:) hope to be interested

2. Breastfeeding difficulties 
refers to problems that arise from breastfeeding, the
feeding of an infant or young child with milk from
a woman's breasts . Although babies have a sucking
reflex that enables them to suck and swallow milk,
and although human breast milk is usually the best
source of nourishment for human infants, there are
circumstances under which breastfeeding can be
problematic, or even, in rare
instances, contraindicated.

3. 1- Insufficient milk syndrome
2- Retracted nipples
3- Sore nipples
4- Breast engorgement
5- Brest abscess
6- Mastitis

4. There is a very tiny percentage of unaltered women who truly
,physiologically, will not be able to create breast milk you
would believe that insufficient breast milk is a very popular
problem
The fact is, mother’s breasts are designed to produce as much
milk as baby desires, whenever natural feeding is allowed.
Careful studies demonstrate that nearly all mothers who
initially complain of insufficient milk are in fact producing
adequate quantities, and their babies are growing normally.

5. Supply and demand :
When a baby cries with hunger but a schedule prevents feeding,
mother’s body still responds to the cries with oxytocin release. But
when the milk is not taken, prolactin is not produced; thus, there
is no milk production when suckling does not occur
If milk production is suspected to be inadequate, the last thing
to do is to provide a supplement to baby. The first thing to do
is to increase nursing time and frequency and make sure the
mother is not dehydrated. The milk supply can be quickly
renewed within a few days in this way if supplementation or
infrequent feedings have caused decreased production

6. Causes
 Painful condition and any illnesses
 Incorrect method of breast feeding
 Maternal stress and insufficient sleep
Advice mother to
 Sufficient rest and adequate fluid intake
 feed baby on demand

7. An inverted nipple  is a condition where the nipple
, instead of pointing outward, is retracted into
the breast . In some cases, the nipple will be
temporarily protruded if stimulated. Women and
men can have inverted nipples.
Causes 
Breast feeding ,born with the condition ,trauma may
be result from surgery ,breast cancer , breast
inflammation ,genetic, pregnancy ,tuberculosis

8. Antenatal examination and counseling for
cleaning of nipples and their aversion is
important
20cc syringe may be also used for removing
retraction
Use of Brest pump

9. NormalRetracted

10. The cause is always trauma from the
baby`s mouth and tongue which
result from incorrect positioning of
the baby`s mouth at the breast .
Correcting this will provide
immediate relief from pain and will
also allow rapid healing

11. Signs nipple is red ,cracked ,bruised and
tender
Symptoms mild to sever pain
Management 
 teach correct latch on and positioning
 teach on breakdown suction before taking off
the baby off the breast
 expose the breast to air after massaging a drop
of breast milk on the nipple
 check correct tongue motion

12. Other causes of soreness 
Infection with Candida albicans :(thrush) can
occur , it frequently follows a period of
trouble feeding . The nipple and areola are
inflamed ,shiny and pain persists throughout
the feed . The baby may show signs of oral
or anal thrust . Both mother and baby should
receive fungicide treatment

14. Definition  `It is the accumulation of milk in the breast .
Time  this condition occurs around the third or fourth day
Postpartum
Signs  The breasts are hard , painful and sometimes
flushed .The mother may develop pyrexia .Engorgement
results from an increase in the blood volume in the breast
with accompanying edema and indicates that the baby is not
in step with the stage of lactation .
The condition may also occur when the baby is unable to feed
efficiently because he is not correctly attached to the breast
Breast engorgement can lead to mastitis

15.  Management :
 encourage frequent breast –feeding .(empting the
breast from milk)
 start breast feeding with the engorged breast .
 if breast feeding is not enough ,express breast milk .
symptomatic relief:
 hot compresses before breast feeding
 cold compresses after breast feeding or milk expression
 Encourage breast support by wearing support bra

17. Mastitis : mean inflammation of the breast
Mastitis is two type :
A- Non-infective mastitis
B- Infective (superficial)Mastitis

18. A- Non-infective Mastitis : caused by blocked milk
duct or milk engorgement
 It can occur because of unresolved engorgement
or at any time when poor feeding
*It is extremely important that breast –feeding from the
affected breast continues ,otherwise milk stasis will
increase further and provide an ideal condition for
pathogenic bacteria to replicate .And if not treated
may leads to abscess formation causing much pain
and distress to the mother

19. S&
S
Local pain
Swelling of
the affected
area
Warmth of
the affected
area
Redness
&pyrexia

20. B- Infective (superficial ) mastitis :
Caused by staphylococcus Aureus , E-coli or Candida
Albicans
 The main cause of infection is damage to the epithelium, which allows
bacteria to inter the underlying tissues . The damage results from
incorrect attachment of the baby to the breast which has caused
trauma to the nipple .

21. Signs and symptoms
Fever Flu-like
symptoms
Presence
of abscess

22. 1- frequent emptying of the breast
2- Hot compresses in mild mastitis
3- cold compresses in sever mastitis
4- antibiotics are used in bacterial
infection

23. Mastitis

24. A fluctuant swelling develops in a previously
inflamed area . Pus may be discharged from
the affected breast . Breast feeding from the
affected breast is stopped for a few days but
breast feeding should be commenced as
soon as possible because this has been
shown to reduce the chances of further
abscess formation

25.  Stop feeding from the affected breast for a few
days especially if there is blood or pus
discharge from the nipple
 Simple needle aspiration may be effective
 If not . An incision and drainage is necessary
to drain the pus from the breast
 Breast feeding is reestablished if no pus or
blood with the milk
 Antibiotic is used

27.  Abnormal nipple such as large nipple ,short
nipple, long nipple ,or inverted nipple
 Abnormality in the baby such as cleft lip cleft
palate ,blocked nose , downs` syndrome ,
prematurity , illness or surgery

28. Breast engorgement
Engorged lymphatic &venous channel around the alveoli
Increase alveolar pressure
Flatness epithelium &blocks the ducts