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| Fifth is tight clothes- if mother uses tight clothes, especially in night if mother wears a tight bra, it brings pressure on the breast and can block the milk ducts. | | Fifth is tight clothes- if mother uses tight clothes, especially in night if mother wears a tight bra, it brings pressure on the breast and can block the milk ducts. | ||
Revision as of 12:05, 20 February 2019
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| 00:00 | Welcome to this Spoken Tutorial on Breast conditions in lactating mothers. |
| 00:06 | In this tutorial, we will learn about- Breast engorgement and Mastitis. |
| 00:13 | Let us begin with Breast engorgement. |
| 00:17 | Engorgement occurs most commonly between 3 to 5 days after delivery. |
| 00:23 | It occurs in both breasts simultaneously. |
| 00:28 | Mother should not confuse breast engorgement with breast fullness. |
| 00:33 | Thus, now we will discuss the difference between breast engorgement and full breasts. |
| 00:40 | In engorgement, breast becomes firm, swollen and painfully full of milk. |
| 00:46 | It gives shiny appearance and shows dilated veins on the surface. |
| 00:52 | Mother may suffer from fever that lasts for more than 24 hours and latching becomes hard for the baby. |
| 01:01 | Whereas, full breasts are normal. |
| 01:04 | Full breasts appear big but they do not give shiny appearance. |
| 01:10 | Full breasts are not painful and fever is absent during breast fullness. |
| 01:17 | Now, let’s discuss the causes of breast engorgement in lactating mothers. |
| 01:23 | Breast engorgement can occur in the following conditions- |
| 01:27 | If mother has not fed the baby soon after delivery. |
| 01:32 | Mother is not feeding the baby frequently. |
| 01:36 | Baby has poorly latched on mother’s breast during breastfeeding and |
| 01:42 | Mother has stopped breastfeeding suddenly. |
| 01:47 | Now let’s discuss how engorgement can be treated. |
| 01:51 | First- Ask the mother to wash her hands with the clean water |
| 01:56 | Then, bring the baby closer to the mother so she can see, smell and touch the baby. |
| 02:03 | If baby is too fussy, mother can smell the baby’s towel. |
| 02:08 | After that, mother should drink a glass of water. |
| 02:12 | Then, keep wet warm cloth on the breast for 5 to 10 minutes or |
| 02:18 | mother can also take a warm shower. |
| 02:21 | It will help the breast milk to come out. |
| 02:24 | After that, health worker should tell the mother to relax as excess of stress will affect the let-down reflex and |
| 02:33 | milk will not come out. |
| 02:36 | Now, either health worker or any family member should massage on the mother’s neck and upper back. |
| 02:43 | It will help the breast milk to come out. |
| 02:46 | Since, nerve supply towards upper back and breast is same. |
| 02:52 | Then, mother should start gently massaging her breast in circular motion. |
| 02:57 | Massaging will make her relax and will improve the let-down reflex. |
| 03:03 | All these things will help in releasing of Oxytocin. |
| 03:07 | It is known as Oxytocin reflex or let-down reflex. |
| 03:12 | Oxytocin is a hormone which helps the breast milk to come out. |
| 03:17 | Then, mother should manually express some amount of milk to soften the areola. |
| 03:23 | It will help the baby to latch on the breast correctly. |
| 03:27 | During expressing the breast milk, mother should apply pressure around the areola. |
| 03:33 | After expressing, mother should guide the areola in the baby’s mouth, as it would be difficult for a baby to self-attach. |
| 03:43 | Try to breastfeed on both sides. |
| 03:46 | Between the feeds, mother should keep wet cold cloth on breasts for 5- 10 minutes. Or,
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| 03:54 | mother can keep cold cabbage leaves on breasts. |
| 03:58 | She can store these cabbage leaves either in refrigerator or in earthen pot. |
| 04:04 | It helps in reducing the tenderness and edema in the breast. |
| 04:09 | Then mother should breastfeed frequently. |
| 04:13 | Now, let’s learn how can we prevent breast engorgement. |
| 04:17 | First, try to understand the hunger signals of a baby such as squirming, |
| 04:25 | increasing rooting reflex- |
| 04:28 | in rooting reflex, baby turns her head towards anything which touches her cheek or mouth. |
| 04:36 | sucking on fingers. |
| 04:39 | In late stage, the baby starts crying. |
| 04:43 | Breastfeed the baby whenever she shows early hunger signals and not wait for the baby to cry. |
| 04:50 | Make sure that the baby is latched on properly and feeding well. |
| 04:55 | Remember, empty one breast completely before you switch to the other side. |
| 05:02 | Next, let’s learn another breast condition called Mastitis. |
| 05:08 | It is a condition where part of breast becomes red, swollen and hard. |
| 05:14 | Mother feels severe pain, fever and ill. |
| 05:18 | Many mothers go through mastitis in first 6 weeks. |
| 05:22 | But, it can occur at any time during lactation. |
| 05:27 | It is sometimes confused with breast engorgement. |
| 05:31 | However, engorgement affects whole breast and often both breasts. |
| 05:37 | Whereas mastitis affects part of the breast and usually only one breast. |
| 05:44 | Mastitis may develop in an engorged breast or follow condition of blocked ducts. |
| 05:51 | Now, we will discuss how blocked duct develops into mastitis if untreated. |
| 05:59 | Blocked duct is a condition where milk is not removed from the part of a breast. |
| 06:04 | Usually this duct is the part of breast blocked by thickened milk. |
| 06:11 | It leads to lump formation. This lump is tender and often present with redness of the skin over the lump. |
| 06:20 | Blocked duct and breast engorgement causes milk stasis. |
| 06:24 | When milk stays in part of a breast in blocked ducts and breast engorgement, it is called stasis. |
| 06:32 | If this stasis is not removed, it could lead to inflammation of breast tissue. It is called non-infective mastitis. |
| 06:42 | Whereas, sometimes breast becomes infected with the bacteria and this is called infective mastitis. |
| 06:51 | In following conditions, bacteria will easily enter through fissure: |
| 06:56 | if fissure is present on the breast, Mastitis remains untreated and delayed treatment. |
| 07:06 | Note that breast abscess is a progression of untreated mastitis. |
| 07:11 | Now, let’s discuss the causes of mastitis. |
| 07:15 | The first and foremost cause of mastitis is infrequent feedings. |
| 07:21 | If lactating mother is a working woman then frequent breastfeeding becomes challenging. |
| 07:27 | Other reason for infrequent feedings could be illness in mother or a baby. |
| 07:33 | Second is nipple feeding. In nipple feeding, baby will not empty the breast completely. |
| 07:40 | Third is oversupply of milk. |
| 07:43 | Fourth is rapid weaning where baby eats other foods apart from breast milk. |
| 07:50 | Fifth is tight clothes- if mother uses tight clothes, especially in night if mother wears a tight bra, it brings pressure on the breast and can block the milk ducts. |
| 08:03 | Sixth is maternal stress - if mother is going through any stressful conditions, it will affect the let-down reflex. |
| 08:12 | Seventh is nipple fissure- it provides a way for bacteria to enter the breast tissue and may lead to mastitis. |
| 08:22 | Let’s look at the treatment for mastitis. |
| 08:26 | First try to identify the cause and then start the treatment. |
| 08:31 | Mother should use warm compresses before breastfeeding |
| 08:35 | or should take a warm shower. |
| 08:37 | She should start breastfeeding from affected breast first. |
| 08:42 | If it is increasing the pain or affecting the let-down reflex then start with the unaffected breast. |
| 08:50 | Remember, frequent breastfeeding is necessary. |
| 08:55 | If the open wound is not on the nipple or on the areola then mother can breastfeed on the affected side. |
| 09:04 | Remember, whenever a mother is feeding to a baby from mastitis breast- |
| 09:09 | she should monitor the baby for signs of infection as there will be a risk of infection to a baby |
| 09:17 | since breast milk from affected side will have many harmful bacteria. |
| 09:24 | Massaging the breast may improve the milk supply. |
| 09:28 | It should be a gentle massaging from affected area towards the nipple. |
| 09:34 | And, mother should take enough rest. |
| 09:37 | If symptoms are severe then she should refer to the doctor. |
| 09:40 | Breast abscess will require surgical drainage of abscess and antibiotics. |
| 09:47 | Apart from these, mother should make a special effort to relax her body and breathe deeply and evenly. |
| 09:55 | Listen to the soothing music and think about her baby to help in starting the let-down reflex. |
| 10:04 | Remember, for preventing mastitis, correct latching is necessary. |
| 10:09 | It will avoid blocked duct and baby will get enough milk. |
| 10:14 | Keys to prevent all these breast conditions are- proper attachment and positioning of a baby and frequent breastfeeding. |
| 10:24 | This brings us to the end of this tutorial on breast conditions in lactating mothers. |
| 10:31 | In this tutorial, we learnt about breast engorgement and Mastitis. |
| 10:37 | This tutorial has been contributed by the Spoken Tutorial Project, IIT Bombay. |
| 10:43 | Spoken Tutorial Project is funded by NMEICT, MHRD, Government of India.
More information on this mission is available at this link. |
| 10:56 | This tutorial is partly funded by a generous contribution from WHEELS Global Foundation. |
| 11:03 | This tutorial is a part of “Maa aur Shishu Poshan Project”. |
| 11:07 | The domain reviewers for this tutorial are - Dr. Rupal Dalal, MD Pediatrics and Dr. Taru Jindal, MS Obstetrics and Gynecology. |
| 11:20 | This is Nutritionist Rajani Sawant along with animator Arthi Anbalagan from IIT Bombay, signing off.
Thanks for joining. |
