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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2019-11-10-15</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-3075</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>НЕОНАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>NEONATOLOGY</subject></subj-group></article-categories><title-group><article-title>Мастит и/или лактостаз? Как отличить? Чем помочь? Как лечить?</article-title><trans-title-group xml:lang="en"><trans-title>Mastitis and/or plugged ducts? How to differentiate, help and treat?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Ирина Николаевна – заслуженный врач РФ, доктор медицинских наук, профессор, заведующая кафедрой педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Zakharova Irina Nikolaievna – Honoured Doctor of the RF, Dr. of Sci. (Med.), Professor, Head of G.N. Speransky Chair for Paediatrics with Outpatient Paediatrics Module</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1 </p></bio><email xlink:type="simple">zakharova-rmapo@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кучина</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuchina</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кучина Анастасия Евгеньевна – аспирант кафедры педиатрии с курсом поликлинической педиатрии имени академика Г.Н. Сперанского</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Kuchina Anastasiya Evgenievna – a postgraduate student, G.N. Speransky Chair for Paediatrics with Outpatient Paediatrics Module</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1 </p></bio><email xlink:type="simple">simba_87@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бережная</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Berezhnaya</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бережная Ирина Владимировна – кандидат медицинских наук, доцент кафедры с курсом поликлинической педиатрии имени академика Г.Н. Сперанского Федерального государственного бюджетного образовательного учреждения дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</p><p>125993, г. Москва, ул. Баррикадная, д. 2/1, стр. 1, </p><p>141400, Московская обл., г. Химки, Куркинское шоссе, вл. 11</p></bio><bio xml:lang="en"><p>Berezhnaya Irina Vladimirovna – Cand. of Sci. (Med.), Associate Professor, G.N. Speransky Chair for Paediatrics with Outpatient Paediatrics Module, Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</p><p>125993, Moscow, Barrikadnaya St., 2/1, b. 1, </p><p>141400, Moscow Region, Khimki, Kurkinskoye Shosse, Est. 11</p></bio><email xlink:type="simple">berezhnaya-irina26@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Санникова</surname><given-names>Т. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Sannikova</surname><given-names>T. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Санникова Туйаара Николаевна – кандидат медицинских наук, заместитель главного врача</p><p>141400, Московская обл., г. Химки, Куркинское шоссе, вл. 11</p></bio><bio xml:lang="en"><p>Sannikova Tuiaara Nikolaievna – Cand. of Sci. (Med.), Deputy Chief Physician</p><p>141400, Moscow Region, Khimki, Kurkinskoye Shosse, Est. 11</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации;&#13;
Химкинская центральная клиническая больница Московской области</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Additional Professional Education «Russian Medical Academy of Continuing Professional Education» of the Ministry of Health of the Russian Federation;&#13;
Moscow Region Khimki Central Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Химкинская центральная клиническая больница Московской области</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Region Khimki Central Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>15</day><month>07</month><year>2019</year></pub-date><volume>0</volume><issue>11</issue><fpage>10</fpage><lpage>15</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Захарова И.Н., Кучина А.Е., Бережная И.В., Санникова Т.Н., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Захарова И.Н., Кучина А.Е., Бережная И.В., Санникова Т.Н.</copyright-holder><copyright-holder xml:lang="en">Zakharova I.N., Kuchina A.E., Berezhnaya I.V., Sannikova T.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/3075">https://www.med-sovet.pro/jour/article/view/3075</self-uri><abstract><p>Мастит – одно из наиболее распространенных гнойно-воспалительных осложнений послеродового периода. Частота встречаемости мастита варьируется от 0,5% до 33%. В отсутствие стандартизированного протокола подходы к диагностике и лечению лактационного мастита у педиатров и акушеров-гинекологов расходятся. Лактостаз является основным фактором, предрасполагающим к развитию мастита. К сожалению, часто назначаемое антибактериальное лечение пагубно влияет на микробиоту грудного молока и создает субтерапевтическую концентрацию препарата в молоке, что способствует риску развития антибиотикорезистентности у ребенка. Ключевой способ профилактики и борьбы с лактостазом и маститом – эффективное сцеживание грудного молока. Рекомендации предпочтительного метода сцеживания требуют индивидуального подхода, в первую очередь в зависимости от оценки состояния сосков. По некоторым данным, 80–90% женщин в период лактации сталкиваются с болезненностью и трещинами сосков, что часто становится причиной отсроченных и пропущенных кормлений. Обучение женщин правильной технике грудного вскармливания способно предотвратить цепочку этих неблагоприятных событий: трещины сосков – лактостаз – лактационный мастит. Здоровый доношенный новорожденный с активным сосательным рефлексом в условиях хорошо организованной техники грудного вскармливания вполне может обеспечить своей матери беспроблемный лактационный период.</p></abstract><trans-abstract xml:lang="en"><p>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.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>мастит</kwd><kwd>лактостаз</kwd><kwd>трещина сосков</kwd><kwd>антибиотикорезистентность</kwd><kwd>сцеживание</kwd><kwd>молокоотсос</kwd></kwd-group><kwd-group xml:lang="en"><kwd>mastitis</kwd><kwd>plugged duct</kwd><kwd>cracked nipples</kwd><kwd>antibiotic resistance</kwd><kwd>decantation</kwd><kwd>breast pump</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Amir L.H.; Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #4: Mastitis, revised March 2014. Breastfeed Med. 2014; 9 (5): 239–243. doi: 10.1089/bfm.2014.9984.</mixed-citation><mixed-citation xml:lang="en">Amir L.H.; Academy of Breastfeeding Medicine Protocol Committee. 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