IDENTIFICATION DATA

NAME : Miss Amee patel

CLASS : M.Sc. 2nd year

SUBJECT : Obstetrics & Gynecology

TOPIC : Care of Breast & Engorged Breast

GROUP : B.Sc 3rd year students

SIZE OF GROUP : 40

VENUE : Laboratory

DURATION OF TEACHING : 45 minutes

AUDIO VISUAL AIDS : articles

DATE AND TIME : 14/12/2019

PREVIOUS KNOWLEDGE : The group has some basic knowledge regarding the
topic.

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INTRODUCTION –

Daily washing is all that is necessary for breast hygiene. The normal skin flora are beneficial
to the baby. Brassieres may be worn in order to provide comfortable support and are useful if
the breast leaks and the breast pads are used.

DEFINATION

“The breasts are compound secreting glands composed mainly of glandular tissue, which is
arranged in lobes approximately 20 in number.”

DEFINATION OF BREAST CARE

“Breast care is the activity to prepare and clean the breasts during pregnancy and lactation for
breast feeding.”

PURPOSE OF BREAST CARE

 To prepare the women for breast feeding.

 To correct the minor defects of the breast.

GENERAL INSTRUCTIONS IN BREAST CARE

1. Pay special attention to the nipples.

2. Use circular movements while applying soap.
3. Never use strong soap/antiseptic.
4. Never put the baby on breasts if the nipples are cracked.
5. Inspect breasts and nipples daily for engorgement, retracted / cracked / depressed
nipples, mastitis and other complications.
6. Never take out nipple from baby’s mouth abruptly.
7. Mother should have short nails and should wash hands before feeding.

ARTICLES USED IN BREAST CARE

A tray containing,

a. Bowl of cotton swabs

b. Sponge cloth-2
c. Soap in soap dish
d. Ointment ,if prescribed
e. Kidney tray
f. Small mackintosh and towel
g. One basin
h. Jug of warm water

Screen

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STEPS OF PROCEDURE

1. Wash hands.
2. Assemble all the articles.
3. Explain the procedure to the patient.
4. Take the articles to the bed side.
5. Screen the mother.
6. Make the mother sit.
7. Expose the breast.
8. Place the mackintosh and the towel under the breast /over the lap.
9. Pour warm water in the basin.
10. Apply soap with the sponge cloth in a circular motion starting at the nipple and working
outwards.
11. Wash the breasts with sponge cloth.
12. Clean the nipples and remove all the crusts with the cotton swab to prevent blockage of
the duct.
13. Express the milk to ensure the patency of the nipple.
14. Check for cracks and inversion of nipples or engorgement of the breasts.
15. Dry the breast with towel.
16. Put the baby on the breast but before putting the baby to breast, any discharges from the
baby’s eyes or nose must be cleaned, and napkin must be changed.
17. Advise her to wear the support bra.
18. Make the mother and child comfortable.
19. Remove all the articles and the screen from the bedside of the patient and replace.
20. Wash hands and do the recordings.

DEFINATION OF ENGORGED BREAST

“Engorgement is the 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 the discomfort of the mother by relieving the pain and tenderness.
 To maintain lactation.
 To prevent further complication of the breast.

ARTICLES REQUIRED

1.A tray containing,

a) A medium sized bowl with warm water.

b) Four sponge cloth or other thick material.
c) Kidney tray or paper bag.
d) Towel to spread over the mackintosh
e) A few pads of cotton wool in a bowl.
f) Medicines,if prescribed.

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g) Mackintosh
h) A small hand towel for drying the mother after the procedure.
2. A screen for privacy.

GENERAL INSTRUCTIONS

 Breasts must be completely empty after the expression.

 An effort should be made to lactation.
 Water should not be very hot.
 Inspect for any breast complications.

Sucking by the baby and manual expression are avoided in severe Engorgement.

STEPS OF PROCEDURE

1. Bring the tray to bed side.

2. Explain the procedure to the mother.
3. Screen the mother.
4. Put the mother in a sitting or a side lying position.
5. Expose the mother’s breast.
6. Place the mackintosh and towel under the breast.
7. Soak the sponge cloths in warm water, wring the sponge cloth well , test there temperature
and apply on breast.
8. Soak the other two sponge clothes in warm water.
9. Change the sponge cloth when cold.
10. Continue fomentation of the breasts for 10-15 minutes.
11. Put the baby to breast.
12. Express the rest of the milk from the breast manually into the kidney tray.
13. Clean the breast and wipe it dry and apply the ,medicine if any.
14. Ask the mother to wear a well- fitting bra. She can use cotton pads in the bra for absorbing
milk secretion from the breast.
15. Wash the articles and replace.

Record the condition of the breast , nipples and if any medicine (if used).

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 SUMMARY

The care of breast is of utmost importance to women in both antenatal and postnatal
period. It should be taken care of with caution without any risk of causing injuries to the organ.

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 CONCLUSION

This demonstration includes the definition of breast, breast care, Engorged breast,
articles required, general instructions and steps of procedure.

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 BIBLIOGRAPHY:

1. Annamma Jocob. A Comprehensive Textbook of Midwifery and Gynecological

Nursing: Breast disorder. Fourth Edition. New Delhi: Jaypee Brother Medical Publisher
(P) Ltd; 2015.
2. D.C. Dutta’s. Text Book of Obstetrics: Breast disorder. Seventh Edition. New Delhi:
New Central Book Agency (P) Ltd; 2010.
3. Dr. Shally Magon. Sanju Sira. Textbook Of Midwifery And Obstetrical Nursing:
Nursing Management. Third Edition. New Delhi: Lotus Publisher; 2013.
4. Myles. Text Book for Midwives: Diagnostic evaluation. Fifth Edition. UK: Churchill
Livingstone Elsevier; 1964.
5. Nima Baskar. Midwifery and Obstetrical Nursing: Breast Disorder. Seventh Edition.
Bangalore: EMMESS Medical Publisher; 2015.