Presented by: Moya McLeod Sheena-Gay Jackson Robert HamiltonENGORGEMENT & MASTITIS

EngorgementSometimes few days after parturition, the breasts will become full, firm, warm, and perhaps tender.Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.

Improper LatchingIf the baby is not latching properly or feeding frequently enough, the breasts may become overly full. This reduces the elasticity of the breasts and nipples.When the breasts are too firm, some babies cannot grasp enough tissue to latch on well.The baby may suck overly hard trying to pull in the breast tissue, which can lead to sore nipples.

Signs & SymptomsThe breasts may redden and become painful. . Mothers may sometimes develop a low-grade fever. (Fever may also signal infection).Severe engorgement may interfere with milk production.The milk pooling in engorged breasts releases chemical signals that tell the body to decrease milk production. If unrelieved, prolonged engorgement can contribute to insufficient milk supply or begin the weaning process.

ENGORGED BREASTS

PreventionBegin breastfeeding as soon as possible after the birth, to give the baby time to learn to breastfeed before the breasts become full and firm.Unless medically indicated, avoid early use of bottles and pacifiers while the baby is learning to breastfeed.Once the milk comes in, breastfeed at least 8 times in 24 hours to prevent over fullness.Ask for help from the hospital lactation consultant so that latch-on problems are solved as soon as possible.Any time a feeding is missed, use hand expression or a breast pump to remove the milk.Always wean gradually.

TreatmentUse moist heat on the breasts for a few minutes, or take a brief hot shower before breastfeeding. This may help the milk begin to flow. Note: Use of heat for extended periods of time (over 5 minutes) may make swelling worse.Use cold compresses for 10 minutes after feedings to reduce swelling.Gently massage and compress the breast when the baby pauses between sucks. This may help drain the breast, leaving less milk behind..A well-fitted, supportive nursing bra makes some women feel better. Others prefer to go bra-less during engorgement.Gentle breast massage and relaxation techniques may help improve milk flow and reduce engorgement.

TreatmentHand expression or brief use of a breast pump may help soften the nipple and areola so that the baby can get a better latch.Some women find that a single use of a breast pump to soften severely engorged breasts diminishes painful inflammation. They then return to frequent breastfeeding as the main way to manage engorgement.Pumping, hand expressing, or nursing to comfort prevents the negative consequences of retained milk. Relieving the milk pressure will not make engorgement worse.If the baby is premature or complications interfere with breastfeeding, a hospital grade pump can help the mother through engorgement until her baby can breastfeed.Fever higher than 101 F or severe pain may signal a breast infection.

mastitis

MastitisMastitis is a condition that causes a woman'sbreast tissue to become painful and inflamed.Mastitis related to breastfeeding is sometimes called lactation mastitis or puerperal mastitis.Non-breastfeeding women often have a type calledperiductal mastitis.

CausesIn breastfeeding women, mastitis is often caused by a build-up of milk within the breast. This is known as milk stasis.Milk stasis can occur for a number of reasons, including:ababy not properly attaching tothe breast during feedingababy having problems suckinginfrequent feeds or missing feeds

CausesIn some cases, this build-up of milk can also become infected with bacteria. This is known as infective mastitis.In non-breastfeeding women, mastitis most often occurs when the breast becomes infected as a result of damage to the nipple, such as a cracked or sore nipple, or a nipple piercing.

SymptomsMastitis usually only affects one breast, and symptoms often develop quickly.Symptoms of mastitis can include:a red, swollen area on your breast that may feel hot and painful to touchabreast lumpor area of hardness on your breasta burning pain in your breast that may be continuous, or may only occur when you are breastfeedingnipple discharge, which may be white or contain streaks of bloodMothers may also experienceflu-like symptoms, such as aches, a high temperature (fever), chills and tiredness.

TreatmentMastitis can usually be easily treated and most women will make a full recovery very quickly.Self-help measures are often helpful, such as:getting plenty of rest and staying well hydratedusing over-the-counter painkillers, such as paracetamol oribuprofen to reduce anypain or feveravoiding tight-fitting clothing (including bras) until your symptoms improveif you are breastfeeding, continuing to feed your baby and makingsure your baby is properly attached to your breastBreastfeeding the baby with mastitis, even if there is an infection, will not harm the baby and can help improve the mothers symptoms. It may also help to feed more frequently than usual,express any remaining milk after a feed andexpress milk between feeds.Fornon-breastfeeding women with mastitis, and breastfeeding women with a suspected infection, a course of antibiotic tablets will usually be prescribedtobring the infection under control.

PreventionAlthough mastitis can usually be treated easily, the condition can recur if the underlying cause is not addressed.Breastfeeding mothers can help reduce the risk of developing mastitis by taking steps to stop milk building up in breasts, such as:breastfeed exclusively for around six months, if possibleencourage the baby to feed frequently, particularly when breasts feel overfullensure the baby is well attached to the breast during feedslet the baby finish their feedsmost babies will release the breast when they have finished feeding; avoid suddenly going longer between feedsif possible, cut down graduallyavoid pressure on the breasts from tight clothing, including bras.

ReferencesWilson, W. 2014. Relieving and Treating Engorged Breasts. Retrieved from http://www.medelabreastfeedingus.com/tips-and-solutions/47/relieving-and-treating-engorged-breasts#RelatedFiles on September 30, 2014