Class Teaching

Ms Shalini JoshiM.S.c. Nursing Ist yearS.C.O.N. Dehradun

NAME OF THE ACCESORY FEMALE REPRODUCTIVE ORGAN?

FUNCTION OF THE BREAST?PRODUCE MILK FOR FEEDING

THE BABY.

BREAST ENGORGEMENT AND

INFECTIONS

OBJECTIVES:-

•To define the breast engorgement•To describe the causes, onset and symptoms of breast engorgement•To discuss the prevention and treatment of breast engorgement.•To define mastitis.•To explain the onset and causative organism of mastitis•To enlist the risk factor and clinical features of mastitis.•To describe mode of infection, prevention and treatment of mastitis.

Definition Breast engorgement swelling of

the breast due to an increase in blood and lymph supply as a precursor to lactation.

Or Breast engorgement occurs in

the mammary glands due to expansion and pressure exerted by the synthesis and storage of breast milk.

CAUSE OF

ONSET:It usually manifests after the milk

secretion started (3rd or 4th day post partum

SYMPTOMS:PainFeeling of tenderness Heaviness in both breastsGeneralized malaiseTransient rise of temperaturePainful breastfeeding

PREVENTION

TREATMENT

Proper support of breast

Manual expression

Analgesics

Breastfeeding

Gentle use of breast pump

Step 1:-

Nurse baby if mother is breast feeding

Breast engorgement results from over-production of milk or under-feeding by the baby. The easiest, and quickest, way to alleviate breast engorgement is feeding baby from the breast that is engorged.

Advise a new mother to nurse her baby every 2-to-3 hours. Breast engorgement can be prevented if you follow this schedule.

Manually remove milk from breasts. There may be several days when breasts are going to be engorged if mother has decided not to breastfeed her baby. Use hands or a breast pump to manually remove milk from breasts.

Make sure only remove enough milk to alleviate the pain and firmness if ultimate goal is to let milk dry up.

Take a warm shower.

Allow the spray to start at the top of the breasts and adjust body so it works its way down. Mother can also massage them at the same time. This will be a bit painful at first, but it will ease the tenderness and hardness in the breasts.

Use cold compresses between feedings or breast pumping.

Try cold compresses to help reduce swelling and ease the pain if breasts still feel painful and are hard to the touch, even after nursing or pumping milk. Apply the compress several times for 5 minutes on, 5 minutes off. Bags of frozen vegetables work well for this method.

Wear a loose-fitting bra.

Tight-fitting bras can compress the lower part of the breast to the rib cage. This has the effect of trapping milk in the lower milk ducts and will aggravate the problem.

Chill cabbage leaves and place them inside your bra. This is a remedy that goes back to ancient times. Chill clean cabbage leaves for 30 minutes. Poke a hole in the center of a leaf for the nipple. Lay them on and around the breast and put on cloth. Do this for 20-to-30 minutes 3 times a day until the engorgement eases.

MASTITIS

ACUTE MASTITISMastitis is inflammation of tissue in

one or both mammary glands inside the breast. Mastitis usually affects lactating women - women who are breastfeeding, producing milk. 

INCIDENCEThe incidence of mastitis is 2-5 %

in lactating1% in non lactating women

ORGANISMS RESPONSIBLE:

Staphylococcus aureusStaphylococcus epidermisStreptococci viridance

RISK FACTORPoor nursingMaternal fatigueCracked nipple

FIRST TYPE OF INFECTION

Infection of the breast

parenchymal tissues

cellulitis

mastitis

Infection

Lactiferous ducts

Development of primary mammary adenitis

ONSETIn superficial cellulitis the

onset is acute during first 2 – 4 weeks postpartum

Acute mastitis may occur even several weeks after the delivery

CLINICAL FEATURES

Symptoms

Malaise and headache

Fever

Pain and tender swelling in one quadrant of breast

Signs

Presence of toxic featuresWedge shaped swelling on the

breast Overlying skin is red hot and

flushed and feels tender and tense

COMPLICATION Due to destruction of breast tissue

Breast abscess

PROPHYLAXISThorough hand washing before

each feedCleaning the nipple before and

after each feed and keeping them dry

MANAGEMENTBreast supportPlenty of oral fluidsBreastfeedingManual emptying of infected side

after feedDicloxacillin 500mg Q6hAnalgesics (ibuprofen)