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

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Time
Narration
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,


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.
07:59 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.
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 bacterias.
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 your 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 Gynaecology.
11:20 This is Nutritionist Rajani Sawant along with animator Arthi Anbalagan from IIT Bombay signing off.

Thanks for joining.

Contributors and Content Editors

Debosmita, PoojaMoolya, Sandhya.np14