Problem associated with Brest -feeding

Teacher : Insaf Amro

Student: Israa Hassounah

Introduction Breastfeeding difficulties  refers to problems that arise

from breastfeeding, the feeding of an infant or young child with milk from a woman's breasts . Although babies have a sucking reflex that enables them to suck and swallow milk, and although human breast milk is usually the best source of nourishment for human infants, there are circumstances under which breastfeeding can be problematic, or even, in rare instances, contraindicated.

Lactation complication 1 -Insufficient milk

syndrome 2- Retracted nipples

3 -Sore nipples4 -Breast engorgement

5 -Brest abscess6 -Mastitis

1 -Insufficient milk syndromeThere is a very tiny percentage of unaltered women

who truly ,physiologically, will not be able to create breast milk you would believe that insufficient breast milk is a very popular problem

The fact is, mother’s breasts are designed to produce as much milk as baby desires, whenever natural feeding is allowed. Careful studies demonstrate that nearly all mothers who initially complain of insufficient milk are in fact producing adequate quantities, and their babies are growing normally.

Cont `Supply and demand :

When a baby cries with hunger but a schedule prevents feeding, mother’s body still responds to the cries with oxytocin release. But when the milk is not taken, prolactin is not produced; thus, there is no milk production when suckling does not occur

If milk production is suspected to be inadequate, the last thing to do is to provide a supplement to baby. The first thing to do is to increase nursing time and frequency and make sure the mother is not dehydrated. The milk supply can be quickly renewed within a few days in this way if supplementation or infrequent feedings have caused decreased production

Cont`

Causes Painful condition and any illnesses Incorrect method of breast feeding Maternal stress and insufficient sleep

Advice mother to Sufficient rest and adequate fluid

intake feed baby on demand

2 -Retracted nipple(inverted )

An inverted nipple  is a condition where the nipple , instead of pointing outward, is retracted into the breast . In some cases, the nipple will be temporarily protruded if stimulated. Women and men can have inverted nipples.

Causes Breast feeding ,born with the condition ,trauma

may be result from surgery ,breast cancer , breast inflammation ,genetic, pregnancy ,tuberculosis

Retracted nipples Antenatal examination and counseling for cleaning of nipples and their aversion is important

20cc syringe may be also used for removing retraction

Use of Brest pump

NormalRetracted

3 -Sore and damaged nipples

The cause is always trauma from the baby`s mouth and tongue which result from incorrect positioning of the baby`s mouth at the breast . Correcting this will provide immediate relief from pain and will also allow rapid healing

Signs, symptoms and management

Signs nipple is red ,cracked ,bruised and tender

Symptoms mild to sever pain

Management teach correct latch on and positioning teach on breakdown suction before taking off

the baby off the breast expose the breast to air after massaging a drop

of breast milk on the nipple check correct tongue motion

cont,`Other causes of soreness Infection with Candida albicans :(thrush) can occur , it frequently follows a period of trouble feeding . The nipple and areola are inflamed ,shiny and pain persists throughout the feed . The baby may show signs of oral or anal thrust . Both mother and baby should receive fungicide treatment

4 -Breast engorgement Definition `It is the accumulation of milk in the breast .

Time this condition occurs around the third or fourth day Postpartum

Signs The breasts are hard , painful and sometimes flushed .The mother may develop pyrexia .Engorgement results from an increase in the blood volume in the breast with accompanying edema and indicates that the

baby is not in step with the stage of lactation .

The condition may also occur when the baby is unable to feed efficiently because he is not correctly attached to the breast

Breast engorgement can lead to mastitis

Cont` Management:

encourage frequent breast –feeding .(empting the breast from milk)

start breast feeding with the engorged breast .

if breast feeding is not enough ,express breast milk .

symptomatic relief: hot compresses before breast feeding cold compresses after breast feeding or milk

expression Encourage breast support by wearing support bra

5 -Mastitis

Mastitis : mean inflammation of the breast

Mastitis is two type : A- Non-infective mastitis

B- Infective (superficial)Mastitis

Cont`A- Non-infective Mastitis : caused by blocked milk duct or milk engorgement It can occur because of unresolved engorgement or at any time when poor feeding

*It is extremely important that breast –feeding from the affected breast continues ,otherwise milk stasis will increase further and provide an ideal condition for pathogenic bacteria to replicate .And if not treated may leads to abscess formation causing much pain and distress to the mother

S&S

Local pain

Swelling of the affected

area Warmth of the affected

area

Redness &pyrexia

cont ,`B- Infective (superficial ) mastitis :

Caused by staphylococcus Aureus , E-coli or Candida Albicans

The main cause of infection is damage to the epithelium, which allows bacteria to inter the underlying tissues . The damage results from incorrect attachment of the baby to the breast which has caused trauma to the nipple .

Signs and symptoms

Fever Flu-likesymptom

s

Presence of

abscess

Treatment

1 -frequent emptying of the breast

2 -Hot compresses in mild mastitis

3 -cold compresses in sever mastitis

4 -antibiotics are used in bacterial infection

Mastitis

6 -Breast AbscessA fluctuant swelling develops in a previously inflamed area . Pus may be discharged from the affected breast . Breast feeding from the affected breast is stopped for a few days but breast feeding should be commenced as soon as possible because this has been shown to reduce the chances of further abscess formation

Management Stop feeding from the affected breast for a

few days especially if there is blood or pus discharge from the nipple

Simple needle aspiration may be effective If not . An incision and drainage is

necessary to drain the pus from the breast

Breast feeding is reestablished if no pus or blood with the milk

Antibiotic is used

Feeding difficulties may be due to

Abnormal nipple such as large nipple ,short nipple, long nipple ,or inverted nipple

Abnormality in the baby such as cleft lip cleft palate ,blocked nose , downs` syndrome , prematurity , illness or surgery

conclusionBreast engorgement

Engorged lymphatic &venous channel around the alveoli

Increase alveolar pressure

Flatness epithelium &blocks the ducts

. .

Breast hard and painful

Baby struggles and traumatized the nipples

No further breast feeding

Mastitis

Breast abscess

Thank you