Pustotina Olga
a Department of Obstetrics , Gynecology and Perinatology, Peoples' Friendship University of Russia , Mikluho-Maklaya Str 6, Moscow 117198 , Russian Federation.
J Matern Fetal Neonatal Med. 2016 Oct;29(19):3121-5. doi: 10.3109/14767058.2015.1114092. Epub 2015 Nov 30.
To identify the best management approaches to mastitis management in breastfeeding women and heavy breast engorgement in the early postnatal period.
We compared various international guidelines and reviews on mastitis management in breastfeeding women and breast engorgement treatment.
Effective milk removal is recommended as a first step in mastitis management. Active emptying of the breasts can prevent mastitis development in most cases. If it fails, antibiotics should be administered for 10-14 days with continuing breastfeeding. Russian guidelines recommend antibiotic therapy during 5-7 days with temporary bromocriptine-induced breastfeeding suppression. In case of heavy breast engorgement after lactation is initiated, Progesterone-containing gel can be administered. Application of the progesterone-containing gel on the breast skin improves swelling, and reduces engorgement and tenderness in 15-20 minutes.
Antibiotics with temporary suppression of breastfeeding are more effective than with continuing breastfeeding in mastitis management. The progesterone-containing gel is recommended on the 3rd-4th days after childbirth in heavy breast engorgement to prevent mastitis.
确定母乳喂养女性乳腺炎及产后早期严重乳房胀痛的最佳管理方法。
我们比较了关于母乳喂养女性乳腺炎管理及乳房胀痛治疗的各种国际指南和综述。
建议有效排出乳汁作为乳腺炎管理的第一步。在大多数情况下，积极排空乳房可预防乳腺炎的发生。若无效，应给予抗生素治疗10 - 14天，并继续母乳喂养。俄罗斯指南建议进行5 - 7天的抗生素治疗，并临时使用溴隐亭抑制母乳喂养。产后开始哺乳后若出现严重乳房胀痛，可使用含孕酮凝胶。将含孕酮凝胶涂抹于乳房皮肤可改善肿胀，并在15 - 20分钟内减轻胀痛和压痛。
在乳腺炎管理中，临时抑制母乳喂养使用抗生素比继续母乳喂养更有效。产后第3 - 4天，对于严重乳房胀痛，建议使用含孕酮凝胶以预防乳腺炎。
