LU 7 Common Breast Problems in Lactation

What are the common breast problems in lactation ?

• flat and inverted nipples

• breast engorgement

• cracked nipples

• blocked duct and mastitis

• breast abscess

What is colostrum and when is it ?

• mother’s milk that is high in protein and contains mother’s antibody to protect the baby from infection for the first 6 months of life

What is foremilk and hindmilk ?

• foremilk : contain water only (the first milk)

• hindmilk : contain sugar and fats (high calorie)

What are the management for flat and inverted nipples ?

• build the mothers confidence

• help the mother to position her baby correctly

• if baby cannot suckle effectively, encourage mother to feed with expressed breastmilk

Briefly explain breast engorgement in terms of

• when does it usually happen

• clinical presentation

• treatment

• when : usually 3rdday postnatal when secretion of milk begins

• clinical presentation : over distended with visible dilated veins, painful and tender

• treatment : i) breast evacuation ii) manual expression and electric breast pump iii) analgesics iv) cold compress

Briefly explain cracked nipples in terms of

• causes

• treatment

• causes : i) poor hygiene and dryness of nipples ii) vigorous suckling of a hungry baby iii) leaving baby too long at the breast

• treatment : i) rest the affected breast till healing ii) cold compress

Briefly explain blocked duct and mastitis in term of

• what is it

• causes

• clinical presentation

• management

• inflammation of the breast

• causes : i) poor drainage of breast ii) blocked ducts, milk stasis and cracked nipples

• clinical presentation : i) painful, redness, tenderness in the affected breast ii) axillary lymph nodes enlarged iii) breast engorgement

• management : i) improve drainage of milk ii) advice on frequent feeds iii) gentle massage towards nipple iv) warm compress for comfort and circulation

Briefly explain breast abscess in term of

• what is it

• treatment

• a segment of the breast becomes painful and tender

• the skin over it is oedamatous

• enlarged axillary lymph nodes

• treatment : i) incision and drainage under general anaesthesia ii) antibiotics