Question

Discuss the following breastfeeding conditions and the prevention and treatment of each: sore nipples, flat or inverted nipples, letdown failure, hyperactive letdown, hyperlactation, engorgement, clogged ducts, mastitis, and low milk supply.

Answer 1

Answer:

Sore nipples;

• May be prevented by proper positioning of baby or breast
• mothers nipple approximates to the junction of the hard and soft palate

Flat or inverted nipple;

• should not impact breastfeeding if the latch is correct
• if difficult to latch; roll nipples between fingers or use a breast pump prior to feeding
• helps to draw out the nipples

letdown failure;

• milk does not eject from the breast
• oxytocin nasal spray may be prescribed
• relaxation technique may help to enhance letdown

Hyperactive letdown;

• stream of milk comes from the breast
• if too active may cause infants to cough, gulp or choke

Hyperlactation;

• milk volume produced exceeds intake
• reduce production
• cabbage leaves or cold compress may be used to decrease production

Engorgement;

• Breast are overfilled with milk
• cabbage leaves may be used  to reduce discomfort

plugged ducts;

• localized blockage of milk resulting in milk stasis
• caused by milk staying in the ducts
• painful knot may form in breast
• treated by massage and warm compress
• prevented by complete emptying of breast

mastitis;

• inflammation of the breast
• may be infective or non infective
• occur in 1 to 33% of breastfeeding mothers
• may result from sore or cracked nipples or missing a feeding

Low milk supply;

• most common reason for cessation of breastfeeding
• may be real or perceived
• causes; ineffective emptying or breast or stress management
• galactogogue may be prescribed.