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

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|-
 
|-
 
|Title slide
 
|Title slide
 
 
| Welcome to this '''spoken tutorial''' on Breast conditions in lactating mothers.
 
| Welcome to this '''spoken tutorial''' on Breast conditions in lactating mothers.
 
 
|-
 
|-
 
|
 
|
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Image: Breast affected by mastitis.
 
Image: Breast affected by mastitis.
 
 
| In this tutorial, we will learn about-
 
| In this tutorial, we will learn about-
 
* Breast engorgement and
 
* Breast engorgement and
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|-
 
|-
 
|Image: Engorged breasts.
 
|Image: Engorged breasts.
 
 
| Let us begin with Breast engorgement,
 
| Let us begin with Breast engorgement,
 
 
|-  
 
|-  
 
|  
 
|  
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Image: Calendar.  
 
Image: Calendar.  
 
 
|  
 
|  
 
*Engorgement occurs most commonly between 3 to 5 days after delivery.
 
*Engorgement occurs most commonly between 3 to 5 days after delivery.
 
 
* It occurs in both breasts simultaneously,
 
* It occurs in both breasts simultaneously,
 
|-
 
|-
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** baby has poorly latched on mother’s breast during breastfeeding and
 
** baby has poorly latched on mother’s breast during breastfeeding and
 
** mother has stopped breastfeeding suddenly.
 
** mother has stopped breastfeeding suddenly.
 
 
|-
 
|-
 
|
 
|
 
Image: Icon of treatment.
 
Image: Icon of treatment.
 
 
|   
 
|   
 
Now let’s discuss how engorgement can be treated.
 
Now let’s discuss how engorgement can be treated.
 
 
|-
 
|-
 
|  
 
|  
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Image: Mother is smelling the baby’s towel.
 
Image: Mother is smelling the baby’s towel.
 
 
|  First-
 
|  First-
 
* Ask the mother to wash her hands with the clean water,
 
* Ask the mother to wash her hands with the clean water,
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Image: Breastmilk is coming out from the breast.
 
Image: Breastmilk is coming out from the breast.
 
 
|   
 
|   
 
* Then, keep wet warm cloth on the breast for 5 to 10 minutes or
 
* Then, keep wet warm cloth on the breast for 5 to 10 minutes or
 
* Mother can also take a warm shower.
 
* Mother can also take a warm shower.
 
* It will help the breast milk to come out.
 
* It will help the breast milk to come out.
 
 
|-
 
|-
 
|  
 
|  
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Image: Let-down reflex.
 
Image: Let-down reflex.
 
 
|   
 
|   
 
* After that, health worker should tell the mother to relax-
 
* After that, health worker should tell the mother to relax-
 
** as excess of stress will affect the let-down reflex and
 
** as excess of stress will affect the let-down reflex and
 
** milk will not come out.
 
** milk will not come out.
 
 
|-
 
|-
 
|
 
|
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Image: Breast milk is coming out from the breast.
 
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.
 
* 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.
 
** it will help the breast milk to come out.
 
** since, nerve supply towards upper back and breast is same.
 
** since, nerve supply towards upper back and breast is same.
 
 
|-
 
|-
 
|Image: A mother is gently massaging her breasts.
 
|Image: A mother is gently massaging her breasts.
  
 
Image: Oxytocin reflex.
 
Image: Oxytocin reflex.
 
 
|   
 
|   
 
* Then, mother should start gently massaging her breast in circular motion.
 
* Then, mother should start gently massaging her breast in circular motion.
 
* Massaging will make her relax and will improve the let-down reflex.
 
* Massaging will make her relax and will improve the let-down reflex.
 
 
|-
 
|-
 
|  
 
|  
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Image: Milk is coming out from the breast.
 
Image: Milk is coming out from the breast.
 
 
|   
 
|   
 
* All these things will help in releasing of oxytocin.  
 
* All these things will help in releasing of oxytocin.  
 
* It is known as oxytocin reflex or let-down reflex.
 
* It is known as oxytocin reflex or let-down reflex.
 
* Oxytocin is a hormone which helps the breast milk to come out.  
 
* Oxytocin is a hormone which helps the breast milk to come out.  
 
 
|-
 
|-
 
|  
 
|  
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Image: A baby is latched on properly on her mother’s breast
 
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.  
 
* Then, mother should manually express some amount of milk to soften the areola.  
 
* It will help the baby to latch on the breast correctly.
 
* It will help the baby to latch on the breast correctly.
 
 
|-
 
|-
 
| Image: Mother is gently massaging the area around areola.
 
| Image: Mother is gently massaging the area around areola.
 
 
|   
 
|   
 
* During expressing the breast milk-  
 
* During expressing the breast milk-  
 
** mother should apply pressure around the areola.
 
** mother should apply pressure around the areola.
 
 
|-
 
|-
 
|  
 
|  
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Image: A mother is breastfeeding on both sides.  
 
Image: A mother is breastfeeding on both sides.  
 
 
|  
 
|  
 
* After expressing-
 
* After expressing-
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** as it would be difficult for a baby to self-attach.
 
** as it would be difficult for a baby to self-attach.
 
** try to breastfeed on both sides.
 
** try to breastfeed on both sides.
 
 
|-
 
|-
 
|Image: The cold cloth is kept on the mother’s breasts.  
 
|Image: The cold cloth is kept on the mother’s breasts.  
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Image: An earthen pot.
 
Image: An earthen pot.
+
 
 
Image: A mother is breastfeeding the baby.
 
Image: A mother is breastfeeding the baby.
  
 
Image: Engorged breasts
 
Image: Engorged breasts
 
 
|   
 
|   
 
* Between the feeds mother should keep wet cold cloth on breasts for 5- 10 minutes.
 
* Between the feeds mother should keep wet cold cloth on breasts for 5- 10 minutes.
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* She can store these cabbage leaves either in refrigerator or in earthen pot.
 
* She can store these cabbage leaves either in refrigerator or in earthen pot.
 
* It helps in reducing the tenderness and edema in the breast.
 
* It helps in reducing the tenderness and edema in the breast.
 
 
*Then mother should breastfeed frequently.
 
*Then mother should breastfeed frequently.
 
 
|-
 
|-
 
|  
 
|  
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Image: Squirming baby.
 
Image: Squirming baby.
 
 
|  Now let’s learn how can we prevent breast engorgement  
 
|  Now let’s learn how can we prevent breast engorgement  
 
 
* First, try to understand hunger signals of a baby such as-
 
* First, try to understand hunger signals of a baby such as-
 
** squirming
 
** squirming
 
 
|-
 
|-
 
| Image: Rooting reflex.
 
| Image: Rooting reflex.
 
 
|   
 
|   
 
* Increasing rooting reflex
 
* Increasing rooting reflex
 
In rooting reflex-
 
In rooting reflex-
 
baby turns her head towards anything which touches her cheek or mouth.
 
baby turns her head towards anything which touches her cheek or mouth.
 
 
|-
 
|-
 
| Image: A baby is sucking his fingers.  
 
| Image: A baby is sucking his fingers.  
 
 
|   
 
|   
 
* Sucking on fingers
 
* Sucking on fingers
 
 
|-
 
|-
 
| Image: The crying baby
 
| Image: The crying baby
 
+
|  
|
+
+
 
* In late stage, the baby starts crying.
 
* In late stage, the baby starts crying.
 
 
|-
 
|-
 
|  
 
|  
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Image: A crying baby.
 
Image: A crying baby.
 
 
|   
 
|   
 
* breastfeed the baby whenever she shows early hunger signals,
 
* breastfeed the baby whenever she shows early hunger signals,
 
* and not wait for the baby to cry.
 
* and not wait for the baby to cry.
 
 
|-
 
|-
 
| Image: The Correct technique of breastfeeding
 
| Image: The Correct technique of breastfeeding
 
 
|   
 
|   
 
* Make sure that the baby is latched on properly and feeding well.
 
* Make sure that the baby is latched on properly and feeding well.
 
 
|-
 
|-
 
| Image: Mother is checking the breast is emptied or not
 
| Image: Mother is checking the breast is emptied or not
 
 
|  Remember,
 
|  Remember,
 
 
* Empty one breast completely before you switch to the other side.
 
* Empty one breast completely before you switch to the other side.
 
 
|-
 
|-
 
| Image: Overfull breasts.
 
| Image: Overfull breasts.
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Image: The sick mother.
 
Image: The sick mother.
 
 
|  Next, let’s learn another breast condition called Mastitis-
 
|  Next, let’s learn another breast condition called Mastitis-
 
* It is a condition where part of breast becomes red, swollen and hard.
 
* It is a condition where part of breast becomes red, swollen and hard.
 
* Mother feels severe pain, fever and ill.
 
* Mother feels severe pain, fever and ill.
 
 
|-
 
|-
 
|
 
|
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Image: A mother is breastfeeding a baby.
 
Image: A mother is breastfeeding a baby.
 
 
|   
 
|   
 
* Many mothers goes through mastitis in first 6 weeks,
 
* Many mothers goes through mastitis in first 6 weeks,
 
* But it can occur at any time during lactation.
 
* But it can occur at any time during lactation.
 
 
|-
 
|-
 
|  
 
|  
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Image: Engorged breasts.
 
Image: Engorged breasts.
 
 
|   
 
|   
 
* It is sometimes confused with breast engorgement.
 
* It is sometimes confused with breast engorgement.
 
 
|-
 
|-
 
| Image: engorged breasts
 
| Image: engorged breasts
 
 
|   
 
|   
 
* However engorgement affects whole breast and often both breasts.
 
* However engorgement affects whole breast and often both breasts.
 
 
|-
 
|-
 
| Image: One breast which is affected by mastitis.
 
| Image: One breast which is affected by mastitis.
 
 
|   
 
|   
 
* Whereas mastitis affects part of the breast and usually only one breast.
 
* Whereas mastitis affects part of the breast and usually only one breast.
 
 
|-
 
|-
 
| Image: Engorged breasts.
 
| Image: Engorged breasts.
  
 
Image: Blocked ducts.
 
Image: Blocked ducts.
 
 
|   
 
|   
 
* Mastitis may develop in an engorged breast or follow condition of 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.
 
* Now, we will discuss how blocked duct develops into mastitis if untreated.
 
 
|-
 
|-
 
| Image: Blocked duct.
 
| Image: Blocked duct.
  
 
Image: A breast affected by mastitis.
 
Image: A breast affected by mastitis.
 
 
|   
 
|   
 
* Blocked duct is a condition where milk is not removed from part of a breast.  
 
* 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.
 
* Usually this duct is the part of breast blocked by thickened milk.
 
 
|-
 
|-
 
|
 
|
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Image: Breast lump.
 
Image: Breast lump.
 
 
|
 
|
 
It leads to lump formation.
 
It leads to lump formation.
 
This lump is tender and often present with redness of the skin over the lump.
 
This lump is tender and often present with redness of the skin over the lump.
 
 
|-
 
|-
 
| Image: Blocked duct.
 
| Image: Blocked duct.
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Image: Milk stasis.
 
Image: Milk stasis.
 
 
|   
 
|   
 
* Blocked duct and breast engorgement causes milk stasis.
 
* Blocked duct and breast engorgement causes milk stasis.
 
* When milk stays in part of a breast in blocked ducts and breast engorgement,
 
* When milk stays in part of a breast in blocked ducts and breast engorgement,
 
* It is called stasis.
 
* It is called stasis.
 
 
|-
 
|-
 
| Image: Inflammation of breast tissue.
 
| Image: Inflammation of breast tissue.
 
 
|   
 
|   
 
* If this stasis is not removed, it could lead to inflammation of breast tissue.
 
* If this stasis is not removed, it could lead to inflammation of breast tissue.
 
* It is called non-infective mastitis.
 
* It is called non-infective mastitis.
 
 
|-
 
|-
 
| Image: Breasts with infective mastitis.
 
| Image: Breasts with infective mastitis.
 
 
|  Whereas,
 
|  Whereas,
 
 
* Sometimes breast becomes infected with the bacteria and this is called infective mastitis.
 
* Sometimes breast becomes infected with the bacteria and this is called infective mastitis.
 
 
|-
 
|-
 
| Image: Mastitis breast.
 
| Image: Mastitis breast.
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Image: Breast abscess.
 
Image: Breast abscess.
 
 
| In following conditions, bacteria will easily enter through fissure:
 
| In following conditions, bacteria will easily enter through fissure:
 
* If fissure is present on the breast.
 
* If fissure is present on the breast.
 
* Mastitis remains untreated and
 
* Mastitis remains untreated and
 
* Delayed treatment  
 
* Delayed treatment  
 
 
Note that:  
 
Note that:  
 
*Breast abscess is a progression of untreated mastitis.
 
*Breast abscess is a progression of untreated mastitis.
 
 
|-
 
|-
 
| Image: Mastitis breast.
 
| Image: Mastitis breast.
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Image: A sick baby.
 
Image: A sick baby.
 
 
|  Now let’s discuss the causes of mastitis-
 
|  Now let’s discuss the causes of mastitis-
 
* The first and foremost cause of mastitis is infrequent feedings.
 
* The first and foremost cause of mastitis is infrequent feedings.
 
** if lactating mother is a working woman then frequent breastfeeding becomes challenging.
 
** 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.
 
** other reason for infrequent feedings could be illness in a mother or a baby.
 
 
|-
 
|-
 
| Image: Nipple feeding
 
| Image: Nipple feeding
 
 
|   
 
|   
 
* Second, is nipple feeding  
 
* Second, is nipple feeding  
 
** in nipple feeding baby will not empty the breast completely.
 
** in nipple feeding baby will not empty the breast completely.
 
 
|-
 
|-
 
| Image: Breast milk is coming out from the breast.
 
| Image: Breast milk is coming out from the breast.
 
 
|   
 
|   
 
* Third, is oversupply of milk.
 
* Third, is oversupply of milk.
 
 
|-
 
|-
 
|  
 
|  
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Image: Mother is giving other food to the baby apart from breastmilk.
 
Image: Mother is giving other food to the baby apart from breastmilk.
 
 
|   
 
|   
 
* Fourth, is rapid weaning-
 
* Fourth, is rapid weaning-
 
** Where baby eat other foods apart from breast milk.
 
** Where baby eat other foods apart from breast milk.
 
 
|-
 
|-
 
| Image: A mother who has worn a tight bra.
 
| Image: A mother who has worn a tight bra.
 
 
|   
 
|   
 
* Fifth, is tight clothes-
 
* Fifth, is tight clothes-
 
** if mother use tight clothes, especially in night if mother wears a tight bra,
 
** 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.
 
** it brings pressure on the breast and can block the milk ducts.
 
 
 
|-
 
|-
 
|Image: A stressed mother.
 
|Image: A stressed mother.
 
   
 
   
 
Image: Let-down reflex.
 
Image: Let-down reflex.
 
 
|   
 
|   
 
* Sixth is maternal stress -
 
* Sixth is maternal stress -
 
** if mother is going through any stressful conditions.
 
** if mother is going through any stressful conditions.
** it will affect the let-down reflex.
+
** it will affect the let-down reflex.|-
 
+
 
|-
 
|-
 
| Image: nipple fissure  
 
| Image: nipple fissure  
 
  
 
|   
 
|   
 
* Seventh is nipple fissure-
 
* Seventh is nipple fissure-
 
** it provides a way for bacteria to enter the breast tissue and may lead to mastitis.
 
** it provides a way for bacteria to enter the breast tissue and may lead to mastitis.
 
 
 
|-
 
|-
 
| Image: Icon of cause and treatment.
 
| Image: Icon of cause and treatment.
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Image: A mother is taking a shower.
 
Image: A mother is taking a shower.
 
 
| Let’s look at the treatment for mastitis,
 
| Let’s look at the treatment for mastitis,
 
 
* First try to identify the cause and then start the treatment.
 
* First try to identify the cause and then start the treatment.
 
* Mother should use warm compresses before breastfeeding,
 
* Mother should use warm compresses before breastfeeding,
 
* Or should take a warm shower.
 
* Or should take a warm shower.
 
 
 
|-
 
|-
 
|  
 
|  
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Animation of a clock with the green checkmark.
 
Animation of a clock with the green checkmark.
 
 
 
|   
 
|   
 
* She should start breastfeeding from affected breast first,
 
* 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.
 
* If it is increasing the pain or affecting the let-down reflex then start with the unaffected breast.
 
* Remember, frequent breastfeeding is necessary.
 
* Remember, frequent breastfeeding is necessary.
 
 
|-
 
|-
 
|  
 
|  
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Image: A mother is breastfeeding on the affected side with red cross mark.
 
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.
 
*If the open wound is not on the nipple or on the areola then mother can breastfeed on the affected side.
 
 
Remember,
 
Remember,
 
 
* Whenever a mother is feeding to a baby from mastitis breast-
 
* 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.  
 
** 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.
 
** since, Breast milk from affected side will have many harmful bacterias.
 
 
 
|-
 
|-
 
|  
 
|  
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Image: Hand movements during massaging.
 
Image: Hand movements during massaging.
 
 
|  
 
|  
 
* Massaging the breast may improve the milk supply,
 
* Massaging the breast may improve the milk supply,
 
* It should be a gentle massaging from affected area towards the nipple.
 
* It should be a gentle massaging from affected area towards the nipple.
 
 
 
|-
 
|-
 
|  
 
|  
 
Image: A mother is taking rest.
 
Image: A mother is taking rest.
 
 
|  
 
|  
 
* And should take enough of rest.
 
* And should take enough of rest.
 
 
 
|-
 
|-
 
|  
 
|  
 
Image: A mother is talking to a doctor.
 
Image: A mother is talking to a doctor.
 
 
|  
 
|  
 
* If symptoms are severe then she should refer to the doctor.
 
* If symptoms are severe then she should refer to the doctor.
 
 
 
|-
 
|-
 
|  
 
|  
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Image: Surgical drainage of pus.
 
Image: Surgical drainage of pus.
 
 
 
|  
 
|  
 
* Breast abscess will require surgical drainage of abscess and antibiotics.
 
* Breast abscess will require surgical drainage of abscess and antibiotics.
 
 
 
|-
 
|-
 
|  
 
|  
 
Image: A mother involved in relaxation practice.
 
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.
 
* 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.
 
Image: A mother is listening to a music.
 
 
 
|  
 
|  
 
* Listen to the soothing music and  
 
* Listen to the soothing music and  
 
* Think about your baby to help in starting the let-down reflex.
 
* Think about your baby to help in starting the let-down reflex.
 
 
|-
 
|-
 
|
 
|
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Image: Correct latching
 
Image: Correct latching
 
|  Remember,  
 
|  Remember,  
 
 
* For preventing mastitis, correct latching is necessary.
 
* For preventing mastitis, correct latching is necessary.
 
* It will avoid blocked duct and baby will get enough milk.
 
* It will avoid blocked duct and baby will get enough milk.
 
|-
 
|-
 
|  
 
|  
 
 
Image: Mother is breastfeeding a baby with correct positioning and proper latch on  
 
Image: Mother is breastfeeding a baby with correct positioning and proper latch on  
 
 
| Keys to prevent all these breast conditions are-
 
| Keys to prevent all these breast conditions are-
 
* Proper attachment and positioning of a baby and
 
* Proper attachment and positioning of a baby and
 
* Frequent breastfeeding.
 
* Frequent breastfeeding.
 
 
|-
 
|-
 
|  
 
|  
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Image: Mastitis breasts.
 
Image: Mastitis breasts.
 
 
| This brings us to the end of this tutorial on breast conditions in lactating mothers.
 
| This brings us to the end of this tutorial on breast conditions in lactating mothers.
 
In this tutorial, we learnt about  
 
In this tutorial, we learnt about  
 
* Breast engorgement
 
* Breast engorgement
 
* Mastitis
 
* Mastitis
 
 
|-
 
|-
 
| Image: Spoken Tutorial Project logo.
 
| Image: Spoken Tutorial Project logo.
 
 
| This tutorial has been contributed by  
 
| This tutorial has been contributed by  
 
 
* the '''Spoken Tutorial '''Project, '''IIT Bombay '''
 
* the '''Spoken Tutorial '''Project, '''IIT Bombay '''
 
 
|-
 
|-
 
| Link to spoken tutorial project or NMEICT
 
| Link to spoken tutorial project or NMEICT
 
 
|  '''Spoken Tutorial Project '''is funded by''' NMEICT, MHRD, Government of India.'''
 
|  '''Spoken Tutorial Project '''is funded by''' NMEICT, MHRD, Government of India.'''
 
More information on this mission is available at this link.
 
More information on this mission is available at this link.
 
 
|-
 
|-
 
| Image: WHEELS Global foundation logo
 
| Image: WHEELS Global foundation logo
 
 
| This tutorial is partly funded by a generous contribution from '''WHEELS Global Foundation.'''
 
| This tutorial is partly funded by a generous contribution from '''WHEELS Global Foundation.'''
 
 
|-
 
|-
 
| Maa aur Shishu Poshan project logo.
 
| Maa aur Shishu Poshan project logo.
 
 
|  
 
|  
 
* This tutorial is a part of “'''Maa aur Shishu Poshan Project”.'''
 
* This tutorial is a part of “'''Maa aur Shishu Poshan Project”.'''
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** '''Dr. Taru Jindal''', MS Obstetrics and Gynaecology.
 
** '''Dr. Taru Jindal''', MS Obstetrics and Gynaecology.
 
This is Nutritionist '''Rajani Sawant''' along with animator '''Arthi Anbalagan''' from''' IIT Bombay '''signing off.
 
This is Nutritionist '''Rajani Sawant''' along with animator '''Arthi Anbalagan''' from''' IIT Bombay '''signing off.
Thanks for joining
+
Thanks for joining.
 
|}
 
|}

Revision as of 18:28, 10 June 2018

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: 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.

Now let’s discuss the causes of breast engorgement in lactating mothers.
  • 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.

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.

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: 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.

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.

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.

Image: A crying baby.

  • 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.

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.
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 breast or follow condition of blocked ducts,
  • Now, we will discuss how blocked duct develops 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: 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: 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.
  • Mastitis remains untreated and
  • 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: 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.
Image: A mother who has worn a tight bra.
  • 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: 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.

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 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

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. 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.

Contributors and Content Editors

Bellatony911, Rajani st