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Objetivo:analizar la evidencia de estudios previos sobre las diferentes alternativas de tratamientos con el uso de agentes físicos y técnicas manuales utilizados en la fisioterapia para la ingurgitación mamaria a nivel internacional. Material y método:estudio de revisión sistemática con meta-análisis según el pro-tocolo prisma. Búsqueda en las bases de datos de Scopus y Medline a través de PubMed, publicados desde el 01 de enero de 2015 hasta el 31 de diciembre de 2021. La estrategia de búsqueda empleó los siguien-tes términos: breastengorgement, treatment, breastfeeding, six-pointengorgementscale, physiotherapy, breastcancer, physicaltherapy. Los 5 estudios elegidos para esta revisión sistemática fueron valorados con la Escala pedro para conocer la calidad metodológica. Resultados:diferencias medias estandarizadas oscilaron entre 0,5959 y 2,7373, la mayoría de las estimaciones positivas. El resultado promedio difirió significativamente de cero (z = 3,5686, p = 0,0004). Según prueba Q, los resultados reales parecen ser heterogéneos (Q (5) = 23,2212, p = 0,0003, tau² = 0,4759, I² = 83,6163%). Intervalo de predicción del 95 % para los resultados reales viene dado por -0,3733 a 2,5931. Un intervalo de predicción del 95 % para los resultados reales viene dado por -3,6762 a 11,5933. Conclusiones: las técnicas estudiadas disminuyen el dolor y la congestión mamaria, sin embargo, se ha visto que la combinación entre ellas puede favorecer aún más la mejora de los mismos. Al aplicarse en las mujeres con ingurgitación generaron beneficios a corto y largo plazo para disminuir el dolor y la ingurgitación mamaria
Objective: To analyze the evidence of previous studies on the different treatment alternatives with the use of physical agents and manual techniques used in physiotherapy for breast engorgement at an international level. Method: Systematic review study with meta-analysis according to the prisma pro-tocol. Search in Scopus and Medline databases through PubMed, published from January 1, 2015 to December 31, 2021. The search strategy employed the following terms: breast engorgement, treatment, breastfeeding, six-point engorgement scale, physiotherapy, breast cancer, Physical therapy. The 5 stu-dies chosen for this systematic review were assessed with the PEDro Scale for methodological quality. Results: Standardized mean differences ranged from 0.5959 to 2.7373, most of the positive estimates. The average result differed significantly from zero (z = 3.5686; p = 0.0004). According to Q test, the actual results appear to be heterogeneous (Q(5) = 23.2212; p = 0.0003; tau² = 0.4759; I² = 83.6163%). The 95% prediction interval for the actual results is given by −0.3733 to 2.5931. A 95% prediction interval for the actual results is given by −3.6762 to 11.5933. Conclusions: The techniques studied decrease breast pain and engorgement; however, it has been seen that the combination between them can further favor their improvement. When applied in women with engorgement, they generated short and long term benefits in reducing pain and breast engorgement
Objetivo: analisar as evidências de estudos anteriores sobre as diferentes alternativas de tratamento com uso de agentes físicos e técnicas manuais utilizadas na fisioterapia para ingurgitamento mamá-rio internacionalmente. Material e método: estudo de revisão sistemática com meta-análise segundo protocolo prisma. Pesquisa nas bases de dados Scopus e Medline por meio do PubMed, publicadas de 1º de janeiro de 2015 a 31 de dezembro de 2021. A estratégia de busca utilizou os seguintes termos: breastingorgement, treatment, breastfeeding, six-pointengorgementscale, physiotherapy, breastcancer, physi-caltherapy. Os 5 estudos escolhidos para esta revisão sistemática foram avaliados com a Escala pedro para determinar a qualidade metodológica. Resultados: as diferenças médias padronizadas variaram de 0,5959 a 2,7373, com a maioria das estimativas positivas. O resultado médio diferiu significativamente de zero (z = 3,5686, p = 0,0004). Segundo o teste Q, os resultados reais parecem ser heterogêneos (Q (5) = 23,2212, p = 0,0003, tau² = 0,4759, I² = 83,6163%). O intervalo de previsão de 95% para resultados reais é dado por -0,3733 a 2,5931. Um intervalo de previsão de 95% para os resultados reais é dado por -3,6762 a 11,5933. Conclusões: as técnicas estudadas reduzem a dor e a congestão mamária, porém, constatou-se que a combinação entre elas pode melhorar ainda mais a sua melhora. Quando aplicados em mulheres 2024com ingurgitamento, geraram benefícios de curto e longo prazo para reduzir a dor e o ingurgitamento mamário.
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Humanos , Transtornos da Lactação , MastiteRESUMO
BACKGROUND: Breast engorgement is a common issue that affects breastfeeding initiation and continuation. Engorgement can cause exhaustion, making it difficult to care for and feed the infant, and it can cause a mother to wean her baby before she intends to initiate breastfeeding. This study aimed to determine the effectiveness of the alternating application of cold and hot compresses in reducing breast engorgement among lactating mothers. Design, sample size and setting: A quasi-experimental study design is used to conduct this study. A purposeful sample of 100 lactating mothers was screened in the postnatal ward for the presence of breast engorgement. The 100 mothers with engorgement were divided into two equal groups of 50 mothers each - the first group (the intervention) and the second group (the control) - at the postnatal ward of King Abdulaziz Hospital-National Guard in Alahsa City. Sampling and tools: The data collection was conducted over five months, from January 2023 until May 2023. Data collection was done through a structured interview questionnaire sheet. The questionnaire was divided into six parts: socio-demographic data, obstetric and initial women assessment, the six-point engorgement scale (SPES), the visual analog scale (VAS), the LATCH breastfeeding charting scale, and the Infant Breastfeeding Assessment Tool (IBFAT). RESULT: The present study found no statistically significant difference between the study intervention and control groups in breast engorgement, LATCH level, or overall level of breastfeeding assessment before the intervention. While, in terms of breast engorgement, pain level, attachment, and LATCH, the overall levels of infant breastfeeding assessment across study time had a statistically significant variance among the study and control groups after the intervention at p values=<0.001. CONCLUSION AND RECOMMENDATIONS: The alternating application of cold and hot compresses can have a significant role in reducing breast engorgement among lactating mothers. Women should be encouraged to use hot compresses and cold gel packs as an alternative treatment to reduce engorgement and promote comfort. In addition, the study results can be utilized to aid Saudi Arabian nurses and midwives in understanding the advantages of applying a cold gel pack and a hot compress and to decrease levels of engorgement, improve latch, and relieve discomfort.
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Introduction: Breast engorgement (BE) is a problem that affects many women, especially in the first days of breastfeeding, producing inflammatory symptoms. Nonpharmacological therapies are inexpensive, safe, and can produce symptom relief. Objective: This study aims to analyze the safety of therapeutic ultrasound regarding possible risks of overheating and the effects of its use alone and associated with lymphatic drainage (LD) in women. Material and Methods: Effectiveness is measured through thermography, visual analog scale, and six-point scale of BE. This is a nonrandomized clinical trial with a sample of 34 in the ultrasound group (G1), 28 in the ultrasound and LD group (G2), and 37 in the control group (G3). Results: The mean reduction for engorgement was 1.3 ± 0.8 to G1, 1.4 ± 1.0 to G2, and 1.2 ± 0.9 to G3 according to the six-point scale. The mean reduction for pain level was 3.6 ± 2.1 to G1, 4.0 ± 3.1 to G2, and 4.0 ± 2.2 to G3 according to the visual analogue scale. Conclusion: It was observed that all therapies were effective in reducing the level of engorgement, according to the six-point scale. However, combined ultrasound and LD therapy has been shown to be more effective in reducing the level of pain. Brazilian Registry of Clinical Trials (RBR-6btb6zz).
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Transtornos da Lactação , Terapia por Ultrassom , Feminino , Humanos , Aleitamento Materno , Transtornos da Lactação/terapia , Dor , DrenagemRESUMO
Many women experience breast engorgement in the first few weeks after giving birth. Breast engorgement that is somewhat severe. It is characterized by full, tense, heated, and tender breasts that are painfully throbbing and aching. Therefore, it is of interest to evaluate the effect of Gua-Sha therapy on breast engorgement in reducing pain among postnatal mothers. A "non-randomized pre-test post-test control group design" was used for this study. "Purposive sampling techniques" were used to obtain 60 postnatal mothers who satisfied the inclusion criteria. Six point engorgement scale and visual analog scale were used for data collection. After pre-test Gua-Sha therapy was given 30 minutes in one cycle twice a day depending on upon the severity. Reassessment was done immediately after the procedure. The result shows that the post test score of breast engorgement in experimental group was 1.1 (± 0.305), where in control group 4.16 (±2.152). The 't' test value of breast engorgement was 9.869. The result shows that Gua-Sha therapy for breast engorgement in reducing pain was significant effect (p <0.05). The study concluded that the Gua-Sha therapy is an effective for reducing breast engorgement and pain among post natal mothers.
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BACKGROUND: Some mothers may seek lactation inhibition on personal, social, or medical grounds. The common drug used for lactation inhibition is cabergoline. Several adverse effects and contraindications are known for this drug. Its use is contraindicated for patients with hypertensive disorders and fibrotic, cardiac, or hepatic diseases. In addition, pyridoxine (vitamin B6) has been used for this indication, with no significant adverse effect, following studies that demonstrated its efficacy. OBJECTIVE: This study aimed to compare the efficiency of cabergoline vs pyridoxine for lactation inhibition. STUDY DESIGN: A randomized controlled trial was conducted. Postpartum patients who requested lactation inhibition were randomly allocated to receive either cabergoline (1 mg once on postpartum day 1 or divided to 0.25 mg twice a day for 2 days thereafter, according to the departmental protocol, which is in line with the manufacturer recommendations) or pyridoxine (200 mg 3 times a day for 7 days). The patients enrolled were free of diseases in which contraindications to cabergoline are present. All patients completed a questionnaire for assessing breast engorgement, breast pain, and milk leakage on a scale of 0 (no symptom) to 5 (severe symptom) on days 0, 2, 7, and 14. The primary outcome was lactation inhibition success, defined as a score of 0 for both engorgement and pain on day 7. The secondary outcomes included the assessment of milk leakage, adverse effects, fever, mastitis, and treatment discontinuation or alteration. RESULTS: Of note, 45 and 43 patients received cabergoline or pyridoxine, respectively, and were included in the analysis following the intention-to-treat principle. Cabergoline was superior to pyridoxine in inhibiting lactation at day 7 (78% vs 35%, respectively; P<.0001). Mild symptoms, defined as a score of 0 to 2 for breast engorgement and pain, at day 7 were 40 (89%) in the cabergoline group and 29 (67%) in the pyridoxine group (P=.01). The incidence of milk leakage was lower in the cabergoline group after 7 and 14 days than in the pyridoxine group (9% vs 42% [P=.0003] and 11% vs 31% [P=.02], respectively). Cabergoline had more adverse effects than pyridoxine (31% vs 9%, respectively; P=.01), but all adverse effects were mild. The rates of mastitis and fever that were related to engorgement were similar in the cabergoline and pyridoxine groups (4 [9%] vs 2 [5%], respectively; P=.67). Furthermore, 9 patients (21%) in the pyridoxine group switched to or added cabergoline because of treatment failure. Accordingly, on day 7, the pyridoxine success rate was reduced from 35% (15 women) to 28% (12 women) and from 67% (29 women) to 53% (23 women) for a score of 0 and 0 to 2 for both engorgement and pain, respectively. CONCLUSION: Cabergoline was superior to pyridoxine in inhibiting lactation. Cabergoline had more adverse effects, but no major adverse effect was documented in either treatment group. As pyridoxine inhibited lactation successfully in previous studies and in 67% of patients in this study, its use should be considered in women with contraindications for cabergoline.
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Pyoderma gangrenosum (PG) is an inflammatory disease characterized by recurrent painful ulcers, eventually leading to cribriform scars. PG is mostly a diagnosis of exclusion with neutrophilic skin infiltration. We present a case of a 35-year-old female patient whose first presentation of PG occurred in the first trimester of pregnancy, which recurred after discontinuation of breastfeeding. The patient also had a history of taking prolonged IM and IV analgesics for her chronic migraines. The patient was initially treated with steroids and necessary wound care, during which symptoms remained controlled. However, a year later, the patient presented with an acute flare-up of the disease in her postpartum period, mainly involving her breasts bilaterally. Extensive wound debridement was performed due to the severity of her necrotic ulcers and failure to respond to conservative management, which was followed by partial thickness skin grafting.
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Context: Breastfeeding is the best way of providing nutrients to young infants for their healthy growth and development. World Health Organization (WHO) and UNICEF recommend that breastfeeding should be initiated as early as possible after delivery and exclusive breastfeeding should be continued till 6 months of age. The proper positioning of the baby and mother makes breastfeeding effective. Aim: The study aimed to determine the effect of lactation counseling on breastfeeding practices, breast engorgement, and newborn feeding behavior among postnatal mothers. Methods: A quasi-experiment posttest-only control group research design was used and the setting of the study was antenatal OPD and postnatal ward at a teaching institution. A sample of 60 primigravidae in the age group of 18-35 years with gestational age ≥ 36 weeks seeking antenatal care at antenatal OPD were selected by consecutive sampling technique. The experimental group received two lactation counseling sessions of 30 min each 1 week apart (in person/video call), whereas control group received routine care. Breastfeeding practices, breast engorgement, and newborn feeding behavior were assessed on the 3rd postnatal day using breastfeeding practices checklist, breast engorgement scale, and newborn feeding behavior assessment tool, respectively. Descriptive and inferential statistics were used to analyze the data. Result: There was significant improvement in breastfeeding practices (t = 7.18, P = 0.00), breast engorgement (t = 2.41, P = 0.01), and newborn feeding behavior (t = 5.24, P = 0.00) in the experimental group, which proves that the prenatal lactation counseling was effective in improving breastfeeding practices, newborn feeding behavior, and reducing breast engorgement. Conclusion: The study concluded that prenatal lactation counseling was effective in improving breastfeeding practices, breast engorgement, and newborn breastfeeding behavior among primigravidae. These findings suggest that if proper lactation counseling is provided to the mothers even at the primary health centers and periphery level it can contribute to improving the breastfeeding practices, newborn feeding behavior and can prevent breast engorgement.
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Introduction: Family doctors manage mild to moderate postpartum morbidities that do not receive attention. The morbidities are higher after cesareans, which are increasing in number. The aim was to calculate the relative risk of various maternal morbidities occurring during 6 months postpartum among cesarean-delivered women in Pune District, India. Material and Methods: This was a large multisite study, which included all 11 non-teaching government hospitals performing at least five cesarean sections per month, one teaching government hospital, and one private teaching hospital. All eligible cesarean delivered and an equal number of age and parity matched vaginally delivered women were the participants. The obstetricians interrogated women before discharge, after 4 weeks, 6 weeks, and 6 months. Results: In this study 3,112 women participated. At any visit and among any group lost to follow-up proportion was <10%. There was no major intra-operative complication among vaginally delivered women. The relative risks of acute and severe morbidity as intensive care unit admission and blood transfusion among cesarean-delivered women were 2.59 [95% confidence interval (CI) = 1.96 to 3.44], 4.33 (95% CI = 2.17 to 8.92), respectively. The adjusted relative risk of surgical site pain and infection at 4 weeks; surgical site pain at 6 weeks; and lower abdominal pain, breast engorgement/mastitis, urinary incontinence, and weakness at 6 months among cesarean-delivered women was higher (P < 0.05). Vaginally delivered women resumed family activities earlier. Conclusion: Health care workers, including family doctors, during follow-up of cesarean-delivered women, must assess for pain, induration/discharge at the surgical site, urinary incontinence, and breast engorgement/mastitis.
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BACKGROUND: Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. RESEARCH AIMS: (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. METHODS: Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. RESULTS: Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p < .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p < .001), and 5-7 days (OR: 0.24, 95% CI [0.08, 0.74], p = .013) and breast pain (standardized mean difference: -1.33, 95% CI [-2.26, -0.40]) at postpartum 4-14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p = .001) and improved exclusive breastfeeding at postpartum 1-6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p = .001). CONCLUSIONS: Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.
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Aleitamento Materno , Transtornos da Lactação , Feminino , Humanos , Mães/educação , Período Pós-PartoRESUMO
INTRODUCTION: There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation. MAIN ISSUE: The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor. MANAGEMENT: The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status. CONCLUSIONS: The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother-infant pair are essential for preserving lactation.
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Aleitamento Materno , Transtornos da Lactação , Retroalimentação , Feminino , Humanos , Lactente , Lactação , Transtornos da Lactação/terapia , Período Pós-PartoRESUMO
Breast engorgement is an uncomfortable and sometimes painful component of the postpartum period. The effective treatment of breast engorgement may provide an avenue for clinicians to improve postpartum care for women and promote breastfeeding. This case report presents one woman's experience with breast engorgement in the early postpartum period. The etiology, evidence-based practices for treatment, clinical implications, and recommendations for practice are reviewed. The importance of interprofessional care to minimize conflicting information a lactating woman receives is highlighted. Interprofessional teamwork can optimize care to resolve breast engorgement and facilitate a woman achieving her breastfeeding goals.
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Aleitamento Materno/métodos , Transtornos da Lactação/terapia , Período Pós-Parto/psicologia , Adulto , Aleitamento Materno/psicologia , Feminino , Humanos , Transtornos da Lactação/psicologia , Resultado do TratamentoRESUMO
INTRODUÇÃO: A amamentação constitui uma importante etapa no processo reprodutivo, oferecendo benefícios tanto para mãe como para a criança. O Ingurgitamento mamário é uma complicação que ocorre do terceiro ao quinto dia de pós-parto. O Ultrassom Terapêutico (UST) é amplamente utilizado, e consiste em um aparelho capaz de produzir energia acústica de alta frequência. OBJETIVO: verificar o efeito agudo do ultrassom no processo terapêutico do ingurgitamento mamário. METODOLOGIA: Estudo transversal, que avaliou a mama e classificou o ingurgitamento, além de realizar avaliação da dor e da percepção subjetiva das mamas. Foi administrado o protocolo com ultrassom terapêutico na frequência de 1Mh, modo pulsado, intensidade/ dose de 0,5w/cm2, ciclo ativo de 20% com tempo de aplicação de 02 minutos por área de radiação efetiva (ERA). Após aplicação, a lactente foi submetida à amamentação e realizada nova avaliação das mamas. RESULTADOS: A amostra foi composta por 4 mulheres entre 20 e 30 anos com quadro de ingurgitamento mamário. O valor inicial do ingurgitamento mamário foi de 2 a mediana e a final foi de 1 a mediana. Em relação à dor mamária, inicialmente foi de 5 mediana e a final 2 a mediana. Em todos os casos analisados houve melhora na dor, na disponibilidade do leite e no aspecto de ingurgitamento da mama. CONCLUSÃO: O ultrassom terapêutico se mostrou eficaz na redução da dor, no aumento da disponibilidade do leite e na melhora do enrijecimento característico do ingurgitamento mamário.
INTRODUCTION: Breastfeeding is an important step in the reproductive process, providing benefits for both mother and child. Breast engorgement is a complication that occurs from the third to the fifth postpartum day. Therapeutic Ultrasound (UST) is widely used, and consists of an apparatus capable of producing high frequency acoustic energy. OBJECTIVE: to verify the acute effect of ultrasound in the therapeutic process of breast engorgement. METHODOLOGY: Cross-sectional study, which evaluated the breast and classified the engorgement, besides evaluating the pain and the subjective perception of the breasts. The protocol with therapeutic ultrasound was administered at a frequency of 1Mh, pulsed mode, intensity / dose of 0.5w / cm2, active cycle of 20% with application time of 02 minutes per effective Radiation Area (ERA). After application, the infant was submitted to breastfeeding and a new breast evaluation was performed. RESULTS: The sample consisted of 4 women between 20 and 30 years of age with breast engorgement. The initial value of breast engorgement was 2 the median and the final value was 1 to median. Regarding breast pain, it was initially 5 median and the final 2 median. In all the analyzed cases there was improvement in pain, milk availability and breast engorgement aspect. CONCLUSION: Therapeutic ultrasound has been shown to be effective in reducing pain, increasing milk availability and improving the stiffness characteristic of breast engorgement.
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Terapia por Ultrassom , Mama , Aleitamento MaternoRESUMO
Objective@#Systematic review and analyze the domestic and foreign research literatures on interventional measures for pathological breast engorgement, and explore the differences between intervention measures for pathological breast engorgement at home and abroad, and provide reference and new ideas for further optimization of breast intervention measures in China.@*Methods@#Scientifically search the domestic and foreign research literatures on pathological breast engorgement intervention measures, import the search data into Citespace and VOS viewer to achieve co-occurrence analysis, and then systematically analyze the literature at the core node in the co-occurrence map.@*Results@#A total of 384 articles (267 foreign ones; 117 articles in China) were included in this study. The main themes of foreign research hotspots are: female, adult, first child, lymphedema, inflammation, breast basic diseases, breast tumors and time-influencing factors are mainly concerned with the exploration of high-risk influencing factors and early intervention of breast-related tumor diseases. Domestic research hotspots mainly focus on nursing interventions as the main intervention measures and effects evaluation. The content analysis in the core literature shows that foreign studies are mainly based on cohort studies, including the topical application of progesterone, psychological intervention, and breastfeeding time factors. Domestic research is mainly based on experimental research, mainly using massage techniques. Improvement, comparison of different external dressings as the main intervention.@*Conclusions@#At present, both domestic and foreign research have carried out active exploration and comparative research on the external materials and achieved certain results. The current study of postpartum breast engorgement in China needs to be further explored based on large samples and cohort studies.
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Objective Systematic review and analyze the domestic and foreign research literatures on interventional measures for pathological breast engorgement, and explore the differences between intervention measures for pathological breast engorgement at home and abroad, and provide reference and new ideas for further optimization of breast intervention measures in China. Methods Scientifically search the domestic and foreign research literatures on pathological breast engorgement intervention measures, import the search data into Citespace and VOS viewer to achieve co-occurrence analysis, and then systematically analyze the literature at the core node in the co-occurrence map. Results A total of 384 articles (267 foreign ones; 117 articles in China) were included in this study. The main themes of foreign research hotspots are: female, adult, first child, lymphedema, inflammation, breast basic diseases, breast tumors and time-influencing factors are mainly concerned with the exploration of high-risk influencing factors and early intervention of breast-related tumor diseases. Domestic research hotspots mainly focus on nursing interventions as the main intervention measures and effects evaluation. The content analysis in the core literature shows that foreign studies are mainly based on cohort studies, including the topical application of progesterone, psychological intervention, and breastfeeding time factors. Domestic research is mainly based on experimental research, mainly using massage techniques. Improvement, comparison of different external dressings as the main intervention. Conclusions At present, both domestic and foreign research have carried out active exploration and comparative research on the external materials and achieved certain results. The current study of postpartum breast engorgement in China needs to be further explored based on large samples and cohort studies.
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BACKGROUND: Maternal breast engorgement is one of the most common problems in the postpartum period. There are several alternative treatments, but there have not been any randomized controlled trial studies about the effects of herbal compresses for breast engorgement. OBJECTIVE: The objective is to investigate the effects of herbal compresses for maternal breast engorgement. MATERIALS AND METHODS: A randomized controlled trial was conducted. The postpartum mothers who had breast engorgement were randomly assigned to herbal or hot compress treatments. The breast engorgement pain scores were assessed by visual analog scales pre- and post-treatment. The pain reduction scales of the herbal compress treatments were analyzed and compared with the hot compress treatments. The adverse effects of each treatment were recorded and collected after 24 hours from treatments. RESULTS: The data from 500 postpartum mothers with breast engorgement were available for analyses, 250 from the herbal compress group and 250 from the hot compress group. The baseline characteristics of both groups were similar except baseline breast engorgement pain score (herbal compress group higher than hot compress group). There were statistically significant mean differences of breast engorgement pain before and after treatment between the herbal and hot compress groups. No serious complications were found after treatment from herbal compresses. CONCLUSION: Among the postpartum mothers who had breast engorgement, the herbal compresses could decrease breast engorgement pain. The pain reduction after herbal compresses was found to be greater than with the hot compresses.
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Aleitamento Materno/efeitos adversos , Mama/fisiopatologia , Transtornos da Lactação/terapia , Preparações de Plantas/uso terapêutico , Adulto , Feminino , Humanos , Transtornos da Lactação/fisiopatologia , Dor/etiologia , Medição da Dor , Folhas de Planta , Período Pós-Parto , Tailândia , Adulto JovemRESUMO
Objective To choose a reasonable non-drug treatment program for women with postpartum breast pain. Methods Based on an adequate assessment of the patients′ condition, the clinical questions were proposed and the references were searched in a series of databases, such as Cochrane Library, PubMed, Ovid, CINAHL, CNKI, Wanfang, Weipu, CBM. Results A preliminary search of 484 articles on cabbage therapy for postpartum breast pain was carried. Through rigorous preliminary screening and screening, 11 articles were finally included, including 2 systematic reviews, 2 randomized controlled trials and 7 quasi-experiment. Through the analysis of the inclusion literature, the data was extracted, and the evidence and summary evidence were strictly evaluated.According to the results of evidence, based on the patients′ condition and the wishes of the family, the cold and hot cabbage leaves were alternately applied to the breast of 10 postpartum women with breast engorgement, the breast distended pain were improved. Conclusions The method of evidence-based nursing can provide safe and effective treatment for postpartum women with breast engorgement.
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BACKGROUND: The effects of cold cabbage leaves and cold gel packs on breast engorgement management have been inconclusive. No studies have compared the effects of these methods on breast engorgement using a rigorous design. OBJECTIVES: To examine the effectiveness of cold cabbage leaves and cold gel packs application on pain, hardness, and temperature due to breast engorgement, the duration of breastfeeding and satisfaction. DESIGN: A randomised controlled three-group pre-test and repeated post-test study. SETTING: A private maternal and children's hospital in Singapore. PARTICIPANTS: Mothers (n=227) with breast engorgement within 14days after delivery. METHODS: The mothers were randomly assigned into either cold cabbage leaves, cold gel packs, or the control group. Pain, hardness of breasts, and body temperature were measured before treatment. Two sets of post-test assessments were conducted at 30min, 1h, and 2h after the first and second application. The duration of breastfeeding was measured up to 6 months. IBM SPSS 23.0 was used to analyse the data. RESULTS: Mothers in the cabbage leaves and gel packs groups had significant reductions in pain at all post-intervention time points compared to the control group, starting from 30min after the first application of cabbage leaves (mean difference=-0.38, p=0.016) or gel packs (mean difference=-0.39, p=0.013). When compared to the control group, mothers in the cabbage leaves group had significant reductions in the hardness of breasts at all post-intervention time points, and mothers in the gel packs group had significant reductions in the hardness of breasts at two time points (1h and 2h after the first and second application, respectively). Mothers in the cabbage leaves group had significant reductions in pain (mean difference=-0.53, p=0.005) and hardness of breasts (mean difference=-0.35, p=0.003) at 2h after the second application compared to those in the gel packs group. Both interventions had no impact on body temperature. There was no significant difference in the durations of breastfeeding for mothers among the three groups at 3-month and 6-month follow-up. More mothers were very satisfied/satisfied with the breast engorgement care provided in the cabbage leaves group compared to the other groups. CONCLUSION: While cold cabbage leaves and cold gel packs can relieve pain and hardness in breast engorgement, the former had better effect, which can be recommended to postnatal mothers to manage breast engorgement.
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Brassica , Aleitamento Materno/efeitos adversos , Géis , Transtornos da Lactação/terapia , Manejo da Dor/métodos , Folhas de Planta , Adulto , Temperatura Corporal , Temperatura Baixa , Feminino , HumanosRESUMO
Breast engorgement affects lactation. The present study was conducted to determine the effect of hollyhock combined with warm and cold compresses on improving breast engorgement in lactating women. Participants included 40 women with breast engorgement divided into intervention and control groups, with participants in both groups being applied routine interventions and warm compress before nursing and a cold compress after nursing; however, the intervention group was also applied hollyhock compress. Both groups received these treatments 6 times during 2 days. The data collected were analyzed in SPSS-16 using a generalized estimating equation. According to the results, a significant difference was observed in the overall breast engorgement severity in the intervention group (P < .001). The severity of breast engorgement was also found to have a significant relationship with time (P < .001). According to the findings, hollyhock leaf compress combined with performing routine interventions for breast engorgement can improve breast engorgement.
Assuntos
Althaea , Mama/fisiopatologia , Transtornos da Lactação/terapia , Preparações de Plantas/uso terapêutico , Adulto , Feminino , Humanos , Transtornos da Lactação/fisiopatologia , Folhas de Planta , Adulto JovemRESUMO
OBJECTIVE: To identify the best management approaches to mastitis management in breastfeeding women and heavy breast engorgement in the early postnatal period. METHODS: We compared various international guidelines and reviews on mastitis management in breastfeeding women and breast engorgement treatment. RESULTS: Effective milk removal is recommended as a first step in mastitis management. Active emptying of the breasts can prevent mastitis development in most cases. If it fails, antibiotics should be administered for 10-14 days with continuing breastfeeding. Russian guidelines recommend antibiotic therapy during 5-7 days with temporary bromocriptine-induced breastfeeding suppression. In case of heavy breast engorgement after lactation is initiated, Progesterone-containing gel can be administered. Application of the progesterone-containing gel on the breast skin improves swelling, and reduces engorgement and tenderness in 15-20 minutes. CONCLUSIONS: Antibiotics with temporary suppression of breastfeeding are more effective than with continuing breastfeeding in mastitis management. The progesterone-containing gel is recommended on the 3rd-4th days after childbirth in heavy breast engorgement to prevent mastitis.
Assuntos
Doenças Mamárias/terapia , Aleitamento Materno , Bromocriptina/uso terapêutico , Antagonistas de Hormônios/uso terapêutico , Mastite/terapia , Guias de Prática Clínica como Assunto , Infecções Estafilocócicas/terapia , Doença Aguda , Antibacterianos/uso terapêutico , Extração de Leite , Feminino , Humanos , Lactação/efeitos dos fármacos , Mastite/etiologia , Progesterona/administração & dosagem , Federação Russa , Staphylococcus aureus/isolamento & purificaçãoRESUMO
BACKGROUND: Many women in developed countries do not meet their breastfeeding goals and wean early because of breast pain. OBJECTIVE: This study aimed to describe clinical response to therapeutic breast massage in lactation (TBML) in the management of engorgement, plugged ducts, and mastitis. METHODS: Breastfeeding women presenting with engorgement, plugged ducts, or mastitis who received TBML as part of their treatment were enrolled (n = 42). Data collected at the initial visit included demographic, history, and exam data pre-TBML and post-TBML. Email surveys sent 2 days, 2 weeks, and 12 weeks following the initial visit assessed pain and breastfeeding complications. A nested case control of engorged mothers (n = 73) was separately enrolled to compare engorgement severity. RESULTS: Reasons for the visit included engorgement (36%), plugged ducts (67%), and mastitis (29%). Cases, compared to controls, were significantly more likely to have severe engorgement (47% vs 7%, P < .001). Initial mean breast pain level among those receiving TBML was 6.4 out of 10. Following TBML, there was significant improvement in both breast (6.4 vs 2.8, P < .001) and nipple pain (4.6 vs 2.8, P = .013). All women reported immediate improvement in their pain level. At the 12-week survey, 65% found the massage treatment very helpful. The majority of the women with a new episode of mastitis or plugged duct during the study follow-up found the techniques learned during the office visit very helpful for home management of these episodes. CONCLUSION: In office, TBML is helpful for the reduction of acute breast pain associated with milk stasis. Mothers find TBML helpful both immediately in-office and for home management of future episodes.
