Final answer:
To prevent engorgement in a bottle-feeding postpartum client, it is important to avoid nipple stimulation and wear a supportive bra, as engorgement results from continued lactation due to hormonal signals, mainly prolactin, leading to discomfort when milk is not expressed.
Step-by-step explanation:
The question pertains to a postpartum client who has decided to bottle-feed their newborn and is seeking advice to prevent the discomfort of breast engorgement. Engorgement occurs because lactation is a process that is naturally initiated in the postpartum period. The mother's body prepares for breastfeeding with the mammary glands producing milk in response to hormonal signals, particularly the hormone prolactin. This leads to breast engorgement and leakage if the milk is not expressed. To prevent discomfort when not breastfeeding, it is advisable to avoid nipple stimulation which can trigger milk production and to wear a supportive bra that does not apply excess pressure on the breasts. Therefore, the correct instruction to prevent discomfort would be: D. Wear a supportive bra and avoid nipple stimulation.
If breastfeeding is stopped suddenly, it takes about a week for any remaining milk to be reabsorbed; if the process is not gradual, engorgement may occur due to continued prolactin and oxytocin release encouraging milk production and ejection.