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The Occurrence of Breast Engorgement

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Abstract

This study describes breast engorgement during days 1-14 postpartum of 114 first and second time vaginal- and cesarean-delivery breastfeeding mothers. Most mothers reported experiencing their most intense engorgement after hospital discharge. Previous breastfeeding experience of the mother is a more critical variable than parity in predicting engorgement. Second time breastfeeding mothers experienced engorgement sooner and more severely than did first time breastfeeding mothers, regardless of delivery method. Anticipatory guidance by the care provider is discussed in an effort to enhance the experience of the breastfeeding dyad.
... 3. Six-point engorgement scale: This was used to assess the severity of breast engorgement. The reliability has been recorded to be 0.84 (Hill and Humenick, 1994). The minimum score in this scale is 1 and the maximum is 6. ...
... It is a standardized tool to assess the occurrence of breast engorgement during the first, second and third day of the postnatal period. The reliability of the tool has been recorded as 0.84 (Hill and Humenick, 1994). Scoring: Minimum score in this scale is 1 and the maximum is 6. ...
Article
Breast engorgement is one of the main reasons why women throughout the world stop or reduce the duration of breast feeding. The objective of the study, was to determine the efficacy of non-thermal ultrasound in the management of breast engorgement. Fifty-two postpartum women with breast engorgement were included in the study and were randomly assigned to an experimental group and a control group of 26 participants each. Pain and breast engorgement were assessed using the visual analogue scale (VAS) and the six-point engorgement scale (SPES), pre- and post-intervention in both groups. The experimental group received non-thermal therapeutic ultrasound therapy along with conventional treatment interventions for two days while the control group only received conventional treatment for two days. The control group received massage, advice on proper latching technique and the use of bra. Results indicate a significant (P<0.05) difference in symptoms of breast engorgement between pre-intervention and post-intervention in both groups, with greater reduction in symptoms in the experimental group. Also, a maximum of two days was found to be effective in the management of breast engorgement in the experimental group. The use of therapeutic non-thermal ultrasound for 3 treatment sessions in two successive days was effective in the management of breast engorgement and is recommended for use in physiotherapy clinical settings.KEY WORDS: breast engorgement, non-thermal ultrasound, postpartum, pain
... Meme dolgunluğu doğum sonu dönemde sık karşılaşılan bir durum olmasına rağmen ülkemizde meme dolgunluğunu değerlendirmek için kullanılan geçerli ve güvenilir bir ölçüm aracı bulunmamaktadır. Pamela Dee Hill ve Sharron Smith Humenick (1994) tarafından geliştirilen Meme Dolgunluğu Değerlendirme Skalasının uluslararası çalışmalarda yaygın olarak kullanıldığı belirlenmiştir(7,(9)(10)(11)(12)(13). Ülkemizde laktasyon dönemindeki kadınlarda meme dolgunluğu belirlemek üzere bir ölçüm aracı bulunmaması nedeniyle, bu çalışmada Meme Dolgunluğu Değerlendirme Skalasının Türkçe literatüre kazandırılması için psikometrik özelliklerinin incelenmesi amaçlanmıştır. ...
... Bulgular genelde doğumdan sonraki ilk hafta ortaya çıkmakla birlikte daha geç dönemlerde de görülebilir. 20 Bu durum tıkalı meme (engorjman) olarak adlandırılır ve emzirme başarısızlığının en önemli sebeplerinden biridir. Bazen ateş eşlik edebilir, ancak 24 saatten daha uzun sürmesi beklenmez. ...
Chapter
Bebeklik döneminde ideal büyümenin ve gelişmenin sağlanabilmesi için en uygun besin anne sütüdür. İlk 6 ay sadece anne sütü ile beslenme, 2 yaş ve sonrasına kadar da emzirmeye devam edilmesi önerilmektedir. Tüm dünyada olduğu gibi ülkemizde de emzirme oranları ilk aylardan sonra hızla düşmekte ve bu düşüşün sebeplerinin başında da annenin emzirme döneminde karşılaştığı sorunlar gelmektedir. Sorunların çoğu erken müdahale ile önlenebilir ve ortaya çıkmaları halinde neredeyse tamamı tedavi edilebilir. Emzirme sorunlarının çoğu, doğum sonrası hastaneden taburcu olmadan önce başlamaktadır. Özellikle ilk günlerde ve haftalarda yapılan müdahaleler emzirmenin erken kesilmesine engel olacaktır. Bu durumun ancak sağlık profesyonellerinin emzirmede sık karşılaşılan problemler hakkındaki farkındalıklarının artması ile mümkün olabileceği unutulmamalıdır.
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Lactation problems including delayed onset of lactation, insufficient milk volume, and breast engorgement are important barriers for primiparous mothers because these lead to their early stopping of exclusive breastfeeding. Therefore, a randomized controlled trial was conducted with primiparous mothers to investigate the effects of Southern Thai traditional massage with warm compression on onset of lactation, milk volume, and breast engorgement. A minimized randomization program was used to assign the participants into either 1) Southern Thai traditional massage with warm compression group (n = 21), 2) Southern Thai traditional massage group (n = 21), or 3) control group (n = 21) who received usual care. The instruments used for data collection consisted of a Demographic Data Form, the Onset of Lactation Form, the Milk Volume Recording Form, and the Six-Point Engorgement Scale. Descriptive and inferential statistics were used to analyze the data. The results showed that the onset of lactation was significantly earlier and milk volume was significantly higher in the Southern Thai traditional massage with warm compression group than those in the Southern Thai traditional massage and control groups. Breast engorgement in the Southern Thai traditional massage with warm compression group was significantly lower than those in the Southern Thai traditional massage and control groups. Therefore, the Southern Thai traditional massage with warm compression intervention is effective in improving lactation and breast engorgement. Thus, nurses can use this intervention by teaching nurse-midwife, pregnant women, and relatives to promote the onset of lactation, increase milk volume, and prevent breast engorgement. Further testing with different groups is required before this can be extended to other population groups.
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Chapter
Human milk has hundreds of milk proteins, which provides many benefits on breastfeeding. Breastfeeding is a mother’s gift to herself, her baby, and the earth, there is no substitute for mother’s milk. Milk protein is most important for baby’s growth, development and protects the baby from different illness. Colostrum is produced during early days immediately after child birth, which contains important nutrients and antibodies. Breast engorgement is a problem that is commonly encountered in breastfeeding mothers, which is to be addressed and treated to provide good milk proteins to baby, by relieving discomforts of lactating mothers. A randomized controlled trial was conducted with 30 subjects based on inclusion and exclusion criteria where the subjects are divided into two groups, which contain 15 lactating mothers in each group. The control group that is group-A was treated with ultrasound, and the experimental group that is group-B was treated with ultrasound and Taping Technique. The result of the study showed that there was a significant difference between the pre- and posttest intervention, and we conclude that the ultrasound therapy and Kinesio taping was effective in treating lactating mothers with breast engorgement.
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Strong evidence supports breastfeeding as the appropriate health choice for both mothers and infants. However, the mechanics of breastfeeding are frequently less well understood. This review of both the research and clinical evidence regarding appropriate breastfeeding management is designed to aid the midwife and other health care professionals in providing care and teaching, which will optimize maternal and infant health.
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It is possible that a rigid feeding schedule could have a harmful effect on the establishment of lactation. The higher incidence of successful lactation in primitive communities than in more civilized ones could be attributed to a self-demand feeding schedule. This paper presents the results of an experiment conducted to determine the effectiveness of self-demand vs. rigid feeding schedule. 106 babies in a maternity unit were fed on a rigid feeding schedule of 6 feeds in 24 hours (rigid group) and 131 babies were fed on demand (demand group). Demands were more frequent between the 4th-7th days in the demand group. On the 5th day 36 babies (28.6%) demanded 8 or more feeds and 12 babies (9.5%) demanded 9 or more feeds. Babies in this group gained weight faster than those on a rigid schedule; by the 9th day 49.1% of babies in the demand group had regained their birthweight compared with 36.1% of babies in the rigid group. Weight gain strongly correlated with amount of milk taken from the mothers breasts. The number of feeds taken in 24 hours positively correlated with the quantity of milk taken from the breast in that period. Soreness of the nipples was experienced by 27.4% of mothers in the rigid group compared with 12.9% in the demand group. Overdistension of the breast occurred in 34% of the rigid group compared with 16.9% of the demand group. 88.1% of the babies in the rigid group and 94.4% of the demand group were discharged fully breastfed. At 1 month of age 64.5% of the rigid group and 80.3% of the demand group were fully breastfed. Self-demand feeding had a more favorable effect on the establishment and maintenance of lactation than the rigid feeding shecule by causing better emptying of the breast and reducing the incidence of frequent nipple soreness.
A retrospective survey of 34 breastfeeding mothers was undertaken. From the data the following hypotheses have been suggested for further study: 1) Class preparation for breastfeeding favors a longer duration of nursing. 2) Nipple rolling and breast massage with manual expression of colostrum during pregnancy are not associated with a longer duration of nursing, nor do they prevent sure nipples or breast engorgement postpartum. 3) Mothers with multiple complications are at high risk for lactation failure. 4) Limiting nursing time for the first few days postpartum does not prevent sore nipples.
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The focus of this study was to identify variables that correlate significantly with breast engorgement and that might be amenable to nursing interventions. Data on the initiation of feeding, frequency of feedings, feeding duration, rate of milk maturation, and supplementation were obtained of 54 women. These variables were found to be significantly correlated with breast engorgement.
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The purpose of this study was to identify postpartum concerns of breastfeeding mothers from hospital discharge through the first month postpartum. The sample (N = 32) consisted of first time breastfeeding mothers with uncomplicated vaginal deliveries who planned to breastfeed for at least one month. Subjects were telephoned daily for the first two weeks and twice a week for the third and fourth weeks post-hospital discharge. During the study period, 97% of the mothers reported concerns regarding their infant (210 total concerns), 81% reported concerns about themselves (237 total concerns), and only 19% reported concerns about interactions with family or friends (15 total concerns).
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: This study compared the effectiveness of the application of expressed breastmilk or colostrum with that of hydrous lanolin to women's nipples after breastfeeding for prevention or reduction of nipple pain and trauma during the first 10 post-partum days. Each of the 23 subjects was her own control, applying lanolin to one nipple and expressed breastmilk or colostrum to the other. After every feeding mothers rated nipple pain for each breast on a 4-point scale. On postpartum days 0 to 5, 7, and 10, nipple condition was assessed by investigators who were “blind” to the intervention used on each nipple. Nipple pain and trauma experienced by the women were similar for the two interventions. Of the 95 percent reporting nipple pain during feeding, 26 percent had “extreme pain.” All women experienced nipple trauma. Engorgement, the most common breast problem, correlated positively and significantly with nipple trauma. No significant correlations were found between the following variables: perceived nipple pain and observed nipple trauma, nipple pain and number of feedings perday, nipple pain or trauma and hair or skin color, and nipple pain and prenatal preparation for breastfeeding.
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For 14 days following birth, 114 breastfeeding mothers rated their level of breast engorgement twice daily, using a six-point engorgement scale. Individual engorgement ratings were plotted by intensity over time to provide a visual display of each subject's breast engorgement experience. Four distinct patterns of breast engorgement emerged; mothers experienced either a bell-shaped pattern, a multi-modal pattern, a pattern of intense engorgement, or a pattern of minimal engorgement. Characteristics of mothers and infants, and feeding frequency were similar across the four breast engorgement patterns.