Home | | Medicine Study Notes | Breast in Pregnancy and Breastfeeding

Chapter: Medicine Study Notes : Reproductive and Obstetrics

Breast in Pregnancy and Breastfeeding

Oestrogen, progesterone, HPL, PRL and HCG -> acinar cellular hyperplasia in early pregnancy, hypertrophy in later pregnancy, duct sprouting

Breast in Pregnancy and Breastfeeding

 

·        Changes during pregnancy: 

o   Oestrogen, progesterone, HPL, PRL and HCG ® acinar cellular hyperplasia in early pregnancy, hypertrophy in later pregnancy, duct sprouting 

o   By end of pregnancy, breast is composed almost entirely of lobules separated by relatively scant amount of stroma


·        Immediately after childbirth: 

o   ¯Progesterone ® milk production under the influence of PRL 

o   Milk let down: sucking ® ­pulsitile oxytocin ® myoepithelial cells squeezes milk down duct. Also due to neuroendocrine reflex (eg hearing baby cry). Sensitive to emotional stress 

o   Sucking also stimulates PRL ® continued milk production


·        Advantages of breast feeding: 

o   Infant: ¯infant mortality (two fold), bonding, cheap, anti-infective properties (lysozyme, IgA, lactoferrine, etc), ¯SIDS 

o   Maternal: contraceptive, sucking promotes uterine contractions ® ¯PPH, ¯pre-menopausal breast cancer 

o   Sufficient on its own until 4 – 6 months


·        Contra-indications: maternal HBsAg, CMV or HIV +ive, active breast HSV lesions, amiodarone


·        Breast care:

o   Sore/cracked nipple prevention:

§  Poor position, poor hygiene, irritation (clothing, soap)

§  Treatment: shields, advice on position, break suction with finger

o   Breast engorgement: 

§  Supply > demand ® enlarged breast ® baby can‟t latch on

§  Management: feed on demand, no other fluids for baby, express, paracetamol

o   Mastitis:

§  Cellulitis of interlobular connective tissue (mainly Staph Aureus)

§  Fever, tiredness, muscle aches and pains 

§  Treatment: antibiotics (flucloxacillin), analgesics, regularly empty breast, massage lumps towards nipple when feeding

 

·      Abscess:

o   Secondary to mastitis, febrile and toxic, red and tender > 48 hours

o   Treatment: surgical drainage, antibiotics, antipyretics, analgesics, ?suppress lactation


·        Inverted or retracted nipples: gently pull out through pregnancy

 

Study Material, Lecturing Notes, Assignment, Reference, Wiki description explanation, brief detail
Medicine Study Notes : Reproductive and Obstetrics : Breast in Pregnancy and Breastfeeding |


Privacy Policy, Terms and Conditions, DMCA Policy and Compliant

Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.