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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 .
- 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
- 4. It usually manifest after the milk secretion start (3 or 4 day postpartum )
- 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
- 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 .
- 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 .