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After childbirth, an inexperienced mother faces many difficulties. They are not always related to caring for a newborn. Failures in diet and feeding technique cause stagnation of milk. Many women encounter this problem 1-2 times during the entire period of breastfeeding, some several times a month. Why does lactostasis occur in a nursing mother? How to prevent it and what to do if milk stagnation has already occurred?

What is lactostasis

Experts in natural feeding in courses for expectant mothers report that lactostasis (stagnation of milk in the breast) is easier to prevent than to cure. During the classes, they show you how to pump your breasts and how to massage to get rid of congestion. After all, not a single first-time mother is immune from it. The structural features of the mammary glands and errors in feeding can lead a woman to lactostasis again and again.

For the first time, lactostasis can occur in the maternity hospital, when milk begins to flow rapidly. The breasts become larger, heavier, harder, and pain appears - this is a normal process that affects all nursing mothers. At this time the baby needs to be fed, trying to give both breasts at once. Before application, pain and congestion are relieved with a light massage and a warm compress. After some time, lactation will normalize and the body will begin to produce as much milk as the baby needs.

Causes of lactostasis

Doctors note the following causes of lactostasis that occurs in a nursing mother:

1. Straining unnecessarily. When the mother believes that the baby is not sucking well and the breast should be completely emptied, she begins to express after feeding. Then the threat of lactostasis arises. Milk production in a nursing mother depends on the baby's needs. The more it is sucked out, the larger volumes it returns. The portion expressed the day before will be superfluous the next time, causing breast fullness. The baby doesn't need that much milk and won't be able to handle the emptying. You will have to express again and a vicious circle will form, threatening lactostasis.
   When you cannot do without pumping, you can pump a little before feeding in order to soften the breasts. The resulting milk can be frozen. It will come in handy in the future when mommy needs to go away for a while. But you can’t pump until the last drop.
2. Long-term absence of breastfeeding. The cause of lactostasis can be a long walk, a prolonged trip to the doctor, or a missed feeding. You need to find a secluded place (hall, nursing room in a hospital, corridor, bench in the park) and feed the baby. When going somewhere, you need to think about this option and wear comfortable underwear.
3. Holding the breast during feeding. A caring mother can press the breast with her finger so that the baby can breathe freely while sucking. This should not be done. The ducts are squeezed and clogged.
4. Incorrect application technique. The baby, without grasping the areola entirely, sucks only the nipple and cannot fully absorb the breast. As a result, he will lose strength, remain hungry, and mommy will suffer from lactostasis.
5. The bra is not the right size. Hard underwires, narrow straps, and compression of the breasts lead to stagnation of milk in a nursing mother. If, after removing the underwear, marks are found on the body, the underwear is changed to a looser one.
6. Chest injuries. If before pregnancy the mother had operations on the mammary glands, it is necessary to carefully monitor breast fullness and at the first signs of lactostasis, get rid of it immediately.
7. Psychological condition. Stress, increased physical activity, and lack of sleep have a spasmodic effect on the ducts. Milk flow deteriorates and stagnation occurs.

The main signs of lactostasis

Symptoms of developing lactostasis are recognized quickly:

• swelling inside the chest and palpable lumps;
• nagging pain when pressing on the chest;
• redness of the skin in the area of ​​congestion;
• when expressing, it is noticed that milk does not splash from one duct, but drips barely noticeably;
• after feeding there is relief;
• the temperature rises to 37.5 degrees in the armpit on the side of the chest, where stagnation has formed. If the temperature rises higher, this is a dangerous condition with lactostasis, threatening purulent inflammation. With such symptoms, urgent consultation with a doctor is necessary.

The difference between lactostasis and mastitis

Mastitis in nursing women occurs if lactostasis is not treated in a timely manner. The disease occurs when improper and infrequent attachment, infection of cracked nipples, and decreased immunity. The breasts become hot, increase in size, and begin to hurt very much. Associated pathogenic infections affect the mammary glands, causing purulent inflammation. Symptoms of lactostasis differ from mastitis in general, local symptoms, and intensity.

Mastitis is characterized by:

• a sharp deterioration in the health of the nursing mother (headache, lethargy, drowsiness, fever up to 38 C);
• the chest turns red, swells, shines, acquiring a bright red color. When palpating and in a calm state, pain is felt;
• milk is separated with great difficulty;
• after pumping there is no relief;
• lymph nodes enlarge.

Treatment methods for lactostasis

When the process is not aggravated, treatment of lactostasis is carried out at home. In the first 2 days of stagnation, you need to pay special attention to the breasts, using all possible methods. The main task is to resolve lactostasis and, by freeing the ducts from the milk plug, restore the outflow of milk.

Decantation

A baby can best resolve lactostasis. It is applied to the sore breast more often than usual. Night feedings are especially valuable. The child will quickly cope with a small blockage and within 1-2 days the outflow will be completely normalized. But it happens that sucking causes pain.

Then feeding is facilitated by straining:

1. Warm shower. Heat stimulates milk flow and improves milk output. A stream of warm water is directed onto the chest. You can take a bath by lying in it for 10-15 minutes. It will relieve fatigue and stress, warm the chest and help eliminate congestion.
2. Careful light movements in the area of ​​lactostasis will help soften lumps and compactions. Palms can be lubricated with oil or baby cream. It is important that they do not get on the nipple and areola. Breast massage during lactostasis will relax the muscles, stimulate milk secretion and speed up the release of the milk plug. Movements should not cause pain or injure the skin. Smooth stroking, rubbing, kneading are carried out from the tops to the nipple. This will help the milk move through the milk ducts. Massage is done on the back and forearms. It can be done by the husband or relatives. In this case, the back is massaged in a sitting position, bending slightly. Then they start pumping - see breast massage for congestion.
3. Milk is expressed in small quantities to relieve pain and is always applied to the baby’s breast. This sequence of straining is followed 2-3 times a day.

Oxytocin

A hormone that regulates many processes in the female body during pregnancy and lactation. When it is not enough, the doctor may prescribe the drug Oxytocin, which promotes lactogenesis. The muscles of the mammary glands relax and milk flow improves. The dosage and course of treatment are determined by the doctor, based on the severity of lactostasis and the condition of the nursing mother.

No-shpa

Prescribed for the combined treatment of lactostasis. It is an antispasmodic that dilates arterial vessels, reduces pressure, and eliminates pain in problematic breasts. Treatment with tablets and intramuscular injections is possible.

Ointments

Vishnevsky ointment, Vaseline or camphor oil should be added to compresses for lactostasis after consultation with a doctor. They have an antimicrobial effect. The ointment contains alcohol, phenol and xylene, which cause severe irritation to sensitive skin. These products should be used with caution.

Ultrasound

Treatment of lactostasis with ultrasound is an alternative technique to tablets and ointments, allowing you to painlessly, quickly and safely get rid of lumps in the breast. Ultrasonic vibrations thin the milk and increase blood flow.

Folk remedies

Many breastfeeding mothers do not know which doctor to contact if they have a high fever and palpable lumps in the breast.

In case of lactostasis, consultation with the treating gynecologist or mammologist is necessary.

But when a doctor is unavailable or the symptoms of lactostasis are not pronounced, the mother can carry out treatment at home within 1-2 days after signs of stagnation appear. If traditional methods prove powerless, you cannot put off going to the doctor.

1. Cabbage leaf- a common method of treating mastitis and lactostasis. The cabbage leaf is washed, cut in several places or crushed with a rolling pin to release the juice. Honey will help improve the effect. A cabbage leaf, smeared with honey, is applied to the sore area, secured and kept on the chest for 3 hours. After which a fresh one is applied.
2. Chamomile decoction- prevents the development of lactostasis and purulent mastitis in a nursing mother. 2 tbsp. l. Brew dried flowers with a glass of boiling water and wait an hour. Pieces of cloth soaked in a warm infusion are applied to the nipple. The procedure is repeated 3 times a day.
3. Honey cake— For lactostasis, honey cake is considered a popular remedy. Raw onions are cut into small pieces and mixed with honey 1:1. Add a little rye flour to the mixture and knead the dough. The resulting cake is attached to the problematic breast and worn constantly, changing it 3 times a day.
4. You can bake the onion— Apply warm to the problem area of ​​the chest. Wear until feeding, then replace with a new one.

Preventive actions

Prevention of lactostasis is quite simple:

• feed the baby in different positions, alternately giving the breast. There are 3 main poses: in mommy’s arms, lying on her side, feeding from under the arm (see poses in pictures);
• do not leave long gaps between feedings, feed the baby on demand;
• If the baby is sleeping, and the chest begins to hurt and swell, you can feed the baby in his sleep by carefully placing the nipple in his mouth. He will definitely start sucking, eat, and then fall asleep again;
• do not wear synthetic tight underwear. You need to purchase bras for nursing mothers, made from natural fibers with wide straps, without hard protruding seams or underwires. They perfectly support the breasts without constricting the mammary glands;
• sleep during the day with your baby, putting aside household chores. Stress, anxiety and overwork should not be allowed during this important period;
• consume no more than 3 liters of liquid per day, including first courses, milk porridges, juices;
• eat well.

I want to talk about lactostasis. It just so happened that I had to seriously try several times to solve this problem. The first time it got to the point of mastitis and an abscess, and I even had a minor operation.

The problem of lactostasis, unfortunately, does not bypass any nursing mother (with rare exceptions). But it needs to be prevented and overcome as soon as possible so that the entire breastfeeding process is not upset. Of course, there is enough information on this issue, but I want to talk about the knowledge that was useful to me - I read a lot of literature and forums, and chose what was close to me, and, thank God, I solved the problem of lactostasis.

Lactostasis is a blockage of the milk duct, which is caused by poor emptying of the breast or part of it. The breast consists of lobes (according to various sources - from 12 to 20), and each lobe has its own duct in the nipple. When you feel that some part of the breast is thickened and hurts, sometimes redness and swelling occur. If you express your breasts, you will see that milk flows from the nipple in fewer streams or from some part of the nipple it flows little by little, while from other parts it may still flow in streams.

Causes of lactostasis

To prevent lactostasis you need to know the reason why it occurs.

Lactostasis often occurs due to the following points.

• The mother does not often feed the child, either by the hour, waiting for precise periods of time.
• The baby does not latch onto the breast correctly. Therefore, there is poor milk flow in a certain lobe of the breast.
• Mom holds a certain part of the breast with her finger while feeding. It often happens when a mother holds the dimple near the child’s nose with her finger so that he has something to breathe - you just need to find and take a position in which the chest does not hang too much and put pressure on the child, but this skill does not always come immediately. Or the mother incorrectly offers the breast to the child - she squeezes the breast between the index and middle fingers, thereby squeezing some breast lobe or duct, and this happens as a habit - constantly.
• Mom wears a tight bra.
• Feeds the child for a short amount of time, for example, fearing that the child will suck at the breast or overeat.
• Sleeping on your stomach can cause a blocked milk duct.
• Minor chest contusion, microtrauma.
• Stressful situation, overwork - of course, breastfeeding is not such an easy process, so don’t forget about your own rest!
• Lack of night feedings while the breasts are filling.

At the first symptoms of lactostasis, you may feel good, without fever or redness of the breasts, but if nothing is done in this situation, the temperature may rise and uninfected mastitis may begin (high temperature - more than 38, all other symptoms of lactostasis are aggravated).

Treatment of lactostasis

As a rule, to treat lactostasis, and even sometimes it is enough to learn how to properly put the baby to the breast and do it as often as possible (as an option - every hour or more often when the baby is not sleeping, and if it’s really hard for the mother, you can wake him up and slip the breast to the sleepy baby) ) - with this approach, the symptoms of lactostasis disappear within 24 hours. But if, even with frequent breastfeeding, the symptoms of lactostasis do not go away, then you will have to express about 2-3 times a day (more is also not necessary, so as not to force a lot of milk into the breast). But there is no need to express after each feeding, as this will send incorrect information to the brain about how much milk the baby needs. In this case, more milk begins to arrive each time, and the child will not be able to eat that amount of milk. It will turn out that you will have to pump all the time, or a successive series of lactostasis will arise - one passes and another immediately begins. Unfortunately, I struggled with this for quite a long time.

Before pumping, you need to apply a warm compress to the breast (not hot at all!), in order to provoke the oxytocin reflex, so that milk is released from the breast more easily. To do this, take a napkin and wet it in warm water. Place on your chest and hold until it cools down. Then, with light circular movements, massage the breast from the base to the nipple, paying special attention to those lobes that are stagnant. And after that, start pumping. You need to express specifically, that is, exactly the area that hurts, and it is better to do this under a warm shower.

It’s also good to express over steam (if you have steam, it helps a lot). Also regarding the massage - you need to be very careful with your breasts - you cannot knead them too much and do a professional massage. A massage therapist, kneading stagnant areas, can compress the milk ducts. And lactostasis can occur in other areas of the mammary gland.

Alcohol compresses should not be applied to the chest, as they block the release of oxytocin. Although many say that they make it easier, this is a double-edged sword. The warming moment of the alcohol compress will do its job - the ducts will expand and the milk will be redistributed in the breast, but this milk and the new one arriving will be more difficult to flow out (the release of oxytocin, which is responsible for the “flow out” of milk, is blocked). And if you stimulate the production of more milk or you initially had a lot of it, you will get a new lactostasis, only probably stronger and more extensive.

After you have pumped your breast “to the last drop,” it is very important to place your baby on the affected breast so that he can suck out the remaining milk and, possibly, stagnant lumps that can be difficult to express by hand. But a high-quality breast pump is a big help in this!

There is no need to ask your husband to help “suck” stagnant milk - the child sucks milk in a special way, which an adult is no longer capable of, because he has long lost the skill. The baby does not suck, but removes milk from the areola area with his tongue, and then swallows. But the husband will not be able to do this - he will pull the milk like a cocktail through a straw and thereby injure the affected nipples even without it. In addition, in the mouth of any person there is a certain microflora with various bacteria, including pathogenic ones (for example, caries). And he will pass on these bacteria to you when he “sucks” the milk. And if you have a crack on your nipple, then this is a direct path for infection.

Do not expect that after complete pumping, the pain and some swelling of the affected lobe will immediately go away. All this goes away on the 2nd or 3rd day. The redness goes away at the last moment. You should stop expressing your breasts on the 2nd - 3rd day. Sometimes one such complete pumping and then frequent application of the baby to the affected breast is enough to get rid of lactostasis.

Treatment of mastitis

"Uninfected mastitis is a more complex form of lactostasis, the symptoms are approximately the same, but with greater intensity. The state of health worsens sharply, the disease is accompanied by an increase in body temperature of 38 degrees and above, pain in the area of ​​​​the lump increases, can be felt when walking, when changing body position" .

Treatment is the same as for lactostasis. High temperatures are brought down with antipyretic drugs, and after pumping, if the red area becomes hot and swollen, it is recommended to apply ice to this area for several minutes. It is better to choose a feeding position such that the baby's chin is directed towards the affected area. Because this will allow the baby to empty that part of the breast more efficiently. When feeding, the mother can massage this duct to make it easier for the baby to empty it from the base of the breast to the nipple.

On the 2nd day we should see some improvement. But if the symptoms of uninfected mastitis remain severe for two or more days, an infection may enter the chest and then it develops into infected mastitis.

In addition, the causes of infected mastitis can be cracked nipples, since they are a route for infection to enter the body, and this problem must be taken very seriously. Remember! A crack is a direct path for infection to enter the mammary gland and develop an abscess. There are many ways to treat cracked nipples, but the main thing is to properly attach the baby to the breast. The cream also helped me a lot.

Mastitis can also be a complication after an illness. For example, if a woman has been ill, she may develop infected mastitis in about 2 weeks - you need to keep this in mind and take additional care of your breasts.

Infected mastitis is already an inflammatory process and its treatment should be medicinal and timely. As a rule, a course of antibiotics is prescribed that are compatible with breastfeeding - do not give up breastfeeding at this point, otherwise you may never return to it. There is no need to be afraid of antibiotics - the disease is much more dangerous for both you and the child. In addition, you must continue to pump. Without pumping, drug treatment will not be effective.

Expressing should not be done manually to prevent infection from spreading to adjacent lobes of the breast. It is better to use an electric breast pump for this. If you have infected mastitis, you should not apply warm compresses, as they can cause an abscess. If all mastitis treatment measures are effective, then pumping is completed on the 10th day.

But I still had an abscess. Lumps of stagnant milk did not disappear, and a purulent sac appeared inside. The main thing with an abscess is not to panic because you can only feed from one breast. You will be able to feed your baby with this one healthy breast - and the required amount of milk will be produced, you may just have to feed a little more often.

A drain is placed on the sore breast to remove pus from the purulent sac, and again a course of antibiotics is prescribed. Medicines are also selected that are compatible with breastfeeding. Expressing continues with a breast pump (to avoid affecting the purulent sac, manual expression is not recommended). Pumping is also necessary so that lactation in the affected breast does not fade away, and after the end of treatment you can return to feeding the baby from both breasts.

Self-medication of mastitis is unacceptable, but lactostasis can be dealt with on your own; the main thing is to carefully monitor your breasts and take timely measures.

I wish all nursing mothers never have to face this problem! But forewarned is forearmed!

Happy New Year to everyone! May our children be healthy and happy!

The mammary gland is an organ located in the anterior chest wall in front of the ribs. Available in both male and female representatives.

The laying of tissue occurs in the embryonic period, but final formation only at the stage of puberty and pregnancy. In men, the gland is in an undifferentiated state. And in females it is glandular and adipose tissue.

It belongs to the exocrine glands, this is due to the fact that the product of its work is released into the environment. Glandular tissue is hormonally dependent; prolactin primarily affects it.

Its structure is lobular; a ductal system departs from each lobule, which subsequently merges and is discharged into the nipple area. There are also extensions in which milk accumulates for subsequent feeding.

On the surface of the skin there is a nipple that differs in color and tissue structure. It is necessary for feeding a child.

Functions of the breast

The main functions are:

• Milk products.
• Hormone production. So, with a large accumulation of adipose tissue in the organ, the process of estrogen secretion begins.
• This is also an aesthetic function., necessary for the formation of a female constitutional type.
• Erotic. It is due to the fact that a large number of nerve endings are concentrated in the nipple area, which play a role in arousing the body.

What is lactation?

This is the production of breast milk by the mammary gland of the female body. This function of the breast includes several successive stages, as a result of which the possibility of feeding the child is formed.

The process of milk production is possible only after the birth of a child; usually, full education begins on days 3-5. Before full-fledged lactogenesis, colostrum (primary milk) is produced.

What is lactostasis?

Lactostasis is a pathological process that is characterized by a process of stagnation in the area of ​​the milk ducts. This is a common problem that almost every breastfeeding woman faces.

With the wrong tactics and ignorance of the initial symptoms, a powerful inflammatory process can develop, which in advanced stages leads to serious consequences, including death.

Lactostasis most often occurs in young mothers, usually immediately after the birth of a child. During this period, the final formation of the milk ducts of the gland is underway, which causes severe pain.

Etiology

The main reason for the development of lactostasis is a violation of the outflow of milk through the milk ducts.

Most often this is due to its initial accumulation in the gland and gradual thickening. Since milk in the first days has a fairly thick composition, when it remains in the breast for a long time, it turns into a thick plug, which is a curdled mass.

After the birth of a child, a woman experiences difficulties associated with feeding, because... at this time it is accompanied by severe pain, and additional difficulties may arise such as a flat nipple, the appearance of cracks, etc.

In some cases, lactostasis may be associated with excess milk production, resulting in insufficient pumping after feeding. This is how milk residues are gradually preserved in the ducts.

Signs of milk stagnation

1. The initial symptom of the development of lactostasis is the appearance of discomfort in the gland area, there is constant discomfort, as well as a feeling of heaviness in the organ. In this case, initially there is no pain syndrome.
2. Another significant problem is milk flow. Its severity depends on the volume of the lesion.
3. For minor blockage of single lobules Only a decrease in the amount of milk secreted from the gland may appear, provided there is adequate nutrition and other reasons that contribute to a decrease in lactation.
4. In case of massive blockage Complete obstruction of the milk duct may occur. If a woman does not start pumping on time, the process will continue to get worse.

Symptoms

Has the following symptoms:

• The gland increases in size. In the initial stages of lactostasis and not abundant milk secretion, this symptom grows slowly, but later a pronounced asymmetry is revealed.
• By self-palpation, a woman can determine the presence of a lump., which is characterized by the development of tubercles, as well as compactions of various sizes, most often irregular in shape. During palpation, discomfort or severe pain may appear.
• Lactostasis creates a constant feeling of bursting symptoms, with complete obstruction of the duct they are most pronounced.
• The skin on the affected area indicates the development of a pathological process, just as there is no initial increase in local temperature.
• The state of health begins to change with severe discomfort, as well as the addition of an infectious cause.
• Fever and swollen lymph nodes characterizes the transition of the process to mastitis.

Treatment

Therapy for lactostasis is quite diverse. It includes the use of non-drug methods, as well as medications.

The main limitation in the use of drugs is the effect on the child’s body through milk, so the selection is based on the safest drugs.

Non-drug methods include massage and pumping. These two mechanisms reduce congestion in the breast and prevent the transition to mastitis.

Among medicines, these are drugs for local and systemic therapy. Local ointments include ointments with different mechanisms of action, as well as compresses.

The most widely used systemic drugs are:

• Oxytocin. This is a synthetic hormonal agent, its mechanism of action is similar to a natural hormone. It has a selective effect on the muscles of the uterus, as well as the milk ducts of the mammary glands. The drug helps relax the milk ducts and improves the removal of accumulated milk from them. The drug is administered parenterally, for this purpose one milliliter of solution or one ampoule is used and administered intramuscularly. The number of side effects is minimal, but the drug can only be used after being prescribed by a specialist.
• No-shpa. A drug with a pronounced antispasmodic effect, due to this effect an analgesic effect is also achieved. Promotes relaxation of the milk ducts and easier milk discharge. Can be used in various dosage forms, both tablet and solution. It is preferable to use it intramuscularly; it can rarely be combined with other components for applying compresses.
• Antibacterial drugs. The most popular of them is Amoxiclav. It is used as etiotropic therapy and to prevent the transition of lactostasis to mastitis. Can be used in the form of tablets and solution. The average course of therapy is a week.
• Dostinex or Bromocriptine. These are drugs that help stop lactation. Helps inhibit prolactin production. The main negative effect is the likelihood of a complete irreversible cessation of lactation; this is especially important in the early stages of a child’s development, since the only way to feed will be artificial.
• Non-steroidal anti-inflammatory drugs can be used for symptomatic treatment, they reduce body temperature, as well as the severity of pain.

Oxytocin

No-Shpa

Dostinex

Bromocriptine

Amoxiclav

Massage

The basis of non-drug treatment for lactostasis is breast massage followed by pumping. It is necessary to soften the resulting plugs, as well as reduce pain.

To do it correctly, you need to know a few rules:

• First of all, use special products, mainly with a warming effect. These can be oils, as well as creams.
• It is recommended to massage the tissue in the direction towards the nipple from the base. The entire gland should be covered without skipping areas.
• In addition to the previous direction, circular ones are also used periodically; they help improve blood flow. You cannot make rough movements, everything should be done softly and carefully.
• The seals soften gradually.
• The massage should be completed by patting the skin with your fingertips, as well as subsequent pumping.

Compresses

The following types of compresses can be used:

Ointments

This type of medicine is a popular and effective method of treating lactostasis. The advantage of ointments is their local effect.

The main mechanism of their action is the removal of swelling, pain, and the resorption of areas of compaction.

The main rule of application is to apply to prepared, cleansed breast skin, without affecting the areola area.

Types of ointment:

• Menovazin ointment (Menovazan). This is an alcohol-containing product with the addition of novocaine, as well as other local anesthetics. Used to reduce pain. The drug is not the main one for the treatment of lactostasis, but is used as a symptomatic one. It is not recommended to apply it if the skin is damaged.
• Levomekol. Antibacterial ointment containing chloramphenicol. Used when there are signs of suppuration. Due to the presence of a strong antibiotic in the composition, it is recommended to use it without subsequent feeding of the baby, but pumping should take place regularly.
• Vishnevsky ointment. Has an antimicrobial effect. It is currently used quite rarely, this is due to its strong irritating effect on the skin. Therefore, it should not be used if the skin is damaged. It is more effective in combination with other drugs, and not as the main drug.
• Troxevasin. The drug has a main venotonic effect and is used for lactostasis to reduce the severity of edema and improve blood circulation. Helps restore the normal functioning of the milk ducts. The drug is used twice a day, using massage movements during application. Lyoton also has a similar effect; in addition, it has a slight anti-inflammatory effect.
• Ichthyol ointment. The product has an antimicrobial effect, therefore it is used to prevent the transition of lactostasis to mastitis. The advantage of its use is its low resorptive effect, so the child receives almost no antimicrobial agents through milk.

Pumping

Expressing is the process of removing accumulated milk from the mammary gland. There are several reasons why a woman is forced to use this method:

Lactostasis- the process of accumulation and disruption of the outflow of milk from the milk ducts. In this case, the effectiveness of reducing compaction in tissues is assessed.

The procedure should be quite long, on average it should be at least half an hour, but you also cannot pump for a long time, this will act as a factor in the development of tissue trauma. The frequency of pumping for lactostasis is on average once every two hours.

Prevention of accumulation of large amounts of milk in the gland. This is a physiological moment at the stage of breastfeeding, since a woman does not always have the opportunity to feed the baby, but at the same time it is also impossible to leave milk.

To do this, the woman needs to empty the gland. It is carried out on average in the absence of feeding at the right time, as well as a feeling of fullness of the organ.

As a supportive measure for maintaining lactation. A woman cannot always breastfeed; these can be diseases on both the mother and the child.

At the same time, during a long absence of feeding, the process of milk production decreases or stops completely. A woman begins to express milk as it accumulates in the gland.

Some women resort to this method to increase lactation. This is true in the first days after childbirth, as well as in moments when the number of feedings has been reduced.

When lactostasis occurs, several rules regarding pumping must be taken into account:

Is it necessary to feed a child with lactostasis?

Many mothers worry whether they need to feed their baby when lactostasis has developed. Great doubts are associated with the fact that lactostasis provokes the growth of pathogenic bacteria developing in the tissue.

But as soon as a woman notices the initial signs of pathology, she needs to change her lifestyle, including her feeding regimen. It should be done as often as possible.

To do this, the baby is put to the breast as soon as possible, even if massage or pumping has been done beforehand. The most effective way to treat lactostasis is to feed the child.

It is recommended to choose the most suitable position. The maximum emptying of the milk ducts occurs in the place where the child’s chin rests. Therefore, if a woman has identified a pathological area in the gland, then it is with an emphasis on it that feeding and decanting are carried out.

If a child refuses to suckle at the breast due to lactostasis, it is necessary to pump independently or with the help of devices, despite severe pain.

When to see a doctor?

Very often, a woman ends up in a hospital at advanced stages of the pathological process. This is due to the fact that in the initial stages, a young mother tries to treat the pathology on her own at home, using folk recipes, and does not always find time to consult with a specialist.

Therefore, in order to avoid a neglected process, you need to seek help as early as possible if a woman notices any disturbances in the functioning of the gland, as well as deterioration in well-being.

You can initially contact an obstetrician-gynecologist, either in a hospital or in the antenatal clinic. He will conduct an examination, help in determining the cause of the development of the pathological process, and give recommendations for treatment and prevention.

If there is a significant disturbance in general well-being, and a focus of inflammation is detected in the gland, a consultation with a surgeon is required. In some cases, hospitalization in a hospital for surgical treatment may be required.

Therefore, if a woman notices the presence of such symptoms, she should contact a medical institution:

Complications

The following complications may occur:

Prevention

Includes a set of activities aimed at proper breastfeeding:

Lactostasis is the stagnation of milk in the ducts of the mammary gland that occurs in a nursing mother during breastfeeding.

The term "Lactostasis" comes from the Latin word lac (lactis), which means milk, and the Greek stasis- stop, difficulty, stagnation, standing, slowing down

According to statistics, lactostasis occurs in at least a third of all nursing mothers on the planet. According to the survey, almost all women experience temporary disruption of milk flow during breastfeeding.

Lactostasis is associated with a quantitative imbalance in the synthesis of milk by the mammary glands and its excretion through the nipple, while the volume of milk produced is always greater than the amount excreted.

Milk production occurs in special epithelial cells, the smallest community of which is called the lacteal lobule. The lobules are combined into lobes (segments), and 15-20 lobes form the mammary gland as a whole. Milk is released through a system of milk ducts of small, medium and large caliber. The small-caliber ducts are lobular, with a minimal lumen diameter, and unite into the middle lobar excretory tracts. These, in turn, form large milky passages that open at the top of the nipple.

The well-being of lactation depends on a number of factors

First, the cells in which milk synthesis occurs are surrounded by a layer of tissue containing muscle fibers. This is an extremely important factor, since it is the contractions of these fibers that push milk out of the cells, move it along the ducts and ensure reflex release in the nipple area.

Secondly, an adequate diameter of the lumen of the excretory tract is necessary. After childbirth and the beginning of lactation, there is often a relative narrowness and tortuosity of the milk ducts, a discrepancy between the production of secreting cells and the capabilities of the excretory pathways. From feeding to feeding, this initial lack of development of the excretory system of the mammary gland is eliminated, but under the appropriate unfavorable circumstances, lactostasis may occur in the first 4-5 days of lactation.

Causes of milk stagnation during breastfeeding

Lactostasis occurs when, for some reason, the movement of milk through ducts of smaller or larger caliber to the nipple slows down and stops. In such cases, the displaced fluid accumulates to the point of obstruction and can put pressure on adjacent outflow tracts, as well as on secreting cells, microvessels and nerve fibers. Compression of neighboring, previously passable, milk ducts involves them in lactostasis, leading to an increase in the scale and progression of the process. Compression of arterial microvessels leads to a lack of supply of oxygen and substances necessary for milk synthesis to the secreting cells. The pressing effect on the venous and lymphatic capillaries inhibits the removal of carbon dioxide and toxic metabolic products, which also reduces the formation of milk. Compression of nerve fibers disrupts the regulation of the biosynthesis process in the secreting cells of the mammary gland. Thus, stagnation of milk in the breast becomes the cause of further lactation disorders, leading to a constant decrease in the amount of milk and a deterioration in the well-being of the nursing mother, and also jeopardizes breastfeeding of the child.

In addition, compression of the milk ducts, microvessels and nerve formations leads to the development of complications and consequences of lactostasis - inflammation and swelling of the affected segment of the mammary gland.

As a result, the causes of lactostasis are factors that disrupt the outflow of milk.

These factors include a number of situations:

• increased viscosity of colostrum and intermediate milk in the first days after birth;
• insufficient breast emptying and infrequent feedings;
• feeding in the same position;
• improper attachment to the breast;
• unreasonable frequent pumping;
• abrupt cessation of breastfeeding;
• chest injuries;
• congenital and acquired anomalies of the structure of the mammary glands;
• hypothermia,
• overwork, including mental
• habit of sleeping on your stomach, tight bra, etc.

1. Increased viscosity of colostrum and interim milk in the first days after birth. The formation and secretion of colostrum, rather than milk, is typical for the first days after childbirth. Colostrum has greater density and viscosity compared to mature milk. In the next three to four days, intermediate milk appears, the specific gravity of which is also higher than that of mature milk. This is combined with the undeveloped and narrowness of the milk ducts and physiologically increased lactation. The formation of mature milk begins only on the 5th day after birth, and until this moment, in a woman who has given birth, the narrowness of the ducts is combined with the high viscosity of colostrum or intermediate milk. This leads to a low linear speed of movement and their delay in the outflow tract. Thus, in combination with physiologically increased lactation, real prerequisites for blockage of the milk ducts appear.
2. Lactostasis can also be caused by insufficient breast emptying. It becomes possible when feeding weakened children, or with “regulated” or rare feeding, when the mother breastfeeds the baby no more than 6-8 times a day, because she is convinced of the need to limit food intake over time, creating a so-called “diet regime.” Stagnation of milk in the breast occurs because unclaimed milk in itself is an obstacle to the outflow of newly formed portions. Currently, this approach is not supported by experts. On the contrary, “on demand” feedings are recommended.
3. Feeding in the same position often accompanied by complete consumption of milk in some segments of the mammary glands and its retention in others, which can also disrupt the outflow of milk.
4. Another reason for the development of lactostasis is improper attachment to the breast. To completely empty the mammary gland, the baby's mouth must completely grasp the nipple and areola. If this does not happen, then some of the milk remains in the ducts and there is a possibility of blockage. Quite often, mothers use this technique when feeding (it’s called "scissors"): the nipple is fixed between the index and middle fingers, remaining compressed during the entire sucking time. This is done to help the baby hold the nipple. But at the same time, compression of the excretory ducts occurs with the possibility of stagnation of milk in them.
5. One of the reasons for milk retention is unreasonable frequent pumping. Frequent pumping is not always recommended for nursing mothers, but only in cases where, firstly, lactostasis has already occurred; secondly, little milk is produced, and pumping is a lactation stimulator; thirdly, with increased milk production. If none of the above is observed, then frequent pumping loses its positive meaning and transforms into factors causing lactostasis. Pumping is a stimulator of lactation (see above), and frequent pumping is a stimulator of increased lactation. The following chain of events unfolds: unreasonable frequent pumping results in an increased volume of milk. This volume is not sucked out by the child and is expressed again. A new increased volume is formed again. Ultimately, the volume of milk always exceeds the volume of the ducts, or, in other words, with frequent pumping, there is always a relative narrowness of the milk outflow paths, the amount of which exceeds their functionality. Excessive milk volume is an obstacle to the outflow of new portions. In addition, the ducts dilated by the increased amount of milk put pressure on the neighboring ones. A violation of the patency of the outflow tract is formed due to compression from the outside and the appearance of an obstacle from the inside. As a result, stagnation of milk occurs in the mammary gland.
6. Abrupt cessation of breastfeeding may be due to the child’s refusal to breastfeed, premature weaning, or transfer to artificial nutrition. In any of the listed cases, the retention of milk in the excretory system of the mammary gland is associated with the cessation of its outflow due to lack of demand.
7. The cause of milk stagnation is spasm (narrowing) of the mammary gland ducts as a result of low temperatures. Spasms, a standard response to the effects of cold, reduce the diameter of the lumen of the ducts, limit their throughput and lead to the formation of lactostasis.
8. Cold is not the only reason for a decrease in the diameter of the lumen of the milk ducts due to spasm. Psycho-emotional stress, negative emotions and fears(so-called psychosomatics), lack of sleep, increased physical activity with which child care and breastfeeding are inevitably associated, are also powerful spasmodic factors, the action of which can lead to stagnation of milk in the breast.
9. Harmless habit of sleeping on your stomach during breastfeeding it becomes a risk factor in terms of the development of lactostasis due to prolonged compression of the gland tissue and its milk outflow system. The same negative effect on lactation has tight bra.

Symptoms of lactostasis in nursing mothers

A delay in the outflow of milk leads to its accumulation in one of the areas of the mammary gland. The affected area increases in volume and becomes denser. In the early stages, such a compaction is detected only by palpation, i.e. by palpation, which allows you to recognize stagnation of milk. Subsequently, the size of the compaction increases, the surrounding tissues are compressed, and swelling forms.

A nursing woman complains of a general deterioration in health, malaise and weakness, chills, headaches, the appearance of a painful lump in the breast area, increased pain during feeding and, associated with this, the ineffectiveness of feeding itself.

Upon examination, swelling, engorgement, and redness of the affected area are detected by palpation (by palpation) and visible to the eye. Also, palpation reveals pain in the area. The skin over the affected segment is dense, stretched, inelastic, and hot to the touch. Low-grade fever with an increase in body temperature to 37.4-37.5 o C is noted.

How to distinguish lactostasis from mastitis?

A complication and consequence of prolonged lactostasis is lactation mastitis.

There are non-infectious and infectious lactation mastitis. The latter develops under conditions of inclusion of pathogenic microflora, most often staphylococcal, in the process. The pathogen infects the ducts and tissue of the mammary gland, entering them through cracks in the nipples, during breastfeeding, and expressing milk.

Manifestations of lactation mastitis correspond to local and general manifestations of inflammation. Local reactions were described by Hippocrates: redness (rubor), swelling (tumor), local increase in temperature (calor), pain (dolor), dysfunction (function laesae).

General symptoms include decreased ability to work, malaise, headaches, chills, temperature up to 38.0-39.5 o C, changes in the cellular composition of the blood.

All these manifestations in general are similar to those for lactostasis, but are expressed to a much greater extent. For example, the temperature with lactostasis (uncomplicated) does not rise above 37.4-37.6 o C, and with mastitis it is much higher; deviations in the general blood test are absent in cases of banal milk stagnation and are very pronounced in conditions of lactation mastitis. If in the treatment of lactostasis in nursing mothers the central measure is expressing milk at home, then lactation mastitis requires complex conservative therapy, and in some cases, surgical intervention.

In order to distinguish between lactostasis and lactation mastitis, a general blood test, bacteriological examination of breast discharge from the nipples, and ultrasound examination may be prescribed.

In a general blood test of patients with lactation mastitis, there are nonspecific signs of an inflammatory reaction that are not characteristic of lactostasis (see table).

Bacteriological examination reveals contamination with pathogenic microflora in discharged pus or milk, which is absent in cases of banal lactostasis.

Ultrasound examination makes it possible to assess the origin of the lump, provides an answer to the question “Mastitis or lactostasis?”, and also distinguishes between individual forms of lactational mastitis, which is a determining factor in choosing treatment tactics.

The main differences between lactostasis and lactation mastitis are shown in the table:

Which doctor should I contact if I have lactostasis?

In such cases, it is best to immediately contact a surgeon who will advise you about both lactostasis and mastitis. You can also get examined by an obstetrician-gynecologist.

Specialists practicing in the field of mammology or pediatrics have completely different areas of activity. For example, a mammologist deals with oncological diseases of the mammary glands, a pediatrician deals with childhood diseases.

What to do when a nursing mother has stagnant milk? Treatment of lactostasis

If a nursing mother has signs of milk stagnation in the mammary gland, then you can consult a surgeon. If the stagnation is not complicated by a secondary infection and there is no fever, then you will be recommended:

1. Continue breastfeeding on demand.
2. Prepare your breasts in a special way for the next feeding.
3. Exclude all possible causes of lactostasis (see). This breast preparation is a central therapeutic measure in order to combat and cope with lactostasis. It consists of mandatory pumping before each application to the breast.
4. In addition, you will be recommended breast massage and physiotherapy for lactostasis (see).

Treatment of lactostasis at home

The main help for lactostasis and treatment is carried out at home - these are mandatory pumping and massage.

Highly effective phonation using a medical device "", which can also be carried out at home. In 1997, the effectiveness of this device for the treatment of lactostasis and serous mastitis was confirmed by the Research Institute of Obstetrics and Gynecology named after. BEFORE. OTTA ().

We bring to your attention doctor's video review highest category, candidate of medical sciences, associate professor of the department of pediatrics of Northwestern State Medical University named after. Mechnikova (St. Petersburg) F.N. Ryabchuk on the use of the Vitafon device for lactostasis and serous mastitis.

As a complement to these methods, it is possible to use some folk remedies: compresses with cabbage leaves and honey.

Expressing is necessary in order to restore the patency of the milk ducts and remove stagnation of breast milk in the affected breast lobule.

How to prepare for pumping? On the first day of the appearance of signs of lactostasis in a nursing mother, thermal exposure to the breast is permissible - a warm heating pad, a warm shower, but only on the first day. If during the first day it was not possible to resolve lactostasis, then heat should not be used in the following days.

You need to take a comfortable position - lying on a sofa or couch. Be sure to calm down. Anxiety can cause spasm of the milk ducts.

How to properly strain stagnant milk by hand at home?

For proper pumping, you need to place the congestive mammary gland (breast) on the palm of your hand (for the right breast - the right palm, for the left - the left). Slightly lift your chest with your palm and massage your chest for 5-15 minutes (see). The appearance of first drops of milk, and then streams, indicates the restoration of the patency of the milky passages.

After this, you can proceed to pumping. To do this, the thumb and index fingers need to be positioned along the edges of the areola (parapapillary circle). Using these fingers, make gentle pressing movements from the surface inward and from the edge of the areola to the nipple. This is a rather long procedure lasting up to 30-40-60 minutes. But manual massage is more gentle than expressing with a breast pump.

Using a breast pump to express very convenient and efficient. This speeds up the process, and the pain will be less intense.

Finish the pumping procedure when the softness and elasticity of the breast and nipple are restored - signs of unloading of stagnation. The use of a breast pump is contraindicated if there are cracked nipples.

After straining You can start directly feeding. First of all, give your baby the sore breast. A hungry baby will suck the maximum amount of milk from her. Position your child so that his chin rests directly on the hardened area. When sucking, the movements of the chin will push the milk out of the stagnation area. Do not feed from time to time in the same position, because... the monotonous position of your body is one of the likely causes of lactostasis. Once your baby is full, express the remaining milk again.

It is very important to know that it is permissible to independently combat milk stagnation only in the first two days, especially if there is an increase in temperature due to lactostasis.

Elevated temperature during lactostasis is associated with the accumulation of milk in a stagnant lobule or lobules and its absorption into the blood. Therefore, a radical antipyretic treatment for stagnation of milk during breastfeeding will be complete emptying of the breast. Medications will only have a temporary effect. Among them, for nursing mothers it is possible to use drugs of the paracetamol group, but only as prescribed by a doctor.

Your doctor will advise you on further steps to remove stagnation of breast milk.

First aid or physical therapy

Stagnation of milk in a nursing mother occurs due to the appearance of a real obstacle in the outflow tract. This obstacle consists of several components:

• reduction in the diameter of the milk ducts;
• edema;
• the accumulated milk itself.

A decrease in lumen diameter is a triggering factor, the reasons for which are described at the beginning of the article. Edema occurs when the volume of non-flowing milk begins to compress microvessels of any profile - arterial, venous, lymphatic. Blood is retained above the obstruction site and overstretches the vascular wall. The permeability of the wall increases and the liquid part of the blood - plasma - passes into the tissues. An increase in the amount of tissue fluid is edema. An increase in the volume of tissue (edematous) fluid increases compression on the milk ducts and blood vessels, milk and blood retention increases, and all disorders develop further. A vicious circle is formed, with each successive revolution of which the manifestations of lactostasis and accompanying microcirculation disorders deepen more and more. If infection also occurs, then lactostasis is complicated by lactation mastitis.

The main goal of therapy in such cases is to break pathological cause-and-effect relationships anywhere in the vicious circle and cure lactostasis.

Normally, the movement of milk through the milk ducts is ensured by contractions of the muscle fibers of the mammary gland, and the lymphatic system is responsible for removing excess tissue fluid. But with lactostasis, both muscle fibers and lymphatic microvessels are pinched by edema and stagnant milk, so this function is not fulfilled and falls out.

After phonation the following are completely restored:

• movement of milk along the outflow tract,
• tone and permeability of vascular walls,
• the amount of tissue fluid, that is, all mechanisms and symptoms of lactostasis are completely eliminated.

In addition, vibroacoustic therapy has an anti-inflammatory effect and strengthens local immunity. Therefore, simultaneously with the elimination of milk stagnation in a nursing mother, "" provides the safest and most reliable prevention of lactation mastitis.

Phonics is absolutely painless, non-traumatic and easily tolerated, and also has a small list of contraindications.

“Vitafon” is used both in medical and preventive institutions and outside them. Thus, with the help of the device you can provide radical help with lactostasis at home. Carry out 4 phonation procedures per day until the symptoms disappear and then for another 2 days. You can see the phonation technique in more detail.

With a review from the Research Institute of Obstetrics and Gynecology named after. BEFORE. OTTA on the use of the Vitafon medical vibroacoustic device in the treatment of lactostasis can be found. The result of using Vitafon was that it was possible to express the mammary glands within 6-8 hours.

Breast massage

Breast massage has proven itself to be effective for milk stagnation. You can do it at home yourself as much as you need. There is no harm to the baby. Massage should be done before pumping or feeding, as well as after feeding. Massage time is 5-15 minutes.

How to massage with lactostasis?

Before starting, lightly grease your hands and chest with vegetable oil. Then place the sore breast on your palm. Raise your palm up and slightly to the side and your chest also rises slightly. In this position, the milk ducts open in the nipple area. With your free hand, using soft circular, enveloping movements, lightly stroke and at the same time press on the breast (Fig. No. 1), starting from the top and moving towards the nipple (Fig. 2 and 3).

After some time, we change the nature of the movements. Now, using your thumb and forefinger, gently massage the areola from top to bottom and from outside to inside.

We alternate circular movements and areola massage. Add gentle tapping on the chest with your fingertips. You can also bend over and shake your chest a little. Milk gradually begins to come out, first drop by drop, then in a trickle. Only now can you move on to pumping or feeding.

Treatment with folk remedies

Traditional medicine over several thousand years has accumulated a huge number of recommendations and recipes for the prevention and treatment of various diseases.

On the one hand, we would be very unreasonable creatures if we abandoned the experience of the healers of the past, proven over decades and centuries. On the other hand, many traditional medicines do not have any evidence base or scientific basis for their effectiveness and can be harmful and even dangerous to health. One of the main dangers is to rely on them and miss the time for timely and effective treatment. The price of such mistakes is the development of severe complications and irreversible consequences, including deprivation of the child's mother's milk.

It is believed that the main folk remedies to get rid of lactostasis in a nursing mother are cabbage leaves and honey. They are often used for milk stagnation in nursing women due to their supposed decongestant properties. Such recommendations can be heard even from midwives. Indeed, relieving edema frees the milk ducts from compression and normalizes their throughput, but it should be remembered that the use of folk remedies is an additional measure and does not cancel the main measures, such as pumping, Vitafon treatment and massage.

The main folk remedy for lactostasis is cabbage leaf. There are several recipes:

1. In the evening, place a whole leaf of cabbage over the area with the seal, put a bra on top or wrap your chest with a bandage so that the leaf does not slip off, and leave until the morning. The next evening use a new sheet;
2. Prepare the cabbage leaf as in option 1, but additionally grease it with a mixture of salt and oil. Replace several times a day;
3. Knead the cabbage leaf thoroughly with your hands or a rolling pin or beat it off, you can make several superficial cuts so that the leaf releases juice, apply a compress to the sore spot, securing it with a bandage. Change every 3 hours.

Perhaps a cabbage leaf will help you, but perhaps not, if all your treatment consists only of cabbage leaves. Therefore, first of all, focus on the main measures for lactostasis: pumping, massage and phonation.

Honey compresses

Traditional medicine suggests treating stagnation of breast milk by using honey compresses. There are quite a lot of recipes for their preparation; there are several general rules that are recommended to be followed:

• honey should be natural and, preferably, May honey;
• use honey heated in a water bath at a temperature of approximately 40°C;
• Regardless of the preparation method, the applied compress is distributed on the skin, covered with cellophane and insulated with a scarf or handkerchief;
• the duration of action of the honey compress is 3 hours;
• a honey compress is not always convenient, because... honey leaks out and stains clothes.
• In essence, the variety of methods for honey compress is the variety of “fillings” for cellophane:
• cabbage leaf with honey for lactostasis - smear a cabbage leaf with honey and apply it to your chest. Or apply a clean sheet to pre-lubricated skin;
• Grind the cabbage leaf in a meat grinder or blender, mix with honey in a ratio of 5:1;
• honey cake for lactostasis - prepare the mixture using equal amounts of honey and flour (rye or wheat), form it into a cake and apply to the stagnant area;

Please note that there is no scientific justification for the use of this drug for the treatment of lactostasis and information about the proven effectiveness of its use. Therefore, the use of honey compresses can only be considered as an additional and not mandatory remedy.

Prevention or how to avoid lactostasis during breastfeeding.

In order to maintain normal milk flow throughout the entire feeding period and prevent lactostasis, you need to adhere to a lifestyle that eliminates all causes (conditions, situations) that could cause stagnation.

A list of reasons was given at the beginning of the article. It's worth using it. For example, if we know that “regulated” feeding can lead to incomplete emptying of the breast, it is better to refuse it. Let the baby suckle when he is hungry, and not strictly every 3-4 hours. Let one feeding take as much time as the child needs, and not the “legalized” 15 minutes that someone once allotted him for this. Modern science believes that this approach is more justified and useful for the growth and development of the baby than the desire for a rigid regime.

So, prevention of lactostasis during breastfeeding:

• Feeding “on demand” without time limit.
• Avoid feeding in the same position.
• Make sure your baby grasps the nipple correctly.
• Do not use scissor finger positions during feeding.
• If there is enough milk and there are no signs of stagnation, then do not express too often.
• Strictly follow the “order” of breasts, keep a record.
• When the time comes to wean your baby, do it gradually.
• Carry out periodically. Phonation perfectly maintains the normal state of muscle cell tone in the breast tissue, the walls of the milk ducts and blood microvessels and prevents the retention of milk on the outflow paths.
• Don't let your chest get cold. This is a very well-known rule among the people. Take all measures to avoid getting a chest cold.
• Give up the habit of sleeping on your stomach.
• Provide yourself with loose, comfortable clothing that does not restrict your chest.

During the period of breastfeeding, psycho-emotional stress, lack of sleep, and increased physical activity become an integral part of your life. And they are the real conditions for lactostasis. Let your loved ones do everything to save you from the influence of this negative triad: help, take on some of the worries, give you additional time for sleep and rest.

Is no-spa used for lactostasis?

Indeed, no-shpa is sometimes used for milk stagnation, but it must be borne in mind that due to the lack of necessary clinical studies on the use of this drug during lactation, the use of no-shpa is not recommended.

How to break milk stagnation?

With lactostasis, in no case should you take any actions that could be characterized as hitting or breaking, as you can damage the mammary glands and greatly aggravate the situation. Only gentle massage and careful pumping are used.

I can’t express the stagnation of milk!

In response to this cry for help, a doctor must come. And before his arrival, you need to calm down and once again, after reading this article, make efforts, including with the help of your loved ones, to massage the breasts, pump, feed the baby and use phonation.

List of used literature:

1. Ailamazyan E.K. Obstetrics: textbook. – Moscow State Medical University named after. THEM. Sechenov. – 9th edition, revised and expanded – Moscow: GOETAR-Media. – 2015
2. Kildiyarova R.R. Nutrition for a healthy child. – 2nd edition, corrected and expanded – Moscow: GOETAR-Media. – 2015
3. Kildiyarova R.R., Kolesnikova M.B. Pediatrician's Directory. – 3rd edition, corrected and expanded – Moscow: GOETAR-Media. – 2015
4. Komarova T.A., Tulendiev T.V. A textbook of traditional medicine – Alma-Ata Publishing House: Kainar. – 1991
5. Horse I.Ya. Nutrition for pregnant women, nursing mothers and young children. – Publishing house Medical Information Agency (MIA). – 2015
6. Kostenko A. Smart herbs for your health. – AST Publishing House. – 2015
7. Nikitin B.P. A healthy childhood without drugs or vaccinations. 6th edition, corrected and expanded - Publisher: List New Year. – 2001
8. Pediatrics: national guidelines. – Moscow: GOETAR-Media, 2009
9. Pediatrics - a textbook for medical universities / Edited by N.P. Shabalova. - Saint Petersburg. – 2003
10. Pervushina E.N. Forest pharmacy. Medicinal plants. – Amphora Publishing House. – 2015
11. Radzinsky V.E. Gynecology: textbook. – GOETAR-Media. – 2015
12. Yakovlev Ya.Ya., Manerov F.K. Lactostasis and lactation mastitis in pediatric practice // Siberian Medical Review. – 2015 - No. 2 (92) - pp. 32-41.

You can ask questions (below) on the topic of the article and we will try to answer them competently!

Lactostasis is a stagnant process in the mammary gland, accompanied by a deterioration in the outflow of milk through the breast ducts. Mostly first-time mothers suffer from the pathology, but the problem often worries mothers who are breastfeeding their second or even third child. How does lactostasis manifest in a nursing mother, what are the symptoms and treatment of the disease - questions that concern almost all women who breastfeed. Today we will talk in detail about the mechanism of development of the problem, causes, symptoms, methods of its elimination and prevention.

The mechanism of development of lactostasis

Lactostasis in a nursing woman can develop on the third or fourth day after birth if the baby is not applied to the breast too actively. But even at later stages, stagnant processes make themselves felt when there is a lot of milk, and the baby cannot cope with the resorption of the glands.

What is lactostasis? This is the formation of a blockage in the gland, as a result of which the movement of milk through the ducts is disrupted, swelling and pain occur in the affected area. The process of milk production continues, which increases the pressure on the ducts, and the liquid penetrates through the wall of the vessel into the blood. When stagnation is advanced, “milk fever” appears.

Lactostasis can also develop after stopping feeding, when the baby is introduced to complementary foods or is planning to be weaned. Lactation is still ongoing, and the baby sucks out less and less milk, as a result of which the ducts become clogged.

The main signs of milk stagnation

In order to take timely measures and prevent the development of mastitis, you need to know the main signs of lactostasis in a nursing woman:

• pain inside the gland, which becomes less pronounced after latching the baby or pumping;
• areas of compaction that can be felt;
• feeling as if the chest is bursting, as if it is overflowing with milk;
• the increase in temperature is not general, but only in the affected areas.

Doctors consider pain in the gland to be the main symptom of lactostasis in a nursing mother. Areas of compaction and hyperthermia may be absent. But if there is pain that was present before feeding, and after emptying the breast, it goes away, this is probably lactostasis.

Attention! At this stage, it is imperative to start treatment. After 2-3 days, the disease may be aggravated by an increase in temperature to subfebrile and febrile levels, redness of the glands and the development of an inflammatory process.

Causes of lactostasis

The reasons for stagnation of milk that appears during breastfeeding are different. The main ones include:

• breastfeeding without changing position - if the baby always suckles at the breast in the same position, resorption of the same lobes of the gland occurs. In the rest, blockage of the ducts is provoked;
• sound sleep in one position - when a nursing mother rarely turns over in her sleep, milk accumulates in the axillary lobes of the gland, creating stagnation;
• compressive underwear - when wearing tight bras with hard underwires, milk cannot fully flow out;
• milk that is too thick and fatty – to prevent this problem, nursing women are advised to drink plenty of fluids. In addition to the development of lactostasis, viscous milk is difficult for the baby to suck out;
• accustoming a newborn to a pacifier - this reduces the child’s activity when sucking the breast, due to which the gland is not emptied fully, causing stagnation;
• trauma to the chest - after an impact, the resulting swelling of the tissues provokes lactostasis.

Also causes of lactostasis include regular pumping without need. If the baby does not completely empty the breast, and the nursing mother constantly expresses the remains, even more milk comes in. As a result, the ducts of the gland become blocked, causing problems with outflow.

Psychosomatics plays a significant role in lactostasis - with an unbalanced psycho-emotional state, the body of a nursing woman responds with problems with milk production and blockage of the ducts. This is why doctors consider confidence and calm to be a prerequisite for breastfeeding.

Frequent pumping unnecessarily can cause lactostasis

Lactostasis and mastitis - differences

Breast lactostasis in a nursing woman is a problem that does not have an infectious etiology, and blockage of the gland, with timely treatment, usually goes away in 2-3 days. Most often, lactostasis occurs without fever, the mother’s well-being does not suffer, only pain in the area of ​​the affected gland appears.

Mastitis is a more serious complication of lactostasis, in which severe hyperthermia is observed, the skin of the breast turns red, swelling increases, and the woman’s condition clearly worsens. If you suspect a problem is developing, you should regularly measure the temperature in both armpits and immediately consult a doctor. If the development of the inflammatory process can be stopped in time, a nursing woman will be able to avoid serious health problems.

Should you feed if you have lactostasis and how correctly?

The most common question that arises when a nursing mother has stagnant milk is what needs to be done and is it possible to continue putting the baby to the breast? You can and should continue to feed, increasing your feeding frequency, if there is no suspicion that the problem has turned into infectious mastitis. Natural feeding is the easiest way to eliminate blockage of the gland ducts if you choose the right feeding positions suitable for lactostasis:

• “cradle” - in a sitting position, a nursing mother holds her baby in her arms, like a baby’s cradle;
• feeding from under the hand - the baby is located on a pillow, the mother holds him facing the breast (the baby’s chin is directed not to the center of the chest, but to the armpit). This is how the newborn effectively absorbs the axillary lobes of the gland;
• face to face - the nursing mother bends over the baby; this position is recognized by doctors as the most physiological for emptying all the ducts and lobes of the mammary glands.

On a note! The golden rule for eliminating pathology is that the baby absorbs the part of the chest towards which its chin is directed. This way, every nursing woman will be able to correctly position the baby for better emptying of the gland and relief of stagnation. It is important to ensure correct latching of the nipple, otherwise the baby will not be able to fully absorb the seals, and at the same time damage the mother’s delicate skin. Infection of the wound on the nipple can provoke the development of mastitis and serious complications.

Do I need to see a doctor?

Which doctor should you contact for lactostasis and is it necessary to do so? An experienced nursing mother who has already had similar problems can independently take measures at home. Set up a feeding regimen, choose the right positions, apply effective and safe compresses. But if a woman has given birth and is breastfeeding for the first time, it is better not to delay visiting the doctor, but to contact a visiting nurse or pediatrician who is monitoring the baby. You can visit your local therapist and get his advice.

For lactostasis, clinical medical recommendations boil down to the use of medications, physiotherapy, correct and frequent breastfeeding, massage and pumping. Before prescribing certain medications for lactostasis, doctors recommend undergoing an ultrasound examination of the glands. This is necessary to confirm the disease and ensure that there are no signs of mastitis.

Treatment of lactostasis - how can a doctor help, and what can you do on your own?

If a nursing mother experiences lactostasis, treatment can be started independently, with simple but effective measures. These include massage and pumping procedures, and it is also recommended as often as possible so that it resolves any lumps that appear. In this case, you need to feed the baby twice from the affected gland, and once from the healthy one. Before breastfeeding, you should lightly express the milk to make it easier for your baby to breastfeed. After feeding, you can make a absorbable, anti-inflammatory compress.

What to do with lactostasis if its symptoms in nursing mothers do not go away, despite treatment at home? Be sure to visit a doctor. In addition to home therapy methods, he will prescribe the necessary medications, prescribe a course of physiotherapy (ultrasound, electrophoresis, darsonval), and explain how to properly express milk and perform a massage. Additional assistance with lactostasis is provided by a special device for electrophoresis at home. With it, under the supervision of a doctor, you can treat with Dimexide, Troxevasin and other drugs to eliminate congestion in the chest.

Breast massage and pumping for stagnant milk

How to deal with lactostasis if the baby is not able to completely dissolve a stagnant lump in the gland? Expressing and massaging your breasts will help, but you can express milk manually or using a breast pump, which is less effective. The procedure should be carried out in a comfortable environment, after taking a warm shower.

4 fingers of the hand should clasp the gland from below, and the upper one should be located at the top. The areola is grasped with the thumb and index finger. Breast massage during lactostasis will help to soften the tubercles and lumps; you need to make radial movements directed towards the nipple. Further, as the gland softens, the milk is carefully expressed, without sharp pressure that causes pain.

Important! If you feel discomfort during massaging and pumping due to inflammation, you can take an approved anti-inflammatory pain reliever. At the end of the procedure, you should apply a cool compress to the gland, this will eliminate swelling.

Ointments

Treatment of lactostasis involves applying ointments to the breasts that are approved for use by a nursing woman. The most effective and safe remedy is Traumeel S - it is a homeopathic ointment that has no side effects and does not cause unexpected reactions. Apply Traumeel C 4-5 times a day to the affected areas to improve lymphatic drainage, blood flow to tissues, relieve pain and reduce inflammation.

Another good remedy is Malavit, the ointment is diluted in half with water. Afterwards, a piece of cotton wool or a piece of gauze is moistened with the solution and applied to the diseased gland. Keep the compress until the next feeding of the baby, after which the breast is washed and given to the baby. After the baby has eaten, you can reapply the ointment.

You cannot use Vishnevsky ointment, which many nursing mothers love! It provides an intensive supply of blood to the tissues, which makes the disease aggravated by mastitis. In addition, the pungent odor of the product cannot be eliminated even by washing; as a result, the baby will refuse the breast, even if he is hungry.

Compresses

How to properly treat lactostasis with compresses? You need to apply the remedy after massage and expressing milk, or after putting the baby to the breast, when the gland is empty and the lumps are broken. The drug magnesia has a good effect - it is sold in the form of a solution or powder. A piece of gauze folded in several layers is moistened with the solution and applied to the affected area of ​​the chest for half an hour. The procedure is repeated three times a day.

Many doctors consider the use of Dimexide for advanced lactostasis to be justified in the form of lotions of a 20% solution mixed with Amoxiclav suspension. This avoids the development of mastitis. But such treatment requires monitoring by the nursing mother of the baby’s reaction. If signs of allergy appear, Dimexide should not be used.

Ultrasound treatment

This procedure allows a nursing mother to painlessly and effectively eliminate lumps in the gland, reduce the level of inflammation and relieve discomfort. Ultrasonic massage should not be performed on women suffering from the following pathologies:

• diseases of the nervous system;
• presence of fibroadenoma;
• malignant neoplasms;
• hormonal imbalances;
• lactostasis, aggravated by mastitis.

During the procedure, the specialist gently massages the nursing mother's breasts using ultrasonic waves to improve the flow of milk through the clogged ducts. After the massage, you should pump; you cannot immediately apply the baby to the diseased gland.

Cabbage leaf and other folk remedies

What can be done for lactostasis at home if there is no suspicion of developed mastitis? Simple but effective methods from the collection of folk recipes will help:

• compress of cabbage leaves. You need to apply the cabbage leaf, lightly crush it to release the juice and hold it until it dries, then replace it with a fresh one. Before applying the nipple, you need to wash it so that the cabbage juice does not cause digestive problems for the baby;
• cottage cheese cake. A flat cake is made from cool fresh cottage cheese, which is applied to the inflamed area for 20-30 minutes (the cottage cheese should be cool, but not icy);
• honey-flour compress. The ingredients are kneaded into a homogeneous mass, then a flat cake is made, placed on the gland and covered with cellophane. Keep it for half an hour to relieve inflammation and pain.

Carefully! It is not recommended to make compresses from camphor, vodka and alcohol, since pathogenic microbes multiply in the gland during warming. Despite the temporary relief of pain, this will cause complications in the form of mastitis.

Drugs for lactostasis

A nursing mother should not take antibiotics for lactostasis immediately, especially without consulting a specialist. Incorrectly selected medications will harm the baby, and the use of antibacterial agents is usually recommended if treatment within 2-3 days does not produce results. for lactostasis it is prescribed in the form of tablets or suspension; it is approved for nursing mothers and is not dangerous for the child. Lactostasis is also treated with the help of, this is an analogue of Amoxiclav, but without clavulanic acid.

Often, for lactostasis occurring against the background of severe pain, the drug No-shpa is prescribed. It relieves spasms and makes the nursing mother feel better, but has a side effect - the milk becomes more viscous. Therefore, while taking No-shpa, you should drink more liquid - a decoction of chamomile, fennel, mint tea, compotes and fresh juices are suitable.

If the temperature rises and aches appear in the body of a nursing mother, you can take an anti-inflammatory pill, but remember that it will not help with lactostasis, but will only eliminate the main symptom. It is not worth taking medications at temperatures below 38 o C; it is better to give the body the opportunity to overcome inflammation on its own. Doctors for lactostasis allow nursing mothers to use Ibuprofen or Paracetamol, but not to abuse medications.

What other drugs are prescribed for nursing mothers:

• Menovazin - for lactostasis, ointment is applied to the chest in case of severe pain and itching. Used both independently and in combination with gland massage. Do not use if you are allergic to novocaine;
• Bromocriptine (analogue of Dostinex) - is prescribed for lactostasis with increased milk production and even greater blockage of the ducts. Reduces the production of the hormone prolactin and weakens lactation to prevent complications;
• Oxytocin in the nose - many doctors recommend using the drug intranasally for lactostasis to avoid increasing the tone of the uterus, especially for women after cesarean section. The hormone allows the gland ducts to relax for the full outflow of milk.

Any medicine for lactostasis should be prescribed by a doctor, especially drugs such as Bromocriptine, Oxytocin and antibiotics. Each medication has its own list of contraindications and side effects, which only a specialist can know about.

Temperature during lactostasis - what you need to know?

Lactostasis is usually not accompanied by a general increase in temperature in a nursing mother; hyperthermia can be observed locally, in the affected areas. Many women do not pay attention to stagnant processes, in the hope that everything will work out on its own, especially in the absence of fever. As a result, the skin in the area of ​​the lumps turns red, the pain radiates from the chest to neighboring areas, as with ARVI, and the temperature rises to 38-39 o C.

Need to know! This is how purulent mastitis begins. It is dangerous to self-medicate; it is necessary to visit a specialist as soon as possible. If a nursing mother does not start treating lactostasis in time, then self-therapy for purulent inflammation is out of the question.

How to understand that lactostasis has passed?

Nursing mothers who take responsibility for their health and begin treatment immediately after detecting signs of stagnation achieve success in therapy within 2-3 days. How can you understand that lactostasis has passed, and the risk of developing mastitis is left behind? The success of the treatment is indicated by soft, painless mammary glands with a natural skin color. If there are no seals in the glands, the baby easily sucks milk, and the temperature in the breast area remains within normal limits, this means that the disease has subsided.

Prevention

How to avoid the development of lactostasis during breastfeeding? It is imperative to follow preventive measures, even if a woman is feeding not her first child, but her second and even third child:

• feed the baby in different positions so that all lobes of the glands are emptied efficiently;
• carry out correct attachment, the baby should completely grasp the nipple and areola;
• a nursing mother should breastfeed her baby on demand, and not on a schedule, every 3-4 hours;
• do not express if the baby eats almost all the milk - this will provoke increased lactation and the formation of stagnation;
• do not sleep on your stomach, turn over more often during sleep;
• do not wear tight underwear with hard underwires;
• avoid hypothermia and infectious diseases.

It is important to follow the rules of hygiene - take a shower twice a day and wash your breasts before each application. Also, prevention of lactostasis includes maintaining a healthy lifestyle, proper nutrition (without abuse of animal fats) and compliance with the drinking regime.

To avoid lactostasis, a nursing mother should monitor the condition of the mammary glands. The disease should not be taken lightly; stagnation of milk often provokes the development of mastitis, especially if the baby is not applied correctly to the breast and the nipples become infected. If signs of pathology are detected, you should feed the baby as often as possible so that he resolves the lumps in the chest on his own, and also use proven methods at hand. If within 3-4 days the nursing mother’s condition has not improved and the temperature begins to rise, you should consult a doctor and strictly follow the treatment recommendations.