Breast Feeding Issues and Their Treatment

Breast Feeding Issues and Their Solution

 

Engorgement To Treat Engorgement Steps to Extract Milk Manually Blocked Duct Treatment Mastitis and Breast Abscess Sore Nipples Cracked Nipples Treatment.

What is Engorgement?

    When the milk first comes in, the breasts may feel hot, heavy and hard. This fullness is due to the milk in the breast. The mother should be encouraged to feed the baby to remove the milk. If feeding does not relieve the fullness, help her to express some milk. If enough milk is not removed, the breasts may become engorged and painful. The milk may also stop flowing.

    Engorgement interferes with breastfeeding because the baby finds a difficult to suck properly, and her mother feeds her less because the sucking is hurtful. The breast may become infected, leading to mastitis or even breast abscess.Engorgement is uncommon when mothers feed the baby frequently. both during the day and night, as most of our rural women do, and when they feed exclusively from the breast soon after birth.

To Treat Engorgement

    The baby should be allowed to continue to suck as far as possible. If the baby cannot suck properly to remove enough milk, help the mother to express the milk. Hand expression is the best, but a pump can also be used.

    A warm compress on the breast or a warm bath also helps. After expressing some milk, help the mother to put the baby to breast Milk should be expressed as often as necessary to make the breasts comfortable.

    It is important to start management of engorgement as soon as t develops. This will avoid a great deal of pain and discomfort to the mother and help the baby to continue sucking

    How to Express Milk by Hand A cup or glass should first be washed, and then rinsed in boiling water, or preferably boiled for two to three minutes to kill the germs. Drying the cup in strong sunlight also helps to destroy germs.

    The mother must wash her hands thoroughly and follow these Lean forward and support the with her hand steps.Place her thumb on the areola above the nipple and her first finger on the areola below the nipple.

Steps to Extract Milk Manually

• Press the thumb and finger
• Press the areola behind the nipple between the finger and the thumb 
• Continue pressing and releasing
• Milk will begin to drip and then flow in a stream
• Press the areola in the same way from the sides to make sure milk is expressed from all segments of the breast The nipple itself must not be squeezed, only the areola.

Blocked Duct

    The gland tissue in the breast is arranged in segments, like those in a lemon, and a duct leads out from each segment. If a duct becomes blocked a painful lump forms.

Treatment

    The mother should continue to feed her child frequently from the breast. If the sucking is insufficient help her to express the milk. Gently massage the lump towards the nipple to try and unblock the duct. It is important to remove milk to prevent stagnation and infection.

Mastitis and Breast Abscess

    If a blocked duct is not cleared, the breast tissue may become infected and the breast itself becomes tender and swollen. If untreated, an abscess develops.

    Encourage the mother to continue to breastfeed the baby. If sucking is painful, she must be helped to express her milk several times a day. This is the most important part of the management. If the milk stays in the breast, the infection may spread. Warm fomentation helps to relieve the pain. She should consult a doctor regarding a course of antibiotics or drainage of the abscess if that becomes necessary.

The most common cause of sore nipples is the baby sucking from a bad position, ie if she does not have enough of the areola in her mouth and sucks only the tip of the nipple. Oral thrush too can cause sore nipples Frequent washing with soap also contributes to this condition.

Sore Nipples

    If the nipples are painful, the mother will feed the baby less often and for a shorter time, and the milk supply will thus diminish. To prevent sore nipples, advise mothers not to wash their nipples with soap. They should wash them only while having a bath, ie, once or twice a day. Help all babies to suck in the correct way. As mentioned earlier, wait until the baby releases the nipple, or instruct the mother to put her finger gently into the baby's mouth to break the suction.

    If the pain continues, help the mother to remove the milk by hand expression or with a pump, and feed the expressed milk to the baby from a cup with a spoon. Experience has shown that babies can learn to drink from a cup soon after birth even.

Cracked Nipples

    If a baby continues to suck from a bad position, it may damage the nipple skin and a fissure or crack appears. The nipple should be exposed to the sun and air as much as possible.

Treatment

    Advise the mother to leave a drop of hindmilk on the nipple after feeding as this helps the skin to heal. Cream from the top of milk (malai) can also be applied.If the pain continues, the milk must be removed by expressing with hand squeezing or with a pump. There is no reason to stop breastfeeding altogether.

    For the majority of rural women, breastfeeding is the most natural way of feeding the baby, and they are absolutely relaxed about it. Thus, such problems as sore or cracked nipples and engorgement are quite uncommon among them. The more affluent urban women can learn a lesson from them.

    "I do not have enough milk", this is one of the most common reason that mothers cite for wanting to give their baby fresh animal milk or powdered milk. However, often the mother has enough milk and the health worker should reassure her about this. The reasons why she believes that her milk is not enough are that her breasts feel empty, the baby continues to cry, or that the baby wants to suck a lot. The health worker has to decide whether or not the mother's apprehensions are correct.

    The weight gained by the baby is the best means of checking whether or not she is getting enough milk. A healthy baby should gain about 800 g to 1 kg. Per month for the first 3 months, and about 600 to 700 g per month between the age of 4 to 6 months. 

    Energy intakes of breastfed infants are less than those of formula-fed infants, and the pattern of weight gain is also somewhat different even though the direction of the weight curve is always upwards. If the weight gain is normal, the health workers should reassure the mother that she has enough milk and advise her not to start a milk supplement. An adequately fed baby will pass urine 5 to 6 times a day and will have normal soft stool.