Introduction
Mastitis is the medical term to denote inflammation of the breasts. As sensitive and tender the organ is, such bad are the pain and sufferings caused to the patient by the inflammation of the same. It usually affects breastfeeding women in their twenties or older but rare cases are reported in teenagers with obesity, diabetes etc. Acute mastitis is caused by germs including bacteria that spread from outside environment. Clogged or blocked capillaries and tubules facilitate the inflammation along with redness, swelling, severe pain and tenderness. The pain can be so severe and sickening. Even wearing a dress over chest may be unbearable. Immediate intervention is needed in such cases to relieve pain and to prevent spread of infection.
Signs & symptom
Acute Signs and symptoms of mastitis include:
- Pain and tenderness of breast tenderness
- Warm touch of breast
- Swelling of breast
- Hardening of breast tissue/breast lump
- Pain or a burning sensation continuously or while breast-feeding
- Wedge-shaped redness on breast
- Generally feeling sick
- High fever
Causes
Most common cause of mastitis is breastmilk trapped in the breast.
Other conditions include:
- Bacteria entering your breast.Bacteria from skin’s surface and baby’s mouth can enter the milk ducts through a crack in the skin of nipple or through a milk duct opening. Stagnant milk in a breast that isn’t emptied provides a breeding ground for the bacteria.
Risk factors for mastitis include:
- Previous bout of mastitis while breast-feeding
- Sore or cracked nipples — although mastitis can develop without broken skin
- Wearing a tightfitting bra or putting pressure on your breast when using a seat belt or carrying a heavy bag, which may restrict milk flow
- Improper nursing technique
- Becoming overly tired or stressed
- Poor nutrition
- Fumer
Physiopathologie
While understanding the specialities of anatomy, each breast has a number of sections (lobules) that branch out from the nipple. Each lobule holds tiny, hollow sacs (alveoli). The lobules are linked by a network of thin tubes (ducts). If a woman is breast-feeding, ducts carry milk from the alveoli toward the dark area of skin in the centre of the breast (areola). From the areola, the ducts join together into larger ducts ending at the nipple. The term mastitis, as explained earlier, denotes an inflammation in the breast tissue or capillaries. It can happen in multiple ways like:
In lactational mastitis, the source of infection is bacteria, mostly from the mouth of baby while feeding. They enter through cracks or fissures in the nipple surface. Once the primary defences are breached, organisms have an ideal culture environment in nutrient rich maternal milk leading to rapid cell division and growth. This can be augmented by milk stasis and overproduction leading to mastitis. In neonates, transient breast enlargement secondary to maternal hormones can make them vulnerable to mastitis.
In duct ectasia, the mammary duct-associated inflammatory disease sequence involves squamous metaplasia of lactiferous ducts, causing blockage (obstructive mastopathy) with peri-ductal inflammation and possible duct rupture. Inflamed ducts are prone to bacterial infection.
In tubercular mastitis, mycobacterium tuberculosis can enter the breast from a direct inoculation (via a nipple abrasion) or more commonly from secondary spread from a distal source such as lymphatic spread, miliary dissemination, or contiguous spread (e.g., empyema necessitans). Clinical presentation is usually of a solitary, ill-defined, unilateral hard lump situated in the upper outer quadrant of the breast. Primary TB of the breast is rare. Necrotizing granulomas are the histopathological hallmark of TB infection.
In granulomatous mastitis, granulomas are usually non-necrotizing, inflammation is focused around breast lobules that clinically may present as a painless mass.
Diagnostic
- A thorough physical exam
- A culture of breast milk
- A mammogram or ultrasound or both to rule out inflammatory breast cancer. A rare form of carcinoma of the breast called inflammatory breast cancer also show similar signs & symptoms.
- A biopsy in needed cases.
Traitements
- Mastitis treatment includes:
- Antibiotics – In an infection, a 10-day course of antibiotics is usually needed. It’s important to take all of the medication to minimize the chance of recurrence.
- Pain relievers – such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).
It is safe to continue breast-feeding if you have mastitis. Breast-feeding actually helps clear the infection. Weaning your baby abruptly is likely to worsen your signs and symptoms.
Guidance to ensure proper and safe breastfeeding
- Avoiding prolonged overfilling of your breast with milk before breast-feeding.
- Trying to ensure that your infant latches on correctly — which can be difficult when your breast is engorged. Expressing a small amount of milk by hand before breast-feeding might help.
- Massaging the breast while breast-feeding or pumping, from the affected area down toward the nipple.
- Making sure your breast drains completely during breast-feeding. If you have trouble emptying a portion of your breast, apply warm and moist heat to the breast before breast-feeding or pumping milk.
- Breast-feeding on the affected side first, when your infant is hungrier and sucking more strongly.
- Varying your breast-feeding positions.
Pronostic
When treated promptly, most of breast infections heal quickly, without serious complications. Most women can continue to breastfeed despite an episode of uncomplicated mastitis.
Complications
Abscess formation and pus discharge
Rarely carcinoma of breast
Maladies et Ayurveda
Sthanaroga – sopha
Nidana
Stagnant milk
Improper breastfeeding
Food and regimen causing vitiation of doshas, especially kapha & Pitta
Purvaaroopa
Non mentionné
Samprapti
Due to causative factors vitiated doshas predominantly kapha causes swelling and obstruction of channels in breast. After that, when Pitta is associated Paaka (inflammation) happens. In the blocked channels, deviated Vaata causes pain and tenderness. These three doshas when vitiated, get lodged in the breast of lactating woman affects rakta&maamsa dhatu and lead to disease manifestation.
Lakshana
- Pain
- Tenderness
- Hardness on touch
- Heaviness of breasts
- Mild fever
- Warmth, discoloration or smell of discharge from breast/breastmilk
Divisions
Not mentioned.
Pronostic
Sadhyam in navam and Apaakai (new and without inflammation)
Krischrasadhyam in puraanam and Paaki(chronic and inflammatory)
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam
Vimlapanam
Sodhana
Paatanam
Vidaaranam
Then treatment of wound should be done
Médicaments couramment utilisés
Guggulupanchapalachoornam
Kanchanaraguggulu
Varasanadi kashayam
Marques disponibles
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Remèdes maison
Some home remedies help reduce the discomfort:
- Avoid prolonged overfilling of your breast with milk before breast-feeding
- Apply cool compresses or ice packs to your breast after breast-feeding
- Wear a supportive bra
- Rest as much as possible
Régime alimentaire
- À éviter
Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Boissons gazeuses - rendent l'estomac plus acide et perturbent la digestion
Aliments réfrigérés et congelés - provoquent une digestion faible et paresseuse en affaiblissant Agni (le feu digestif).
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies
- A ajouter
Des repas légers et des aliments faciles à digérer
Green gram, soups, honey
Aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.
Comportement :
Protect yourself from very hot climate.
Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.
Maintenir une alimentation et un sommeil réguliers.
Évitez de retenir ou de forcer les envies comme l'urine, les selles, la toux, les éternuements, etc.
Avoid sedentary lifestyle.
postures de Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
L'exercice régulier contribue à améliorer la biodisponibilité des médicaments et des aliments ingérés et favorise la santé.
Le yoga permet de maintenir l'harmonie à l'intérieur du corps et avec le système environnant.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Exercices simples pour la santé des poumons et du cœur
Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.
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