Mastitis and/or plugged ducts? How to differentiate, help and treat?

Abstract

Mastitis is one of the most common pyoinflammatory processes that occur in the postpartum. The mastitis incidence varies from 0.5% to 33%. Due to lack of standard algorithms, approaches to diagnosis and treatment of lactational mastitis vary between pediatricians and obstetrician-gynecologists. Plugged ducts is the basic factor that predisposes a woman to plugged milk ducts, which can lead to mastitis. Unfortunately, frequently prescribed antibacterial treatment has an adverse effect on human milk microbiota and creates subtherapeutic drug concentration in milk, which leads to antibiotic resistance in infants. Effective expression of breast milk is a key method to prevent and fight mastitis and plugged ducts. Recommendations for preferred method of breast milk expression require a personalized approach, the first of which depends on the assessment of breast nipples condition. According to some reports, 80–90% of breast-feeding women develop soreness and cracked nipples, which cause delayed or missed breastfeeding. Teaching correct breast-feeding techniques can prevent the chain of these adverse events: cracked nipples – plugged duct – lactation mastitis. Ideally, a healthy mature infant with active sucking reflex, who is breastfed effectively with a good technique, may perfectly ensure a problem-free lactation period.