Chapter 7, Problem 1.1CS

Summary Introduction

To mention: The cause of engorgement.

Introduction: Chronic mastitis is a breast disease that leads to prolonged inflammation. This disease occurs in case of mother who avoids breastfeeding. Breastfeeding is the most important and natural way to feed a new born baby. Mother’s milk provides all the nutrition and immunity to the baby, which is needed during the first six months; breastfeeding satisfies their hunger and thirst and provides the proper amount of protein, minerals, and immunity to the child, which helps to deal with the environment.

Explanation of Solution

Person B was pregnant at the age of 29 and during her pregnancy she has reported experiencing breast enlargement. At two hours postpartum, the infant is put to the breast and the infant handles well. The infant nurses over the initial 3-4 days postpartum in every two hours. Person B noticed fuller during third of postpartum and gradually she fells painful engorgement by fourth postpartum day. During this time, she also reports painful, burning, and cracked sensation in her nipples. At this time, the infant is unable to latch properly at the breast. This leads to irritable sensation for the infant and painful sensation for Person B. Person B consulted a lactation consultant and follows engorgement management. On 5^th day, the engorgement causes discomfort. The nipples of Person D become more cracked and painful because the latch of infant has become shallow and tight to control the milk flow. In case of infant, all symptoms show about the adequate intake of nutrition. By day 7 of postpartum, Person D has mastitis and consulted lactation consultant for treatment. By day 14, her symptoms become very less and she feels much better. At three weeks she still has inflammation during infant feeding and a healing crack and still some symptoms of chronic mastitis are present.

Again she consulted the lactation consultant who helps Person B to position the infant in a comfortable way that mostly allows the drainage of the inflamed area and recommends her to pump the affected side to relieve the discomfort during breastfeeding. Then Person B continues to show the signs of oversupply like breast feeling full after feeding and excess leakage of milk between feedings. Her lactation consultant provides techniques to decrease the overproduction of milk. After 10 days of burning pain in the nipple Person B is treated with fluconazole for a yeast infection. Again after seven weeks of postpartum, Person B consulted lactation consultant to report about another mastitis condition. Her consultant prescribes dicloxacillin for treatment. At eight week of postpartum, her mastitis condition resolved but pain is still present in her nipple also she is improving from mastitis condition.

In this case study the cause of engorgement are as follows:

• • Instability between the demand of milk and the supply of milk.
• • Abundant amount of milk.
• • Improper breast feeding techniques.
• • Infrequent or ineffective removal of milk from breast.