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Pathological postpartum breast engorgement: prediction, prevention, and resolution
Nikolay P Alekseev1, Ilyin I Vladimir, Talalaeva E Nadezhda
11 Department of General Physiology, Saint Petersburg State University , St. Petersburg, Russian Federation .
Summary
Intense breast engorgement during the luteal phase may predict postpartum engorgement. Early expression of colostrum with a breast pump can prevent and resolve engorgement in breastfeeding mothers.
Area of Science:
- Obstetrics and Gynecology
- Lactation and Breastfeeding Research
- Maternal-Infant Health
Background:
- Severe postpartum breast engorgement causes significant maternal discomfort and feeding difficulties for infants.
- Understanding predictive factors and preventative measures for breast engorgement is crucial for successful breastfeeding.
- This study investigates links between menstrual cycle engorgement and postpartum engorgement, and early colostrum expression as a preventative strategy.
Purpose of the Study:
- To explore the predictive value of intense breast engorgement during the luteal phase for pathological postpartum breast engorgement.
- To assess the efficacy of preemptive colostrum expression using a breast pump in preventing and resolving postpartum breast engorgement.
- To evaluate the impact of early colostrum removal on engorgement severity in lactating women.
Main Methods:
- A comparative study involving two groups of postpartum women: 70 with pathological engorgement and 52 in a control/intervention group.
- The intervention group included women who had colostrum expressed by breast pump 1-2 times daily for 20-25 minutes per breast in the first 2-3 days postpartum, in addition to infant feeding.
- Breast engorgement severity was assessed using the Robson four-level scale.
Main Results:
- Ninety percent of women (63/70) with severe postpartum engorgement exhibited intense engorgement during the late luteal phase of their menstrual cycle.
- Preemptive expression of colostrum using a breast pump effectively eliminated excessive breast engorgement in the intervention group.
- Women with colostrum removed solely by the baby experienced engorgement, while those with early pump expression did not.
Conclusions:
- Intense breast engorgement in the late luteal phase is a significant indicator for predicting severe postpartum breast engorgement.
- Early extraction of colostrum before the onset of transitional milk significantly reduces the risk of excessive engorgement in breastfeeding mothers.
- Proactive colostrum management can improve breastfeeding experiences and maternal comfort.
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