Breast Care
Definition
Breast care is the activity to prepare and
clean the breasts during pregnancy and lactation for breast feeding
Purpose
·
To prepare the woman for breast
feeding
·
To correct the minor defects of
the breasts such as inverted nipples.
·
To prevent sore& cracked
nipples during lactation.
·
To prevent engorgement of
breast during perpurem.
Pay
special attention
- To the nipples
- Use circular movements while applying soap
- Never use strong soap/ antiseptic
- Never apply soap on the nipples & areole part
- Never put the baby on the breasts if the nipples are cracked
- Inspect breasts and nipples daily for engorgement, retracted/ depressed/ cracked nipples, mastitis and other complications
- Never take out nipple from baby’s mouth abruptly
- Mother should have short nails and should wash hands before feeding
Preparatory
phase:
a)
Preparation of nurse:
·
Must understand the feeling of
mother
·
Musk know to giv3e advises and
care related to breast
b)
Preparation of articles:
- Bowl of cotton swabs
- Sponge cloth – 2
- Soap in a soap dish
- Ointment, if prescribed
- Kidney tray
- Small mackintosh and towel
- One basin
- Jug of hot water
- Screen
c)
Preparation of environment:
·
Provide calm and safe room
·
Provide privacy
·
Provide adequate lighting
d)
Preparation of mother
·
Provide privacy to mother
·
Explain procedure to the mother
·
Undress the upper body part
II.
Implementation phase:
|
Procedure
|
Rationale
|
|
·
Wash hands
·
Assemble all the articles
·
Explain the procedure to the
mother
·
Take the articles to the bed
side
·
Screen the mother
·
Make the mother sit or lie
down.
·
Expose the breasts
·
Place the mackintosh and
towel under breasts/ over the lap
·
Pour hot water in the basin
·
Apply soap with the hands in
a circular movement start from areola , breast to end with applying soap on
axilla.
·
Wash the breasts with sponge
cloth like above step
·
Clean the nipples and remove
all the crusts with cotton swab to prevent blockage of the duct
·
Express little milk
·
Check for cracks and
inversion of nipples or engorgement of the breasts
·
Dry the breasts with towel
·
Put the baby on the breasts
but before putting the baby to breast, any discharge from baby’s eyes or nose
is to be cleaned, napkin must be changed
·
Advise her to wear supporting
bra
·
Make the mother and child
comfortable
|
To prevent infection
For easy access
To reduce anxiety
To provide privacy
for convenient
To clean the breast
To prevent soiling
to ensure the patency of the nipple
To prevent breast sagging
|
III.
Post procedure phase
·
Remove all articles and screen
from bed side and replace
·
Wash hands and do recordings.
After
care:
Encourage mother to breast feed the child
CARE OF ENGORGED BREAST
Definition
Engorgement is a condition in which the
breasts become enlarged, heavy, hard and tender. It is often seen in varying
degrees commonly between third and fifth day of the puerperium
Purpose
·
To reduce discomfort of the
mother by relieving pain and tenderness
·
To maintain lactation
·
To prevent further
complications of the breasts
Points
to Remember
·
Breasts must be completely
empty after expression
·
An effort should be made to
maintain lactation
·
Water should not be very hot
·
Inspect for any breast complication
·
Sucking by the baby and manual
expression are avoided in severe engorgement
I.
Preparatory phase:
a) Preparation of nurse:
·
Must understand the feeling of
mother
·
Musk know to giv3e advises and
care related to breast
b)
Preparation of articles:
·
A medium size bowl with hot
water
·
Four sponge clothes or piece of
old clean cloth
·
Kidney tray
·
Towel to spread over the
mackintosh
·
A few pads of cotton wool in a
bowl
·
Medicines, if prescribed
·
Mackintosh
·
A small hand towel for drying
mother after the procedure
·
A small bowl for receiving
expressed milk
c)
Preparation of environment:
·
Provide calm and safe room
·
Provide privacy
·
Provide adequate lighting
d) Preparation of mother
·
Provide privacy to mother
·
Explain procedure to the mother
·
Undress the upper body part
II.
Implementation phase
|
Procedure
|
Rationale
|
|
·
Bring the tray to the bed
side
·
Explain to the mother
·
Screen the mother
·
Put the mother in a sitting
or side lying position
·
Expose the mother’s breast
·
Place the mackintosh and
towel under the breast
·
Soak two sponge clothes in
hot water, wring the sponge clothes well, test their temperature and apply on
breast
·
Apply soap on hands &
stroke the breast towards the nipple
·
Clean the breast again with
hot water & dry with towel
·
Continue fomentation of the
breasts for 10-15 minutes
·
Put baby to the breast if
engorgement is reduced
·
Express the rest of the milk
from the breast manually into clean bowl.
·
Clean the breast and wipe it
dry and apply the medicine (if any)
·
Ask mother to wear well
fitting bra. She can use cotton pads in the bra for absorbing the milk
secretion from breast
|
To save time
To reduce anxiety
To provide care
To reduce swelling
To clean the breast
To get effective result
To feed the baby
To prevent accumulation of milk in the breast
To prevent engorgement
|
III.
Post procedure phase:
Wash and replace all articles
Record condition of the breasts, nipples and if any
medicine is used
After care:
Teach patient to repeat the procedure if engorgement
persist.
Document the Condition of breasts and nipples and any
medication/ointment if used.
CARE OF CRACKED NIPPLES
Definition
Loss
of surface epithelium with the formation of a raw area on the nipple or fissure
situated either at the tip or the base of the nipple is known as cracked
nipple.
Purpose
- To reduce discomfort of the mother by relieving pain
- To encourage rapid healing.
- To maintain lactation
- To prevent further complications of breast
I.
Preparatory phase:
a)
Preparation of nurse:
·
Must understand the feeling of
mother
·
Musk know to giv3e advises and
care related to breast
b)
Preparation of articles:
·
A small covered sterile bowl
with sterile swabs, soaked in saline or boiled water
·
A small covered sterile bowl
with dry sterile / clean swabs and gauze pieces
·
Antiseptic ointment or cream as
prescribed
·
Kidney tray
·
Screen
c)
Preparation of environment:
·
Provide calm and safe room
·
Provide privacy
·
Provide adequate lighting
d) Preparation of mother
·
Provide privacy to mother
·
Explain procedure to the mother
·
Undress the upper body part
II.
Implementation phase:
|
Procedure
|
Rationale
|
|
·
Bring articles to the bed
side
·
Screen the patient
·
Explain the procedure to the
patient
·
Expose breasts
·
Discard the dirty dressings
in kidney tray
·
Wash hands
·
Clean the nipples and
surrounding area with sterile swabs soaked in antiseptic lotion
·
Dry the nipples with dry
sterile gauze pieces
·
Apply medications as ordered
·
Cover the nipples with
sterile gauze piece.
·
Support the breasts with well
supporting bra
|
For easy access
To provide
privacy
To reduce
anxiety
To prevent
infection
To treat the
nipple
|
III. Post procedure phase:
·
Clean and replace all articles
- Record the condition of the nipples,
- Presence of any abnormality, such as bleeding, pus etc.
- Medications applied, if any
After
care:
§ Breastfeed from the uninjured (or less injured)
side first. Baby will tend to nurse more gently on the second side offered.
§ The initial latch-on tends to hurt the worst – a
brief application of ice right before latching can help to numb the area.
§ Experiment with different breastfeeding positions
to determine which is most comfortable.
§ If breastfeeding is too painful, it is very
important to express milk from the injured side to reduce the risk of mastitis
and to maintain supply. If pumping is too painful, try hand expression.
