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Engorgement post partum

Merry C.O

Engorgement

(swelling) is
hyperemia, local congestion
vessels or tissue due to
accumulation of fluid, especially
as a result of blood vessels.
Engorgement / swelling breast
(Breast engorgement) occurred
during the postpartum especially
on day 3 or 4.

Etiology
1)
a.

Hormon factor
Baby and placenta is born
Prolactin

b. Oxytocin (posterior pituitary) secrete ASI


>>

2.

baby sucking
Breastfeeding depends in 2 reflexes:
Production reflexs
if Baby sucking increased production of the
hormone prolactinincreased milk production by
secretory cells and alveoli
Let Down reflexs
Baby sucking increased production of the
oxytocin hormone contraction of the cells
contained within the lumen produce milk
Let down reflex is very sensitive to maternal
psychological and the process is hampered when
the mother feels tired, embarrassed or hesitant.

3. Vacation of breast
When milk change the colostrum in
the first day after the delivery, the
breast will become larger and
heavier due to the additional lymph
and blood supply ASI retention
may occur when a mother breast
feeds her baby is often a long time.

4. how to breastfeed
a) Position of breastfeeding: When
breastfeeding, the baby should fix the
nipple, which is the correct apposition
between the tongue papillae with the
baby's gums and areola (the tongue and
palate around the mammary areola).
if the techniques of breastfeeding wrong
Nipple will be scratched Bradykinin and
prostaglandin secretion affect to
hypothalamic vascular vasoconstriction
and pain edema

b. times and frequency of breastfeeding:


breastfeeding is the normal
frequency range is between 8-12
times a day
Give the baby milk after birth or 1
hour after she/he was born.
Duration to breastfeed is 10-15
minutes. After the baby feel full,
the interval to give breastfeeding
is1-2 hours.

Sign and symptom


Breast

feels full
Fever is not as high fever on
mastitis
Heavy and hard
Edema
Pain is weighing on mastitis

Therapy
Remove

some breast milk before


feeding , so the breast is not too
stiff up and more easily inserted
into the baby's mouth.
If the baby can not breastfeed,
its can do breastfed removed by
hand or pump sterile .
If have fever, give antipiretic and
analgetic.

Prevention
Where

possible, give the baby breast-fed immediately after

birth
give the baby breast-fed without schedule
dont give any liquid(instant milk) before breast-fed infants
Clean the nipple regularly to prevent blockage of the duct
Avoid breast cleansing with soap, alcohol, and other
chemicals
Difficult to distinguish the boundaries between
engorgement and mastitis. At engorgement will found
lower milk flow, reddish colored, rarely pain. Theres nothing
sign about mastitis
To free up the blockage further cleaned with clean water in
the pump (breast pump) and then massage the breast to
the inside. It could also be given injections of oxytocin.

Differential between
engorgement and mastitis
Engorgement

there is swelling / tenderness


(soft), pain rarely, full flavor and enlarged, no
sign of infection, sometimes it will be can make
fever . need not be given antibiotics and
antipyretic analgesics.
Mastitis is the inflammation has occurred sign
of tumor, dolor, calor, rubor, functiolaeca.
Already, there are germs. There is already a
relationship between the optic disc with germs
into the baby's intake ducts passing through
the duct. Germs come from the baby's mouth,
hands. Mandatory given antibiotics, anti-pain
and antipyretics.

Thank You