Prevention and treatment of lactostasis and (or) mastitis in the pediatric area: practical aspects

Abstract

Introduction. Incomplete breast emptying is the main cause of lactostasis, which can contribute to the development of mastitis. The article discusses the issues of prevention and treatment of lactostasis in breastfeeding mothers in the district covered by childhealth care: how to arrange breastfeeding, expression of breast milk, regime issues from the baby’s first days, as well as present-day knowledge on breast milk microbiota dysbiosis and an option of probiotic therapy. Clinical cases are presented.Clinical case 1. A breastfeeding mother found breast lumps on the one side 2 weeks after her labour. Lactostasis was diagnosed, it was caused by inappropriate breastfeeding technique. The breastfeeding mother was provided with the recommendations for proper performance of breastfeeding technique and prescribed the drug therapy: ibuprofen 400 mg once at fever ≥ 38.5 ºC and Lactobacillus fermentum CEST5716 – 1 capsule once daily. On the 3rd day, her health state significantly improved, the pain reduced, the temperature returned to normal, the breast lumps practically disappeared, on the 5th day the pain and breast lumps completely disappeared.Clinical case 2. A breastfeeding mother, first labour, 2 months have passed since her labour, exclusively breastfeeding on demand, complaints of pain in the left breast, local hyperemia 3 x 3 cm occurred, no breast lumps, local pain elicited by palpation, fever of 37.2 ºC. The breastfeeding mother was diagnosed with lactostasis, she was provided with recommendations for the arrangement of breastfeeding and expression of breast milk; not proscribed with antibacterial therapy, but the therapy with Lactobacillus fermentum CEST5716, 1 capsule once daily for 1 month. A day later, her health state improved: the pain reduced, the hyperemia disappeared, her body temperature returned to normal. The patient was recommended non-drug measures for preventing lactostasis and continuous administration of Lactobacillus fermentum CEST5716 – 1 capsule daily for 1 month.Clinical case 3. A breastfeeding mother detected daily lactostasis in her right breast 3 months after her labour. It might had been caused by chest contusion before the onset of the 1st episode of lactostasis. Medical examination revealed calcifications in her breast duct. Against the background of non-drug therapy, the patient adminstered Lactobacillus fermentum CEST5716 – 1 capsule daily, which resulted in a positive effect in a week’s time. The follow-up observation showed that lactostasis completely resolved without relapses in a 1.5-months’ time.Сonclusion. The correct breastfeeding technique is key to the prevention of lactostasis and mastitis, and the use of probiotic therapy Lactobacillus fermentum CEST5716 is an effective and safe drug treatment.