The sudden fall in oestrogen level after delivery is associated with reduction in the secrection of prolactin inhibiting factor from the hypothalamus and relese of prolactin from the anterior pituitary.
Prolactin is responsible for milk formation.
Oxytocin released from the posterior pituitary due to suckling is responsible for milk ejection.
1.Breast Engorgement:
Usually occurs in the 3rd day after delivery when secretion of milk begins.
Symptoms:
-breasts are overdistanded with visible dilated veins
-breasts are painful and tender
Is necessary breast evacuation.In early stage baby suckling can be sufficient but later on congestion press on the ducts preventing flow of milk so an electric or manual breats pump is needed.
2.Deficient Lactation:
Causes:
-constitutional
-bad general condition and malnutrition
-infrequent or irregular suckling.
Is necessary a regular breast feeding,to have a good diet and consume plenty of fluids.
3.Cracked Nipples:
Causes:
-lack of cleanness and dryness of the nipple
-vigorous suckling of an hungry baby in deficient lactating breast
-leaving the baby to long at the breast
-repeated taking and leaving the nipple by the baby to breath if its nose is obstructed by the breast
-monilial infection.
In this case take a rest,the baby should not put on the affected breast till healing occurs while it is emptied manually.Gradual going back to the breats is recommended to prevent recurrence.
4.Acute Mastitis:
Causative organism is staphylococcus aureus which may reach the breast from infected baby.
Symptoms:
-breast is tender,painful,red,tense and hot
-axillary limph nodes are enlarged
-high fever may reach.
Proper treatment is indicated otherwise breast abscess will develop.
Stop lactation from affected breast and breats is emptie manually or by an electric pump.When the acute phase is over breast feeding can be resumed.
Support the breats over a pad of cotton wall.
5.Breast Abcess:
A segment of the breast becomes painful and tender and fluctuationcan be detected.
Fever and enlarged xillary limph nodes.
As soon as an abcess is formed it should be incised and drained under general anaesthesia.
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