Question

Maria, Raul and her family have bottle fed Juan during the two days of the postpartum stay. Maria's grandmother brings her chicken and broccoli soup each day to bring "heat" to the "cold" state of postpartum and to promote milk flow for breastfeeding. A protective amulet has been placed around the newborn's ankle for protection. Both mother and newborn have progressed without complications. Prior to discharge Maria states, ""My breasts are getting hard and uncomfortable. I hope I will be able to breast feed him after I get home. Can you help me?"". SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD BE IMPLEMENTED:

a)Reassure Maria that engorgement is a common and temporary condition; lasts about 24 hours, caused by the milk coming in as well as increased blood supply and swelling.Reassuring Maria that engorgement is common and temporary will decrease her anxiety and allow her to hear and remember the other instructions. Provide this reassurance first.
b)Instruct Maria to breastfeed Juan based on infant feeding cuesEarly and frequent feedings in the first 2-3 days can help prevent engorgement. Since Maria chose to bottle feed Juan in the first 2 days, she should now feed frequently to help relieve engorgement.
c)Provide a breast pump and instruct Maria to use it after breastfeeding to soften the second breast if needed.If Juan does not feed on both breasts, a pump may be used to relieve engorgement on the second breast or to soften the breast tissue prior to latch-on. d)Apply cold packs between feedings to relieve swelling; 15-20 minutes on and 45 minutes off.Cold causes vasoconstriction which reduces swelling of breast tissue around the milk ducts.
e)Ibuprofen 600 mg orally can be taken every 6 hours.Anti-inflammatory medications can help reduce pain and swelling associated with engorgement. It can also reduce aching and low-grade fever that are often associated with engorgement. Medication is suggested last if other measures are not effective.

Answer 1

Breast engorgement and leakage after abruptly stopping breastfeeding occurs due to the continued production of milk in response to hormonal signals established during breastfeeding, which does not immediately stop after ceasing suckling.

Step-by-step explanation:

A person who stopped breastfeeding suddenly is experiencing breast engorgement and leakage because of the abrupt change in the pattern of milk removal. Breast engorgement is a result of milk accumulating in the breasts, which occurs when the established balance between milk supply and infant demand is disrupted. When breastfeeding is stopped, the milk that was being produced in response to the baby's need continues to be produced until the body gradually adjusts to the reduced demand. This process can lead to temporary engorgement and leakage.

The lactation process is regulated by hormones such as prolactin and oxytocin. Frequent breastfeeding maintains high levels of prolactin, which stimulates milk production. The action of the baby suckling also prompts oxytocin release, leading to milk ejection. When suckling is ceased suddenly, these hormonal signals do not drop immediately; hence the body continues to produce milk even without the baby's demand, causing engorgement and leakage.