Common problems during lactation

<p>Common problems during lactation</p><p>Breast engorgement</p><p>The three basic components of breast engorgement are:</p><p>congestion/increased vascularization, accumulation of milk</p><p>and edema caused by the congestion and obstruction of lymphatic drainage.It is important to distinguish between physiological and pathological engorgement. The former is discrete and is a positive sign that milk is coming in. It requires nointervention. In pathological engorgement, there is excessive tissue distension, causing great discomfort, sometimes accompanied by fever and malaise. The breast is bigger, painful, with diffuse shiny reddish areas, and edema. Nipples become flat, hampering proper latch-on, and milk sometimes does not flow normally.</p><p>This type of engorgement often occurs around the third to fifth day after delivery and usually is associated with one of the following factors;</p><p>late initiation of breastfeeding, infrequent</p><p>breastfeeding, restriction on the duration and frequency</p><p>of breastfeeding, use of complementary foods, and babies with poor suck.</p><p>Prevention</p><p>The following recommendations are useful for the</p><p>prevention of breast engorgement:</p><p>start nursing as soon as possible</p><p>breastfeed on demand;</p><p>use a proper breastfeeding technique;</p><p>avoid the use of supplements.</p><p>Sore nipples/nipple trauma</p><p>At the beginning of breastfeeding, most women feel a</p><p>mild pain or discomfort, and this may be considered to be normal.</p><p>Prevention</p><p>use a proper breastfeeding technique;</p><p>avoid products that remove the natural protection of</p><p>nipples, such as soaps, alcohol or any drying agent;</p><p>breastfeed on demand . infants who are put to the</p><p>breast as soon as they show they want to feed feel less</p><p>hungry and tend not to suck vigorously on the breast</p><p>Nipple infection caused by <br>Staphylococcus aureus</p><p>Secondary nipple infection is quite common, especially that which is caused by Staphylococcus aureus.</p><p>Candidiasis</p><p>Breast infection caused by Candida albicans in the</p><p>puerperium is quite common. Candida infection often is characterized by itching,</p><p>burning sensation and twinges in the nipples, which persist after breastfeeding. The nipples usually have a reddish and shiny appearance. Some mothers complain of burning and twinges in the breasts.</p><p>Raynaud&#x27;s phenomenon</p><p>Raynaud&#x27;s phenomenon, an intermittent ischemia</p><p>caused by a vasospasm that often occurs in the fingers</p><p>and toes, can also affect the nipples. In general, it occurs</p><p>in response to cold temperature exposure, abnormal</p><p>compression of the nipple in the infant.s mouth or severe</p><p>nipple trauma.</p><p>Plugged ducts</p><p>Lactiferous ducts are plugged when the milk produced in</p><p>a certain breast area does not drain properly for some</p><p>reason (solid obstruction is not necessary). This often</p><p>occurs when the breast is not properly emptied, which may</p><p>occur when breastfeeding is infrequent or when the infant</p><p>has a poor suck.</p><p>Mastitis</p><p>Mastitis is an inflammatory process of one or more</p><p>breast segments (the upper left quadrant is most commonly</p><p>affected) that may or may not progress into bacterial</p><p>infection. It usually occurs in the second and third weeks</p><p>after delivery, and very rarely, after the twelfth week.4</p><p>Initially, the intraductal pressure rises due to milk stasis (a</p><p>plugged duct often is the precursor of mastitis), with</p><p>consequent flattening of alveolar cells and development of</p><p>spaces between the cells.</p><p>Breast abscess</p><p>In general, breast abscess is caused by untreated</p><p>mastitis or results from late or inefficient treatment. It</p><p>affects 5 to 10% of women with mastitis. Improper emptying</p><p>of the breast affected by mastitis, which often occurs when</p><p>feeding is discontinued on that breast, favors the development</p><p>of breast abscess.</p><p>Galactocele</p><p>Galactocele is the cystic formation observed in lactiferous</p><p>ducts containing milky fluid. The liquid, which is initially a</p><p>fluid, becomes thick, and may leak from the nipple.</p><p>Galactocele is believed to be caused by a plugged duct. On</p><p>palpation, it feels like a smooth and round-shaped mass, but</p><p>the diagnosis is established by aspiration or ultrasonography.</p>