Chapter 7, Problem 1.1CS

Summary Introduction

To mention: Various causes of engorgement.

Introduction: Chronic mastitis is a breast disease that leads to prolonged inflammation. This disease occurs in the case of a mother who avoids breastfeeding. Breastfeeding is the most important and natural way to feed a newborn 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 proteins, 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 had reported experiencing breast enlargement. After two hours of postpartum, her newborn was put to the breast and the infant latched well according to the mother. The infant was nursed over the initial 3-4 days of postpartum in every two hours. Person B was noticed with heavy breast during the third day of postpartum and gradually, she felt painful engorgement by the fourth day of postpartum. During this time, she also reports painful, burning sensation and cracks in her nipples. Due to breast engorgement, the infant is unable to latch properly to the breast. This makes the infant irritable. Person B consulted a lactation consultant and follows engorgement management. On the fifth day, the engorgement caused discomfort. The nipples of Person B became more cracked and painful because the vigorous latching of the infant. In the case of the infant, all the symptoms show about the adequate intake of nutrition. By the seventh day of postpartum, Person B had mastitis and consulted a lactation consultant for treatment. By the fourteenth day, her symptoms became very less and she felt much better. During the third week, while feeding the infant, she still had inflammation, a healing crack, and still some symptoms of chronic mastitis were present.

Again, she consulted the lactation consultant who helped 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 continued to show the signs of oversupply like breast feeling full after feeding and excess leakage of milk between feedings. Her lactation consultant provided techniques to decrease the overproduction of milk. After 10 days of burning pain in the nipples, Person B is treated with fluconazole for a yeast infection. Again after the seventh week of postpartum, Person B consulted the lactation consultant to report about another mastitis condition. Her consultant prescribed dicloxacillin for treatment. During the eighth week of postpartum, her mastitis condition resolved but the pain was still present in her nipples. Also, she is improving from mastitis condition.

In this case study, the causes of engorgement in breasts of Person B are as follows:

• Instability between the demand and the supply of breast milk
• Excess production of breast milk
• Improper breastfeeding techniques
• Infrequent or ineffective removal of milk from the breast