Page 284 - كتاب تمريض نسا الاكتروني

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postpartum, especially in primiparas. It is due to lymphatic and venous

engorgement and is relieved when milk comes out.

Causes

 Inadequate and\or infrequent breastfeeding

 Inhibited milk ejection reflex

 Congestion and increased vascularity

 Over production of milk.

Signs and symptoms

 Breasts are firm, heavy (due to blocked ducts), swollen, tender and

hot (37.8 C).

 Areola is firm, flattened nipple if engorgement involve the areola in

severe cases.

 Pain may be present leading to irritability and insomnia. The mother

may refuse the nurse and the infant.

Nursing management

1. Apply moist warm packs to the involved breast 2-3 minutes before each

feeding.

2. Massage and manual expression of milk to relieve areolar engorgement before

feeding. This facilities attachment.

3. Cold application after feeding.

4. A well-fitting bra should be used to provide support and comfort.

5. frequent breast feeding every 2 hours for 15- 20 min /side , if not breast feed

uses a manual or electronic pump.

6. The application of cool cabbage leaves to the breast, left in place for 20

minutes, may reduce symptoms of engorgement.

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