Engorgement
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The breast may become heavier and swollen 3 to 4 days postpartum
-This is caused by an increased flow of blood and fluid to the breast,
swelling of the surrounding tissue, and the accumulation of milk in the
ductal system
-Women may experience a throbbing sensation and discomfort with the
milk ejection reflex (MER) or let-down
-All woman are different and may have different experiences with
engorgement—may be more severe in women who had excessive IV fluids
during labor = EDEMA
-If swelling is severe it can lead to milk stasis (an inability to remove milk
from the breast... the interstitial swelling pinches the ducts closed)
Initiation of Lactation
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Suckling provides the stimulus for the production of prolactin and oxytocin
Pumping Protocols
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-If moms are pumping for NBICU or sore nipples, teach massage and hand
expression first then use pump for 5-10 minutes each breast every 2-3 hours
(or 6-8 times in a 24 hour period) Hand expression prior to pumping has
been shown to double supply.
-Moms pumping for engorgement should use short pumping sessions
(preferably, hand expression) in combination with cold compresses until
milk is flowing freely and baby can latch
Postpartum care for the mother who is NOT breastfeeding
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-It is important to educate mothers on how to care for their breasts if they
are not nursing.
-Excessive pressure from engorgement and interstitial swelling on the milk
ducts can cause damage to the tissue and prolactin receptors making
future breastfeeding difficult.
-To prevent damage to milk ducts that may impair future breastfeeding
have the mom try the following interventions while ceasing milk production:
* Mothers should also refrain from nipple stimulation.
* Follow same care guidelines for engorgement.
*These guidelines would also be appropriate for mothers who have
suffered a fetal demise
, Prolactin
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-Prolactin levels increase with nipple stimulation and removal of milk from
the breast
-Prolactin is the "milk maker"
-The "empty" breast makes milk faster
-Feed often (every 1-3 hours) to increase supply
Feedback Inhibitor of Lactation (FIL)
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-FIL is a small whey protein which slows milk production when the breast is
full.
-Milk production slows when the breast is full, therefore more FIL is
released.
-Milk production speeds up when the breast is empty, therefore less FIL is
released.
-"Research indicates that fat content of the milk is also determined by how
empty the breast is (emptier breast = higher fat milk), rather than by the time
of day or stage of the feed."
Transitional Milk
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Give this one a try later!
The breast may become heavier and swollen 3 to 4 days postpartum
-This is caused by an increased flow of blood and fluid to the breast,
swelling of the surrounding tissue, and the accumulation of milk in the
ductal system
-Women may experience a throbbing sensation and discomfort with the
milk ejection reflex (MER) or let-down
-All woman are different and may have different experiences with
engorgement—may be more severe in women who had excessive IV fluids
during labor = EDEMA
-If swelling is severe it can lead to milk stasis (an inability to remove milk
from the breast... the interstitial swelling pinches the ducts closed)
Initiation of Lactation
,Give this one a try later!
Suckling provides the stimulus for the production of prolactin and oxytocin
Pumping Protocols
Give this one a try later!
-If moms are pumping for NBICU or sore nipples, teach massage and hand
expression first then use pump for 5-10 minutes each breast every 2-3 hours
(or 6-8 times in a 24 hour period) Hand expression prior to pumping has
been shown to double supply.
-Moms pumping for engorgement should use short pumping sessions
(preferably, hand expression) in combination with cold compresses until
milk is flowing freely and baby can latch
Postpartum care for the mother who is NOT breastfeeding
Give this one a try later!
-It is important to educate mothers on how to care for their breasts if they
are not nursing.
-Excessive pressure from engorgement and interstitial swelling on the milk
ducts can cause damage to the tissue and prolactin receptors making
future breastfeeding difficult.
-To prevent damage to milk ducts that may impair future breastfeeding
have the mom try the following interventions while ceasing milk production:
* Mothers should also refrain from nipple stimulation.
* Follow same care guidelines for engorgement.
*These guidelines would also be appropriate for mothers who have
suffered a fetal demise
, Prolactin
Give this one a try later!
-Prolactin levels increase with nipple stimulation and removal of milk from
the breast
-Prolactin is the "milk maker"
-The "empty" breast makes milk faster
-Feed often (every 1-3 hours) to increase supply
Feedback Inhibitor of Lactation (FIL)
Give this one a try later!
-FIL is a small whey protein which slows milk production when the breast is
full.
-Milk production slows when the breast is full, therefore more FIL is
released.
-Milk production speeds up when the breast is empty, therefore less FIL is
released.
-"Research indicates that fat content of the milk is also determined by how
empty the breast is (emptier breast = higher fat milk), rather than by the time
of day or stage of the feed."
Transitional Milk
Give this one a try later!
