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$ Breast engorgement $
1. DEFINITION :-
Breast engorgement in a condition which occur
due to
Excessive production of milk
Obstruction in the outflow of milk
Poor removal of milk by baby (i.e decreased intake
of milk from breast )
or
Breast engorgement occur in the mammary gland due
to expansion & pressure exerted by synthesis &
storage of breast milk .
2.
3. Due to exaggerated normal venous.
Lymphatic engorgement of the breast which precedes lactation
.
The primiparous patient & the patient with inelastic breast
are likely to be involved .
Starting breast feeding too late
Not giving enough feed to baby or poor removal of milk by
the baby
5. 1. Both breast are-
Swollen
Warm
Tender
Painful breast
2. Nipple becomes –
Edematous
Hard areola
Flushed
6. 3.Vein over breast-
Prominent
Engorged
4. Low grade fever(100*F or 37.8*C)
5. Generalized malaise
6.Swollen &tender lymph nodes in armpits
7.Pain on feeding to baby
7.
8. To avoid prelacteal feeds.
Initiate the breast feeding early.
Feed the baby at frequent interval.
When breast are hard & over filled let out (express)
milk enough to soften nipples before putting the baby
to the breast.
Feed the baby in correct position & make sure the baby
is latching on & feeding well.
9. For breast engorgement ,as such there in no medical
treatment. But in case of relief from pain –
Give ibuprofen
Cold /hot compress
10. To support the breast with a binder or brassiere
Manual expression of any remaining milk after each feed &
keeping the interval short between feeds
Administer analgesic for pain
The baby should be put to the breast regularly at frequent
internal
In a severe cases gentle use of abreast pump may be helpful
.This will reduce the tension in the breast without causing
excess milk production.
To administer tab. Bromocriptine 2.5 mg daily for 2.3 days in
obstinate cases where the breast remain tight in spite of
sucking & expression .
11.
12. Apply moist warm packs to the involved breast to 2 to 3 min before each
feeding
Massage and manual expression of milk to relieve areola engorgement
before feeding .
Cold application after feeding .
A well fitting bra should be used to provide support and comfort .
Mild analgesic may be ordered.
Frequent ,short feeding .
Breast feeding should be continued or pumped emptying the affected
side to relive engorgement .
If feeding is too painful , maintained lactation through expression .