Agalactia
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Forecast
- Prevention
Agalaktia is a condition that is a complication of the postpartum period and is characterized by a complete lack of milk in the mother.
Unlike hypogalactia (a condition when breast milk is critically small) and secondary agalactia, true (primary) agalactia cannot be corrected.
With agalactia, the mother has no milk in her breast
Causes and risk factors
The reasons for the lack of milk in the mother in the postpartum period:
- pathology of breast tissue (absence of a glandular component);
- neurohormonal disorders;
- some concomitant diseases;
- toxicosis in late pregnancy;
- infectious and inflammatory diseases suffered during pregnancy or in the postpartum period;
- complications of pregnancy, childbirth and the postpartum period (including bleeding during childbirth);
- traumatic obstetric interventions;
- intense psycho-emotional stress.
The mammary gland consists of glandular, connective and adipose tissue. Dense connective tissue partitions grow from the skin into the thickness of the gland, dividing the organ into 15-20 lobes, filled with glandular tissue with ducts in which milk is produced and separated. The rest of the organ is formed by adipose tissue. The absence of glandular tissue in the mammary glands is a rare congenital pathology. In this case, there is no anatomical substrate for the formation and excretion of milk.
Impaired prolactin secretion leads to irreversible agalactia
Hormonal disorders, in particular, a violation of prolactin secretion, can also lead to a complete irreversible lack of milk. Prolactin (lactotropic, or lactogenic hormone) is synthesized in the structures of the brain and is responsible for the production of colostrum, promotes its conversion into mature milk, and stimulates the development of mammary glands. When the secretion of this hormone is disturbed, milk production stops.
Other factors, as a rule, cause the appearance of reversible (secondary) agalactia, amenable to correction.
Forms of the disease
Allocate primary (true, or absolute) agalactia and secondary (relative):
- primary agalactia is the initial inability to produce milk in a woman's body due to neurohormonal disorders or endocrinopathies, as well as pathology (absence) of glandular tissue. According to the World Health Organization, this form is extremely rare, in less than 3% of cases;
- secondary agalactia - provoked by transient causes or diseases and pathological conditions that cause excessive stress in the body's functions or disruption of its adaptive capabilities (severe diseases, an unfavorable course of pregnancy and childbirth, trauma during childbirth, unsatisfactory psycho-emotional state of the mother, etc.).
Symptoms
Normally, colostrum begins to be produced from the 30th week of pregnancy, by 3-5 days of the postpartum period, it is first replaced by transitional and then mature milk.
In primary agalactia, both milk and colostrum are absent. In certain cases, it is possible to separate a small amount of colostrum, which completely stops 2-3 days after delivery. Due to the failure of lactogenesis, it is not possible to correct this condition.
The main symptom of primary agalactia is lack of milk and colostrum
With secondary agalactia, either a complete absence of milk from the moment of delivery and in the postpartum period is possible, or the cessation of lactation a few days after its onset. With complex therapy, as a rule, it is possible to restore the normal functioning of the mammary glands.
Diagnostics
For the differential diagnosis of primary and secondary agalactia, instrumental and laboratory research methods are used:
- Ultrasound of the mammary glands for the formation of the glandular component;
- a blood test for prolactin;
- if necessary, CT of the brain (detection of neoplasms, structural changes in the hypothalamic-pituitary system).
One of the methods for diagnosing agalactia is ultrasound
Based on the results of the examination, a clarifying extended diagnosis with the involvement of related specialists (endocrinologist, therapist, surgeon, psychotherapist) can be recommended.
Treatment
Treatment of primary agalactia is not possible; the newborn is transferred to artificial feeding.
Secondary agalactia therapy includes:
- treatment of the underlying disease, elimination of provoking factors;
- normalization of the mother's emotional state;
- taking measures to restore and enhance lactation (frequent latching of the baby to the breast on demand, regular pumping, night feedings);
- lactogonic agents (nicotinic acid, vitamin E, Lactin, Desaminooxytocin);
- phytopreparations (decoction of nettle leaves, hawthorn extract, fresh parsley, infusion of walnuts in milk, Lactovit, etc.);
- physiotherapeutic procedures (UV, ultrasound therapy, electrophoresis with nicotinic acid);
- high-calorie diet.
Frequent latching to the breast helps to heal secondary agalactia
Forecast
Primary agalactia is a predictively unfavorable condition for breastfeeding.
With an integrated approach to the treatment of secondary agalactia, the prognosis is favorable: in most cases, it is possible to restore milk production.
Prevention
Prevention of primary agalactia is impossible.
Prevention of secondary agalactia:
- normalization of the "sleep - wakefulness" mode;
- fortified high-calorie diet of the expectant mother and postpartum woman;
- elimination of psycho-emotional stress;
- avoidance of stressful situations;
- physiological stimulation of lactation;
- timely therapy of concomitant diseases.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
