Health-and-Nutrition/C2/Breast-conditions/English

Visual cue	Narration
Title slide	Welcome to this spoken tutorial on Breast conditions in lactating mothers
Image: Engorged breasts. Image: Breast affected by mastitis.	In this tutorial, we will learn about- Breast engorgement and Mastitis
Image: Engorged breasts.	Let us begin with Breast engorgement,
Image: Engorged breasts. 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 becomes 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: 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.	Now let’s discuss the causes of breast engorgement in lactating mothers. Breast engorgement can occur in the following conditions- 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. 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.	First- 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	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: A mother is gently massaging her breasts. 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.
Image: Mother is gently massaging the area around areola.	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 cold cloth is kept on the mother’s breasts. 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.	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: Breast engorgement. Image: Icon of prevention. Image: Squirming baby.	Now let’s learn how can we prevent breast engorgement First, try to understand hunger signals of a baby such as- Squirming
Image: Rooting reflex.	Increasing rooting reflex In rooting reflex- baby turns her head towards anything which touches her cheek or mouth.
Image: A baby is sucking his fingers.	sucking on fingers
Image: The crying baby	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.	breastfeed the baby whenever she shows early hunger signals, and not wait for the baby to cry.
Image: The Correct technique of breastfeeding	* Make sure that the baby is latched on properly and feeding well.
Image: Mother is checking the breast is emptied or not	Remember, Empty one breast completely before you switch to the other side.
Image: Overfull breasts. Image: Mastitis breast. Image: Symbol of pain. Image: The sick mother.	Next, let’s learn another breast condition called Mastitis- It is a condition where part of breast becomes red, swollen and hard. Mother feels severe pain, fever and ill.
Mastitis Image: A calendar.	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.
Image: engorged breasts	However engorgement affects whole breast and often both breasts.
Image: One breast which is affected by mastitis.	Whereas mastitis affects part of the breast and usually only one breast.
Image: Engorged breasts. Image: Blocked ducts.	Mastitis may develop in an engorged breasts or follow condition of blocked ducts, Now, we will discuss how blocked ducts develop into mastitis if untreated.
Image: Blocked duct. 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: Blocked duct. 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.
Image: Inflammation of breast tissue.	If this stasis is not removed, it could lead to inflammation of breast tissue. It is called non-infective mastitis.
Image: Breasts with infective mastitis.	Whereas, Sometimes breast becomes infected with the bacteria and this is called infective mastitis.
Image: Mastitis breast. Image: Medicines. Image: Breast fissure. Image: Breast abscess.	In following conditions, bacteria will easily enter through fissure: If fissure is present on the breast. If mastitis remains untreated, Delayed treatment Note that: Breast abscess is a progression of untreated mastitis.
Image: Mastitis breast. Image: A working mother. Image: A sick mother. Image: A sick baby.	Now let’s discuss the causes of mastitis- 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.
Image: Nipple feeding	Second, is nipple feeding in nipple feeding baby will not empty the breast completely.
Image: Breast milk is coming out from the breast.	Third, is oversupply of milk
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.
Image: A mother who has worn a tight bra.	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.
Image: A stressed mother. Image: Let-down reflex.	Sixth is maternal stress - if mother is going through any stressful conditions. it will affect the let-down reflex.
Image: nipple fissure	Seventh is nipple fissure- it provides a way for bacteria to enter the breast tissue and may lead to mastitis.
Image: Icon of cause and treatment. Image: A piece of cloth is kept on the mother’s breast. Image: A mother is taking a shower.	Now let’s look at the treatment for mastitis, 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 to towards 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 milk stasis	* Abscess will require surgical drainage of milk 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	Remember, 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	Keys to prevent all these breast conditions are- Proper attachment and positioning of a baby and Frequent breastfeeding.
Image: Engorged breasts. Image: Mastitis breasts.	This brings us to the end of this tutorial on breast conditions in lactating mothers. In this tutorial, we learnt about Breast engorgement Mastitis
Image: Spoken Tutorial Project logo.	This tutorial has been contributed by the Spoken Tutorial Project, IIT Bombay
Link to spoken tutorial project or NMEICT	Spoken Tutorial Project is funded by NMEICT, MHRD, Government of India. More information on this mission is available at this link.
Image: WHEELS Global foundation logo	This tutorial is partly funded by a generous contribution from WHEELS Global Foundation.
Maa aur Shishu Poshan project logo.	This tutorial is a part of “Maa aur Shishu Poshan Project”. The domain reviewers for this tutorial are - Dr. Taru Jindal, Gynaecologist and Obstetrician and Dr. Rupal Dalal, MD Pediatrics This is Nutritionist Rajani Sawant along with the animator Arthi Anbalagan from IIT Bombay signing off. Thanks for joining

Contributors and Content Editors

Bellatony911, Rajani st