Breast care During Breastfeeding Period

Breastfeeding is the process by which human milk is fed to a baby by hand or pumped and fed to the infant. Breast milk may be from the breast or may be expressed. Breast feeding is a natural process that should be a good experience for both mother and baby. It helps mother and baby experience an amazing bond together and breast milk has all the nutrients that a growing baby needs. However, it takes a little practice to get it right. If breast feeding becomes painful, the experience can become less than wonderful. Some of the tips that can help moms avoid problems such as soreness and engorgement are explained below.

Basically the breastfeeding mother needs education to practice mainly three things.

1. Observe basic cleanliness.
2. Monitor the moisture balance on your skin, too dry can cause cracking, and too wet can breed germs.
3. Identify any changes that need attention.

As the breasts fill up with breast milk, there may be tenderness, tangling, and leaking of breast milk. Diligent breast care, will help minimize discomforts and help prevent infection.

Measures to Avoid Breast Issues

1. Practice good hygiene

• Wash hands before touching the breasts. Keep breasts and nipples clean by washing them daily with warm water or in the shoulder or bath.
• Avoid using soap on your breasts especially on nipples. Soap can cause dry, cracked and irritated skin. It can also remove the natural oils produced by the Montgomery glands located on the areola surrounding the nipples. The oils help to keep nipples and areolas clean and moisturized.

2. Change breast pads often

If the mother is using breast pads or cotton squares inside the bra to soak up the breast milk from leaking breasts, be sure to change them when they become wet, as dampness can prompt germs to grow. Clean, dry nursing pads can help prevent sore nipples, thrush or mastitis.

3. Wear a supportive bra

• Choose a supportive nursing bra or regular bra that fits well, but not too tight.
• Wear cotton bra as it allows the skin to breath.

4. Make sure the baby is latching on correctly

• Get the baby to latch on well from first feeding and nurse very often, at least every 2 to 3 hours as this can help prevent the development of painful breast problems such as sore nipples, breast engorgement, plugged milk ducts and mastitis. When the baby is latching on, aim the nipple towards the roof of the baby’s mouth. Having both the nipple and some of the areola in the baby’s mouth will help him feed properly.
• Remove the baby from breast correctly. When the bay is to be taken off the breast, do not pull him off. Instead place a finger in the corner of the mouth to gently break the suction between the baby’s mouth and breast.

5. Solutions for common breast-feeding problems

• Treat sore nipples: After feeding the baby, rub a safe cream or put few drops of breast milk on the nipple and areola and then let them air dry (fresh breast can help heal damaged nipples and areola).

6. Treat engorgement

If the breasts become painfully overfull, apply cold compress to reduce inflammation and relieve pain. Pumping or nursing often to relieve the pressure can also help.

7. Perform a monthly breast self-examination

Even though breastfeeding, it is important to check your breasts each month. While it is normal for your breasts to feel lumpy when they are full of milk, the lumps should go away with breast feeding, pumping, or massaging of breasts. If there is a lump that does not go away on its own within a few days, contact doctor to have it checked.

8. Breast care when pumping

Care for breasts when using a breast pump is essentially the same as when the mother is breastfeeding, with few extra components specific to pumping.

• Proper nipple positioning to fit over the areola of the shield or flange is important.
• Keep everything clean.

Always wash hands and thoroughly clean pump parts every time it is used for pumping milk, to prevent infection.

9. Breast care when weaning

Mother’s body will still make breast milk when if when she decides not to breastfeed or wean her baby. If weaning gradually, no particular care will be needed. Breast milk supply will gradually decrease as demand from the baby or pump decreases. If weaning is sudden, there are some steps mother can take to care for her breasts.

Steps that can be taken when the mother wants to stop breastfeeding:

• Medications to relieve pain can be taken after asking the doctor.
• Avoid touching the breasts and nipples as stimulation of breasts and nipples keep producing milk.
• Place a cold compress on breasts to help reliever swelling and discomfort.
• A traditional practice in some communities is place some jasmine flowers or cabbage leaf inside the bra.
• Use breast pads or cotton cloth to soak up leaks.
• Wear a bra that is supportive but not tight as constriction can be painful.

Caring for breasts while breastfeeding can help the mother stay healthy and prevent breast issues that can lead to breastfeeding problems.

Manual Expression or Hand Expression of Breast Milk

Expressing breast milk means squeezing milk out of breasts for storing it to feed the baby at a later time. This is done when the baby is away from the mother or the baby has problem feeding directly from breast as in the case of a baby with cleft lip and palate. Expressed milk can be fed to the baby from a bottle or a feeding cup.

Technique of Hand Expression or Manual Expression of Breast Milk

• Step 1: Wash hands with soap and water to have clean hands before touching breasts for milk expression.
• Step 2: Get into a comfortable position and relax.
• Step 3: Place a warm towel on breasts and gently massage the breasts for a few minutes before the mother gets the breast milk flowing.
• Step 4: Keep the baby’s photo, blanket or the baby nearby to help stimulate the let-down reflex.
• Step 5: Position the hand on breast in a ‘C’ hold that is place the thumb on the top of the breast and fingers underneath the breast so that the hand is in the shape of letter C. The thumb and fingers should be one to two inches behind the nipple.
• Step 6: Hold a clean collection cup or breast milk storage bottle under the breast with the other hand.
• Step 10: Repeat steps 7 and 8 at a steady, rhythmic pace until there is not anymore breast milk corning out or until you have alleviated the fullness of engorgement. Rotate the hand to another position like backward ‘C’ or upside down ‘C’ and begin the process again.
• Step 11: Switch breast when the flow of milk stops.
• Step 12: Give the expressed milk to baby right away or store it to use later.

REFERENCES

1. Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
2. Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
3. Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
4. Annamma Jacob, Manual of Midwifery and Gynaecological Nursing, 4th Edition, 2023, Jaypee Publishers, ISBN: 978-9356961593
5. Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
6. Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
7. Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
8. AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
9. Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/

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