Lactostasis is the stagnation of milk in one or more areas of the mammary gland. This condition is manifested by compaction of the gland tissue and pain – especially during palpation. A network of dilated veins is visible on the skin of the corresponding chest area. The tension and soreness of the areas of the gland can persist even after its emptying. Body temperature with all this is traditionally normal or subfebrile.
Causes of lactostasis
The occurrence of lactostasis is traditionally caused by two reasons: increased milk production and a violation of its outflow from any area or from the gland as a whole as a result of blockage or narrowness of the milk ducts.
Factors predisposing to the development of lactostasis are:
- discrepancy between the active functioning of the glandular tissue that produces milk, and the diameter of the lumen of the lactiferous passages (more often this happens after the first birth);
- flat nipple, the presence of cracks on the nipple, which makes it difficult to breastfeed;
- refusal to breastfeed and the transition to artificial feeding;
- stress and excessive physical activity, which lead to spasms of the ducts of the mammary glands;
- injuries and bruises of the chest;
- improper attachment to the breast, in which the child sucks ineffectively, does not empty the breast enough;
- squeezing the mammary glands with tight clothing or the mother’s fingers during feeding, sleeping on the stomach;
- difficult outflow of milk from the lower part of a large breast when it sags;
- hypothermia or being in a draft, as a result of which the mammary glands “catch cold”.
Increased milk production, as a rule, takes place in the first days when lactation is established. At the first birth, milk arrives by 30% and, sometimes – on the fourth day, with repeated births – about a day earlier. The baby at this time still sucks very little, and the breast is not completely emptied during feeding. With repeated births (or, more precisely, with repeated breastfeeding), the development of congestion is associated, perhaps, only with this. In the case of the first birth, moreover, the outflow of milk is often difficult, since the “undeveloped” ducts of the mammary glands in a primiparous woman are narrow and more tortuous.
Insufficient emptying of the mammary gland leads to an increase in pressure in the lumen of its ducts and inside the lobules. This causes some swelling and infiltration of the tissue of the corresponding area, which leads to irritation of pain receptors and is manifested by local pain. In addition, an increase in pressure in the secretory sections of the gland inhibits further lactation. Milk, which does not leave the gland for a long time, undergoes reabsorption processes, while acquiring pyrogenic properties, which causes an increase in body temperature – the development of the so-called “milk fever”.
Prevention and treatment of lactostasis
It will be necessary to fight lactostasis not only because this condition causes discomfort in a woman, but also because it predisposes to the development of mastitis (inflammation of the breast tissue).
For the prevention of lactostasis a and the fight against it, it is necessary first of all to prevent a sharp increase in the amount of milk. Therefore, it is very important in the first week after childbirth to limit fluid intake (including first courses and fruits) to 800-1000 ml every day. It will most likely not be easy to do this, since at this time you want to drink much more than traditionally.
Another means of preventing lactostasis is the frequent application of the baby to the breast. There is an opinion that only one breast should be given to the child at each feeding, but there is another point of view, according to which it will be necessary to feed alternately from both breasts, ending the feeding by applying to the breast that was given to the baby first. But one thing is certain: you will need to feed the baby on his first demand and allow him to be at the breast for as long as he wants. If the milk stasis is significant, it may be difficult for the baby to take and suckle the breast. In this case, it is necessary to express a small portion of milk, which will relieve tension within the nipple area and allow your child to easily grab the nipple.
It is also useful to periodically massage the chest. Massage is carried out in a circular motion from the periphery to the center of the gland. Particular attention should be paid to more dense and painful areas.
If one breast bothers you more than the other, you can offer it to your baby more often. If the baby still cannot cope with the incoming amount of milk and, after feeding, compacted painful areas remain in the breast, you will have to express the excess. Manual pumping is not often extremely painful, so ask your midwife to “pump” you. High-class specialists are capable of not causing pain at all. Or maybe hardware pumping will be more comfortable for you? In terms of efficiency, it is not inferior to manual, you only need to massage the problem areas of the gland well. Warm compresses on the chest help well – with Vishnevsky ointment, vaseline and camphor oil, alcohol. They should be used after a full pumping. Gauze wipes are moistened with oil or alcohol (70% alcohol is diluted with water 1:1, 96% – 1:2) and applied to the skin of the breast, covering its entire surface. The next layer of the compress is made of polyethylene or cellophane; it does not allow the liquid to dry out. The resulting bandage should be well secured with a bandage or diaper. The compress should be on the chest within six to eight hours.
Ultrasonic massage of the mammary glands can be very effective. In addition, oxytocin is not often prescribed to improve milk flow. It is administered intramuscularly 20-30 minutes before feeding and causes contraction of the ducts of the mammary gland.