Session-12-Breast-and-Nipple-Conditions.ppt

Medidas Medical Center INC
Lactation Training Management
Sesion 12-Breast-and-Nipple-Conditions

1. SESSION 12
Breast and Nipple
Conditions

2. SESSION OBJECTIVES
1.List the points to look for when examining
a mother’s breasts and nipples;
2.Describe causes, prevention and
management of engorgement and
mastitis;
3.Describe causes, prevention and
management of sore nipples;
4.Demonstrate through role-play assisting a
mother with breast or nipple conditions.

3. EXAMINATION OF MOTHER’S BREAST AND NIPPLE
Ante-natal –not helpful ; to reassure that
most breast produce milk regardless of
shape and size.
After delivery -Only if mother has pain/
difficulty.
Observe privacy / make her comfortable
Ask permission to expose breast / No
touch.
Highlight positive signs / Build
confidence.

4. SIZE AND SHAPE
There are
many different
shapes and
sizes of breast
and nipple.
Babies can
breastfeed from
almost all of
them.
12/1
Breastfeeding Counselling: a training course,
WHO/CHD/93.4, UNICEF/NUT/93.2

5. NIPPLE SIZE AND SHAPE
>Change shape –Protractility
*Inverted Nipples -Babies
attach to breast,not to nipple.
*Long or big nipple

6. UNICEF C
-
107
-
19
Full Breast
What do you see ? Normal breast changes ?
Slide12/3

7. ENGORGEMENT
Feedback Inhibitor
of lactation
activated
reduce
milk production
Causes :
-Delayed initiation
-Poor attachment
-Infrequent feeding

8. PRACTICES TO AVOID ENGORGEMENT
Step 4 -Skin to skin, initiate BF within
1 hr
Step 5 –Offer help early show how to
express milk
Step 7 -keep together 24 hrs a day
Step 8 -breastfeed on demand
Step 9 -No pacifiers, teats

9. WHY HELP RELIEVE ENGORGEMENT ?
Relieve discomfort
Prevent further complications
Ensure continuous milk
production
Enable baby to receive
breastmilk

10. HOW TO RELIEVE ENGORGEMENT
Check attachment
Express between feeds
Encourage frequent feeds
Apply warm compress
Massage
Help mother to be comfortable
Provide supportive atmosphere
Cold compress

11. BLOCKED DUCT & MASTITIS
Milk remains in a
part of the breast
Non-infective
mastitis
Infective mastitis
Causes :
Infrequent
feedings
Inadequate
removal
Local pressure

12. 12/4
©UNICEF C107
-
39

13. TREATMENT OF MASTITIS
Frequent emptying of breast
Check attachment
Offer affected breast first
Help milk to flow
Gentle massage
Warm compress
check clothing
Rest with baby

14. DRUG TREATMENT FOR MASTITIS
>Anti-inflamatory
–Ibuprofen(Mild analgesic)
>Antibiotic
–if indicated, 10-14 days
>Generally oral antibiotic
(erythromycin, flucloxacillin,
dicloxacillin, amoxacillin,
cephalexin.)

15. MASTITIS IN THE WOMAN WHO IS HIV-
POSITIVE
>Increase the risk of transmission
-Give antibiotics
>Discontinue breastfeeding on the
affected breast
>Express milk from affected breast
effectively
>Breastfeed from unaffected side
-AFASS

16. SORE
NIPPLE
12/5
©UNICEF C107
-
31

17. SORE
NIPPLE
12/6
©UNICEF C107
-
32

18. CANDIDA ON THE NIPPLE
12/8
©UNICEF C107
-
34

19. CANDIDA ON THE NIPPLE
12/9
©UNICEF C107
-
33

20. TONGUE-TIE
12/10
©UNICEF C107
-
35

21. OBSERVE A FEED
-Check how baby goes to breast
-How BF ends
-What nipple looks like after a feed
-Check mouth
-Check breast pump (if used)
-Decide the cause of sore nipple

22. MANAGEMENT OF SORE NIPPLE
Reassurance
Treat cause/s :
-Improve attachment & positioning
-Treat source of irritation Candida?
Short Frenulum ?
Comfort measure

23. WHAT DOES NOT HELP SORE NIPPLE?
-DO NOT stop breastfeeding
-DO NOT limit breastfeeding
-DO NOT apply any substance
-DO NOT use nipple shield

24. SYRINGE METHOD FOR INVERTED NIPPLES
12/7
Breastfeeding Counselling: a training course,
WHO/CHD/93.4, UNICEF/NUT/93.2