leaf compresses		+
Undergo ultrasound and physiotherapeutic procedures		+
Kneading the breasts, causing pain in the mammary gland			-
Reduce the frequency of feedings			-
Limit the amount of liquid you drink			-
Offer your husband to suck milk			-
Warm up the chest by applying warm compresses to the painful area, practicing intense massage			-
Apply compresses for a long time (more than 1 hour) from any components			-
Apply compresses containing alcohol (vodka, camphor alcohol, etc.)			-
Apply compresses with strong-smelling ointments and solutions (Dimexide, Heparin ointment, Vishnevsky ointment, etc.)			-
Take antispasmodics, incl. No-shpu (Drotaverine)			-
Take drugs that suppress lactation (Dostinex, Progestogel, etc.)			-
Take antibiotics that are incompatible with breastfeeding			-
Take antifungal medications after antibiotic treatment			-