Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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Prevention<br />
It is normal for breasts to become larger, heavier, <strong>and</strong> a little tender when the milk becomes<br />
more plentiful on the second to sixth day following birth. This normal fullness usually decreases<br />
within the first few weeks after birth if the baby is feeding regularly <strong>and</strong> well. Breast fullness may<br />
develop into engorgement if the baby has not been feeding often or long enough. The key to<br />
preventing engorgement is to nurse frequently <strong>and</strong> unrestrictedly.<br />
Management<br />
• If the baby is not able to suckle, encourage the woman to express milk by h<strong>and</strong> or with a<br />
clean pump.<br />
• If the baby is able to suckle:<br />
o Encourage the woman to breastfeed more frequently, using both breasts at each<br />
feeding.<br />
o Show the woman how to hold the baby <strong>and</strong> help him/her attach.<br />
o Relief measures before feeding may include:<br />
̌ applying warm compresses to the breasts just before breastfeeding, or<br />
encourage the woman to take a warm shower.<br />
̌ massaging the woman’s neck <strong>and</strong> back.<br />
̌ having the woman express some milk manually prior to breastfeeding <strong>and</strong> wet<br />
the nipple area to help the baby latch on properly <strong>and</strong> easily.<br />
o Relief measures after feeding may include:<br />
̌ supporting breasts with a binder or brassiere.<br />
̌ applying cold compress to the breasts between feedings to reduce swelling <strong>and</strong><br />
pain.<br />
̌ giving paracetamol 2 tablets or 1000 mg by mouth as needed, not to exceed 4<br />
times or 8 tablets a day.<br />
• <strong>Care</strong>fully examine the breast for signs of infection such as redness, inflammation, or<br />
pus. Check the woman’s temperature <strong>and</strong> ask if she has chills.<br />
• Follow up three days after initiating management to ensure response.<br />
Mastitis<br />
Mastitis is an infection of the breast associated with pain, redness, swelling, fever, <strong>and</strong> chills.<br />
Mastitis usually develops when bacteria enter the breast tissue through an injury to the breast.<br />
Injury to the breast may be caused by bruising from rough manipulation, breast over-distention,<br />
milk staying in the breast (stasis), or cracking or fissures of the nipple.<br />
Symptoms of mastitis<br />
• breast pain <strong>and</strong> tenderness<br />
• reddened, wedge-shaped area on breast<br />
• symptoms occurring 3-4 weeks after delivery<br />
• inflammation preceded by engorgement<br />
• usually only one breast affected<br />
128<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course
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