Difference between revisions of "Health-and-Nutrition/C2/Breast-conditions/English"

Image: Engorged breasts.

Image: Breast affected by mastitis.

• Breast engorgement and
• Mastitis

Image: Engorged breasts.

Image: Natural delivery.

Image: Calendar.

• Engorgement occurs most commonly between 3 to 5 days after delivery.

• It occurs in both breasts simultaneously,

Image: Full breasts.

Image: Engorged breasts.

• Mother should not confuse breast engorgement with breast fullness.
• Thus, Now we will discuss the difference between breast engorgement and full breasts.

Image: Engorged breasts.

Image: A baby is trying to latch on the mother’s big breast.

Image: Clock for showing the duration of 24 hours.

• In engorgement-
  • breast become firm, swollen and painfully full of milk.
  • it gives shiny appearance and shows dilated veins on the surface.
  • mother may suffer from fever that lasts for more than 24 hours and
  • latching becomes hard for the baby.

Image: Full breasts.

Image: The shiny appearance of engorged breasts with the red cross mark.

Image: A sick mother with the red cross mark.

Image: Symbol of pain.

• Whereas, full breasts are normal.
  • full breasts appear big but they do not give shiny appearance,
  • full breasts are not painful and fever is absent during breast fullness.

Image: A mother is breastfeeding the baby soon after delivery.

Image: A mother is breastfeeding to a baby.

Image: Baby is crying but the mother is not breastfeeding her baby.

Image: Poor attachment.

• Breast engorgement can occur in the following conditions-
  • if mother has not fed the baby soon after delivery.
  • mother is not feeding the baby frequently.
  • baby has poorly latched on mother’s breast during breastfeeding and
  • mother has stopped breastfeeding suddenly.

Image: Icon of treatment.

Now let’s discuss how engorgement can be treated.

Image: Washing hands.

Image: Mother is drinking a glass of water in sitting position.

Image: Mother is carrying her baby.

Image: Mother is smelling the baby’s towel.

• Ask the mother to wash her hands with the clean water,
• Then, bring the baby closer to the mother so she can-
  • see,
  • smell and
  • touch the baby.

• If baby is too fussy, mother can smell the baby’s towel.
• After that, mother should drink a glass of water.

Image: A piece of cloth is kept on the mother's breast.

Image: A mother is taking a shower.

Image: Breastmilk is coming out from the breast.

• Then, keep wet warm cloth on the breast for 5 to 10 minutes or
• Mother can also take a warm shower.
• It will help the breast milk to come out.

Image: Health worker is talking to a mother.

Image: Stressed mother.

Image: Let-down reflex.

• After that, health worker should tell the mother to relax-
  • as excess of stress will affect the let-down reflex and
  • milk will not come out.

Image: A health worker is massaging the mother’s upper back.

Image: Breast milk is coming out from the breast.

• Now, either health worker or any family member should massage on the mother’s neck and upper back.
  • it will help the breast milk to come out.
  • since, nerve supply towards upper back and breast is same.

Image: Oxytocin reflex.

• Then, mother should start gently massaging her breast in circular motion.
• Massaging will make her relax and will improve the let-down reflex.

Image: Oxytocin reflex.

Image: Oxytocin hormone.

Image: Milk is coming out from the breast.

• All these things will help in releasing of oxytocin.
• It is known as oxytocin reflex or let-down reflex.
• Oxytocin is a hormone which helps the breast milk to come out.

Image: A mother is expressing the milk using her hands.

Image: A baby is latched on properly on her mother’s breast

• Then, mother should manually express some amount of milk to soften the areola.
• It will help the baby to latch on the breast correctly.

• During expressing the breast milk-
  • mother should apply pressure around the areola.

Image: Mother is helping the baby in latching.

Image: A mother is breastfeeding on both sides.

• After expressing-
  • mother should guide the areola in the baby’s mouth.
  • as it would be difficult for a baby to self-attach.
  • try to breastfeed on both sides.

Image: The Cabbage leaves are kept on the mother’s breasts.

Image: A refrigerator.

Image: An earthen pot.

Image: A mother is breastfeeding the baby.

Image: Engorged breasts

• Between the feeds mother should keep wet cold cloth on breasts for 5- 10 minutes.

Or

• Mother can keep cold cabbage leaves on breasts.
• She can store these cabbage leaves either in refrigerator or in earthen pot.
• It helps in reducing the tenderness and edema in the breast.

• Then mother should breastfeed frequently.

Image: Grouped image of hunger signals of the baby.

Image: Breast engorgement.

Image: Icon of prevention.

Image: Squirming baby.

• First, try to understand hunger signals of a baby such as-
  • squirming

• Increasing rooting reflex

In rooting reflex- baby turns her head towards anything which touches her cheek or mouth.

• Sucking on fingers

• In late stage, the baby starts crying.

Image: The Grouped image of early hunger signals of the baby.

Image: A mother is breastfeeding to a baby with the green check mark.

Image: A crying baby.

• breastfeed the baby whenever she shows early hunger signals,
• and not wait for the baby to cry.

• Make sure that the baby is latched on properly and feeding well.

• Empty one breast completely before you switch to the other side.

Image: Mastitis breast.

Image: Symbol of pain.

Image: The sick mother.

• It is a condition where part of breast becomes red, swollen and hard.
• Mother feels severe pain, fever and ill.

Image: A calendar.

Image: A mother is breastfeeding a baby.

• Many mothers goes through mastitis in first 6 weeks,
• But it can occur at any time during lactation.

Image: Mastitis breast.

Image: Engorged breasts.

• It is sometimes confused with breast engorgement.

• However engorgement affects whole breast and often both breasts.

• Whereas mastitis affects part of the breast and usually only one breast.

Image: Blocked ducts.

• Mastitis may develop in an engorged breast or follow condition of blocked ducts,
• Now, we will discuss how blocked duct develops into mastitis if untreated.

Image: A breast affected by mastitis.

• Blocked duct is a condition where milk is not removed from part of a breast.
• Usually this duct is the part of breast blocked by thickened milk.

Image: Overfull breast with blocked duct.

Image: Breast lump.

It leads to lump formation. This lump is tender and often present with redness of the skin over the lump.

Image: Breast engorgement.

Image: Milk stasis.

• Blocked duct and breast engorgement causes milk stasis.
• When milk stays in part of a breast in blocked ducts and breast engorgement,
• It is called stasis.

• If this stasis is not removed, it could lead to inflammation of breast tissue.
• It is called non-infective mastitis.

• Sometimes breast becomes infected with the bacteria and this is called infective mastitis.

Image: Medicines.

Image: Breast fissure.

Image: Breast abscess.

• If fissure is present on the breast.
• Mastitis remains untreated and
• Delayed treatment

Note that:

• Breast abscess is a progression of untreated mastitis.

Image: A working mother.

Image: A sick mother.

Image: A sick baby.

• The first and foremost cause of mastitis is infrequent feedings.
  • if lactating mother is a working woman then frequent breastfeeding becomes challenging.
  • other reason for infrequent feedings could be illness in a mother or a baby.

• Second, is nipple feeding
  • in nipple feeding baby will not empty the breast completely.

• Third, is oversupply of milk.

Image: Formula feed.

Image: Mother is giving other food to the baby apart from breastmilk.

• Fourth, is rapid weaning-
  • Where baby eat other foods apart from breast milk.

• Fifth, is tight clothes-
  • if mother use tight clothes, especially in night if mother wears a tight bra,
  • it brings pressure on the breast and can block the milk ducts.

Image: Let-down reflex.

• Sixth is maternal stress -
  • if mother is going through any stressful conditions.
  • it will affect the let-down reflex.

• Seventh is nipple fissure-
  • it provides a way for bacteria to enter the breast tissue and may lead to mastitis.

Image: A piece of cloth is kept on the mother’s breast.

Image: A mother is taking a shower.

• First try to identify the cause and then start the treatment.
• Mother should use warm compresses before breastfeeding,
• Or should take a warm shower.

Image: Mother is breastfeeding her baby from affected breast.

Image: a symbol of pain.

Image: mother is breastfeeding her baby from unaffected breast.

Image: Mother is breastfeeding the baby.

Animation of a clock with the green checkmark.

• She should start breastfeeding from affected breast first,
• If it is increasing the pain or affecting the let-down reflex then start with the unaffected breast.
• Remember, frequent breastfeeding is necessary.

Image: Open wound on the areola.

Image: A mother is breastfeeding on the affected side with red cross mark.

• If the open wound is not on the nipple or on the areola then mother can breastfeed on the affected side.

Remember,

• Whenever a mother is feeding to a baby from mastitis breast-
  • she should monitor the baby for signs of infection as there will be a risk of infection to a baby.
  • since, Breast milk from affected side will have many harmful bacterias.

Image: A mother is massaging her breast.

Image: Hand movements during massaging.

• Massaging the breast may improve the milk supply,
• It should be a gentle massaging from affected area towards the nipple.

Image: A mother is taking rest.

• And should take enough of rest.

Image: A mother is talking to a doctor.

• If symptoms are severe then she should refer to the doctor.

Image: Antibiotics

Image: Surgical drainage of pus.

• Breast abscess will require surgical drainage of abscess and antibiotics.

Image: A mother involved in relaxation practice.

• Apart from these, Mother should make a special effort to relax her body and breathe deeply and evenly.

Image: A mother is listening to a music.

• Listen to the soothing music and
• Think about your baby to help in starting the let-down reflex.

Image: Correct breastfeeding attachment.

Image: Blocked duct with red cross mark.

Image: Correct latching

• For preventing mastitis, correct latching is necessary.
• It will avoid blocked duct and baby will get enough milk.

Image: Mother is breastfeeding a baby with correct positioning and proper latch on

• Proper attachment and positioning of a baby and
• Frequent breastfeeding.

Image: Engorged breasts.

Image: Mastitis breasts.

In this tutorial, we learnt about

• Breast engorgement
• Mastitis

• the Spoken Tutorial Project, IIT Bombay

More information on this mission is available at this link.

• This tutorial is a part of “Maa aur Shishu Poshan Project”.
• The domain reviewers for this tutorial are -
  • Dr. Rupal Dalal, MD Pediatrics and
  • Dr. Taru Jindal, MS Obstetrics and Gynaecology.

This is Nutritionist Rajani Sawant along with animator Arthi Anbalagan from IIT Bombay signing off. Thanks for joining