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Postpartum Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Elena R. Magro-Malosso, Sarah K. Dotters-Katz, Daniele Di Mascio
Breast engorgement typically occurs between 2 and 5 days postpartum. A meta-analysis found insufficient evidence to support any single treatment strategy for engorgement [182]. Cold packs and cabbage leaves may be helpful, and acupuncture was associated with some improvement in symptoms. NICE guidelines recommend breast massage, continued breastfeeding, and analgesia for symptom relief [154].
Neonatal Care
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Sylvia Garry, Andrew Chapman, Elizabeth Ledger
First-time mothers may need additional support to establish breastfeeds, including education on the importance of giving colostrum. In addition, specific maternal conditions, such as breast engorgement, breast abscess or mastitis, make it more difficult to breastfeed. It is important to continue breastfeeding even if these conditions are present. If breastfeeding is too painful, mothers should be encouraged to express their milk (see Box 13.3.1).
Medical evaluation and management of pregnant patients undergoing non-obstetrical surgery
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Breast malignancies are not an uncommon occurrence in pregnancy; approximately 10,000 pregnancies per year are associated with breast cancer (46). The prognosis of pregnant patients with breast carcinoma is poorer than those without pregnancy, not due to blood flow changes or hormonal milieu but due to a delay in diagnosis. Physiologic and anatomic alterations of the breast function and anatomy may mask parenchymal breast lesions and self-discovery of a mass or discovery by physical exam may be delayed until a mass has grown to a larger size (47,48). Breast engorgement, proliferation of glands and ducts, lactation, and increased vascularity all contribute to this phenomenon (48,49).
Effect of cold cabbage leaf application on breast engorgement and pain in the postpartum period: A systematic review and meta-analysis
Published in Health Care for Women International, 2023
Breast engorgement is one of the most common physiological breastfeeding problems and a condition characterized by painful swelling of the breasts in the first two weeks of lactation as a result of a sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema (Arora et al., 2008; Sharma, 2018). The reported prevalence of breast engorgement varies among studies, ranging from 20% to 75% (Indrani & Sowmya, 2020; Wong et al., 2017). Overfilling of the alveoli causes the milk-secreting cells to expand, and the tension created by this expansion reduces the blood flow around the alveolar cells and the activity of the milk-producing cells (Kamali Moradzade et al., 2013). Breast engorgement may occur due to ineffective suckling by the infant or inadequate frequency of feeding (Udayan et al., 2014). Breast engorgement may cause numerous problems, such as pain, tenderness, clogged milk ducts, decreased milk production, and inadequate breastfeeding (Aprilina et al., 2021; Wong et al., 2017), which may cause complications such as early termination of breastfeeding, cracked nipples, mastitis, and breast abscess (Mangesi & Zakarija-Grkovic, 2016). Furthermore, it is known that ineffective treatment of breast engorgement leads to failure of milk production in the early postpartum period and premature cessation of breastfeeding (Wong et al., 2017). Therefore, non-pharmacological approaches, such as cold cabbage leaves, massage, cold gel packs, cabbage leaf extract, hot compresses and warm showers, Gua Sha massage, acupuncture, and therapeutic ultrasound to evacuate full breasts are becoming increasingly popular (Disha et al., 2015; Khosravan et al., 2017; Kumari, 2019; Snowden et al., 2001; Wong et al., 2017; Zagloul et al., 2020). Of paramount importance when managing breast engorgement is ensuring that milk continues to flow from the breast and that it is effectively discharged by the breastfeeding infant or an artificial method of expression (Lawrence & Pane, 2011).