Swelling of the breast during feeding
The more milk the baby sucks, the moreit is produced for the next feeding. But sometimes, especially in the process of becoming lactation, there can be a violation of this balance, and milk is produced in an amount significantly exceeding the needs of the child. As a result, milk stagnation develops - lactostasis.
The mammary glands have a structure resemblingstructure of a tree. Cells of the gland that produce milk are combined into lobes and lobes, from each of which the milk ducts come together, merging into larger dairy cords that end at the top of the nipples. In order for milk produced in milk cells to flow unhindered, it is necessary that the milk ducts and milk passages have sufficient clearance for this. During the feeding, the milk moves are gradually developed, but this does not happen immediately. At a time when the glands are beginning to actively produce milk, and the milk moves have not yet been developed sufficiently when the amount of milk produced by the gland significantly exceeds the baby's nutrition needs, and there is a danger of developing lactostasis. Usually this condition develops on the 4th-5th day after birth. But even after the termination of the formation of lactation, the possibility of lactostasis is not ruled out.
Lactostasis is accompanied more or lessa pronounced increase in mammary glands in the volume, engorgement of the site or the entire thickness of the gland, densification of the gland tissue, edema and flattening of the nipples, soreness. Usually a woman wakes up in the morning with a feeling of overflow of the mammary glands and soreness in them.
Often in nursing mother with lactostasis, there is an increase in body temperature with chills, worsening of the state of health from mild indisposition to severe suffering.
The inconvenience and the newborn child are also experiencing,because the cause of lactostasis is primarily a violation of the outflow of milk. In addition, engorgement of the mammary glands is accompanied by a more or less pronounced swelling of the nipples. The nipple becomes dense and, as it were, stretches on the surface of the mammary gland. All this complicates the child's sucking process, often making it almost impossible. The kid is nervous when his attempts to grab the nipple with the mouth remain vain, and in those cases when he still manages to suck, sucking is ineffective. In order for the feeding to pass successfully, it is necessary that the nipple is elastic, supple. Since this condition is violated during lactostasis, the baby, having grasped the nipple and trying to suck, chews it, but can not grasp the nipple circle to press on it and squeeze out the milk. That irritation, which the child has on the nipple in the process of such ineffective sucking, causes still more stimulation of lactation, which only aggravates the engorgement of the mammary glands in the conditions of the available lactostasis.
If lactostasis has already developed, you should immediatelyinform the attending physician in the postpartum department. In no case should you stop breastfeeding. Of course, you need to continue to feed the child in a free regime, But with this, it is necessary to prepare with special care the breast for the upcoming feeding. Before each feeding until the rattling has been eliminated, it is necessary to express the excess milk from the breast.
Start pumping should be sparingon the nipples to reduce swelling in them. With gentle, gentle movements, you need to massage the nipple from top to bottom and from the surface of the nipple into its thickness. First, the milk will be released with rare drops, but gradually, as the edema decreases, the drops become more frequent. As soon as the milk begins to flow in trickles, you can proceed to the decantation of the gland itself. Often good service in this case can be served by breast pumps, which allow it to facilitate expression in this situation, making it less painful for the mother and more effective. Expressing before feeding should be until the breast becomes soft, the nipple - elastic, and the milk will not flow out of the breast without hindrance. After that, you can put the baby to the chest.
Reduce the edema of the nipples can be with the help of coldcompresses or applying ice (or a frozen warmer, having wrapped it with a diaper or a thin towel) to the nipples until the swelling is reduced so that the decantation becomes possible.
In the case where pumping is severely hampered andthe use of cold compresses is ineffective, spasticy drugs are prescribed in the postpartum department of the maternity hospital. Acting on the smooth muscles located in the skin of the nipple, such drugs as NO-SHPA, PAPAVERIN, cause the relaxation of the muscle fibers surrounding the dairy cords, and pumping is much easier,
Another method that helps to cope with developed lactostasis is the administration of the hormonal drug OXYTOCINE. Its action is aimed at improving the outflow of milk.
With developed lactostasis, the amount of fluid consumed should be reduced to 700 ml per day. In any case, all these actions must be performed with the knowledge and under the supervision of the attending physician.
After feeding is established, anddairy moves are designed to the proper degree, the risk of developing lactostasis is reduced to a minimum. But nevertheless, from time to time the situation develops in such a way that the balance between the rush of milk and the emptying of the breast can be disturbed. This can happen if, for some reason, one or two feeding is missed, and the mother does not have the opportunity to express the breast if the child suddenly starts to suck less actively (due to illness or due to psychological factors). In this case, lactostasis manifests itself most often in the engorgement of individual sections of the breast, since the milk passages are already well developed and total stasis usually does not develop.
If lactostasis has developed after several weeksor months of successful breastfeeding, try to analyze what has changed in the last 24 hours in the feeding regime, in the family environment, in the state of the child. If by this time the baby has already established a certain mode of feeding by the hour, it should be transferred to fractional feeding - to apply to the breast more often, but to keep the chest for a shorter time. Before feeding, you can take a warm bath or shower on the mammary glands in order to relieve the spasm of the milk moves and to facilitate the outflow of milk, and immediately after the shower or bath to drain some milk from the nipple. During feeding, you need to ensure that the baby sucks properly, to encourage him to active sucking. So, for example, if the child does not show enthusiasm in feeding, you can slightly rub it on your cheek, gently tickle the corner of your mouth with your finger. This causes a reflex increase in sucking movements. After each feeding, until lactostasis is finally eliminated, it is necessary to express the remains of milk from the breast until it is completely soft.
If lactostasis is accompanied by a pronouncedfever, fever with chills, you need to see a doctor immediately. You can take antipyretics based on paracetamol. PARACETAMOL is not contraindicated for lactating women, it lowers the temperature well, has an anti-inflammatory and analgesic effect.
If the occurrence of lactostasis is associated withexcessive production of milk in the glands, it is justifiable to prescribe phytopreparations that help to reduce lactation-the infusion of sage, cones of hops, walnut leaves.
It should be said that to succeed in eliminatingmilk stagnation can only be using these funds in conjunction with the organization of regular feeding and emptying of the mammary glands, especially those areas where there are seals.
Usually, after the effective emptying of the breast and taking antipyretics, the mother's condition improves literally before our eyes.
The most important point in solving the problemlactostasis is its prevention. The only effective method of prevention can be the joint stay of the mother and child from the first days after birth and feeding the newborn in a free regime. In this mode, the breast is emptied optimally and the milk moves are more quickly developed, preventing the stagnation of milk, it should be carefully monitored so that the baby is well gripped with the mouth of the sucking nipple. This measure will promote good emptying of the breast, stimulation of sufficient lactation and prevention of abrasions and cracks in the nipples.
Not the least role in preventing lactostasisplays a restriction of fluid intake by the mother from the 3rd to the 5th day of the early postpartum period. This condition is better to observe, despite the rather pronounced thirst that the nursing mother is experiencing during this period. The amount of liquid consumed on these days should be limited to 0.8 liters per day.
Lactostasis is not a disease, but a condition,which is borderline, that is capable of causing the disease, if not to take timely and effective measures to eliminate it. If the chest is not emptied, then after a while - from several hours to a couple of days, depending on the characteristics of the reactivity of the mother's body - develops mastitis. In this case, you can already talk about the disease and the possibility of developing the inflammatory process. Of course, it is better to prevent it than to fight it later, but if it has already evolved, in no case can it be expected that it will pass spontaneously. In the absence of proper actions on the part of the nursing mother, her condition is unlikely to improve. And the inflammatory reaction in the mammary glands (mastitis) that developed after lactostasis needs serious treatment. We will talk about this disease in the next issue.
Of folk methods of treatment, lactostasis canit is necessary to use the leaves of cabbage (scalded with boiling water) - they should be applied to the chest, and honey cakes (take 1 tablespoon of honey, add flour until a mass of such consistency from which it is easy to form a cake).
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