Effect of two different nursing care approaches on reduction of breast engorgement among postnatal women

Abstract

Introduction: Breast engorgement is a painful condition that affects a huge number of postnatal women. It is associated with unsuccessful breastfeeding, mastitis, and breast inflammation. So, there is a need to increase awareness regarding the efficiency of different nursing interventions as: warm compresses and cold cabbage leaves to treat breast engorgement. The aim of the study was to reduce the level of breast engorgement among the postnatal mothers and to compare the effect of warm compresses versus cold cabbage leaves on breast engorgement. Methods: A Quasi-experimental (equivalent pre-posttest group) research design was adopted. Setting: This study was conducted at postnatal ward and outpatient clinic at El-Manial Maternity hospital, Cairo Governate, Egypt. Subjects: A total of 90 postnatal mothers.They were randomly assigned into two groups (45 for each). Tools: Four tools were used to collect data; Maternal structured interviewing questionnaire, Six-points engorgement scale, Visual Analog Scale, and LATCH breastfeeding scale. Results: The mean age of the mothers was 26.6 ± 4.3 years old. More than twenty percent of each group suffered from firm and tender breasts (22.2% & 28.9%). Also, there was a statistically significant difference between the pre and post symptoms of breast engorgement, levels of breast engorgement, pain score, and engorgement score for both groups (p < .05*). Hence, both the interventions were effective in relieving pain and reducing breast engorgement. Conclusion: An application of cold cabbage leaves and warm compresses are effective for relieving breast engorgement. In addition, there was a statistically significant difference between the pretest and posttest of pain score and engorgement score for both groups (p < .001*). Recommendation: Nurses should be trained to include cold cabbage and warm compresses nursing approaches for managing breast engorgement in their discharge teaching plan. Also, prevention and early detection of breast engorgement should be done for all postnatal women.

Fenugreek seed poultice versus cold cabbage leaves compresses for relieving breast engorgement: An interventional comparative study

“…[6] It is characterized by intense swelling of the breasts combined with a sudden increase in the amount of milk, vascular congestion and oedema during the 1st two post-partum weeks. [6,29] If breast engorgement is not treated properly, it can lead to complications such as feeding problems or slow weight gain if the baby is unable to latch on the engorged breast, [28] sore and cracked nipple due to the baby fumbling on/off as he tries to grasp hold of a too firm breast, [30] deep breast pain, [18] Thrush; a fungal infection can be formed on the nipple or within the breast as they live on milk, [31] Plugged ducts, [32] Damage of the milk-producing cells which may, in turn, cause an overall decrease in milk supply, [33] Mastitis, and breast abscess. [34] Because nurses represent the largest group of health-careproviders and are responsible for the quality of care (QOC) given to patients, their perspective on the efficacy of their treatment is very significant.…”

“…They registered the highest percentage of mothers in the grouped age between the ages of 24 and 27. [6] Despite the advantages of breastfeeding, it is not widely practiced due to the pain and discomfort of cesarean section wounds, [46] breast engorgement, and breast pain. [47] A mother who undergoes CS may neglect breastfeeding and breast-care due to the pain after the surgery, which requires special medical attention.…”

“…Breast engorgement can cause pain and insufficient emptying of milk during lactation. [1,3,6] Breast engorgement, in turn, can cause numerous consequences as swelled and painful breasts combined with a sudden increase in the amount of milk, vascular and lymphatic congestion/obstruction contributing to interstitial edema. Previous studies have indicated reported that; poor management of breast-engorgement may lead to failure of milk production in the early postpartum period; leading to early cessation of breastfeeding (Breast-engorgement is a painful issue that may lead to premature weaning).…”

“…They should also direct, illustrate techniques, and demonstrate maneuvers to express milk to mothers; so that they can practice while feeding their babies and avoid breast engorgement from occurring. [6] The main aim of management of breast-engorgement is to attain, sustain, and maintain of breast-milk flow, successfully, and empty the breast-milk, effectively, through the baby and/or expression to avoid engorgement. The current approach involves a combination of pharmacological (pain medications) and non-pharmacological measures.…”

“…[1,3,5] Cabbage has antioxidant, anti-irritant and anti-inflammatory properties; this is why lactation consultants also prescribe green cabbage leaf compresses to reduce swelling in moderate to severe engorgement. [6] 1.1 Significant of the study Breast engorgement is considered among the most significant problems encountered in the first weeks of motherhood. Moderate to severe engorgement is of more concern.…”