Breast care in the puerperium

Due to the increasing emphasis on women’s health care, the 6-week postpartum checkup has become a must-do for most young women who are new mothers, and one of the more important tasks is to educate them on how to breastfeed properly and to test the composition of their milk. In our daily outpatient checkups, most of the puerperal women we encounter have two problems: one is too little milk; the other is early acute mastitis. Now, for these two problems, we make some simple explanations and inform the patients of the treatment measures before the hospital visit, for the reference of the young mothers only. The first is low milk. The secretion of milk is a very complex physiological process that is regulated by both the nervous and endocrine systems, and it is also a difficult task that requires long-term mutual cooperation between the mother and the baby. The neurological reflexes and endocrine hormones involved include: 1) lactation reflex: stimulation of the nipple to produce prolactin and release milk from the breast; 2) standing breast reflex: stimulation of the nipple to erect for the baby to receive; 3) discharge reflex: sucking to stimulate the nipple to produce prolactin and release milk to be ejected. It can be seen that if there is a lack of nipple stimulation, not only may there be too little milk at the time of breastfeeding, but also the milk may be depressed and cause complications. In reality, the factors that affect hormone secretion are physiological: the degree of mammary gland development, sleep, mental and psychological state, nutrition level, postpartum blood loss, sweating, etc.; drug stimulation and pharmacological inhibition, as most women are now very careful during pregnancy and breastfeeding, this cause has less influence, except for certain psychotropic drugs taken by patients with mental illness. Problems with the mother’s cooperation with the baby are mostly caused by a lack of understanding of the principles and methods of breastfeeding. All of these factors can lead to low puerperal lactation. Early treatment measures before hospital visits include: 1. Understanding the principles and methods of breastfeeding and proper breastfeeding. Mother and baby should have early contact, suckle and start breastfeeding within 30 minutes after delivery, and breastfeed for the second time within 6 hours, and mother and baby should be in the same room to strengthen their emotional communication. Thereafter, insist on breastfeeding on demand and at night, stimulate the nipples more, and do not add complementary foods too early. The correct method of breastfeeding should be used to prevent breast and nipple pain. 2. Have a happy spirit, get enough sleep and give appropriate psychological guidance to the mother. 3, strengthen nutrition, dietary therapy, including more intake of chicken, duck, fish, eggs, as well as carp soup, black fish soup and pig’s feet and other therapeutic products. The reason for this is that the nipples are congenitally stunted, the milk is not discharged in time, and the milk is difficult to discharge. Nipple cracking is mostly caused by incorrect breastfeeding methods. In the early stage, it is mostly localized swelling and pain in the breast, mostly along the milk ducts, with a slightly higher skin temperature, significant pressure pain and hard nodules with unclear boundaries. Most mothers report having a low fever, but it improves or even disappears the next day after proper treatment. Preventive and treatment measures are: 1. At the end of pregnancy, correct nipple invagination, strengthen the nipple’s ability to be stimulated by the outside world, and apply alcohol topically after massage to promote nipple keratinization; 2. Pay attention to the local cleanliness of the nipple; 3. Breastfeeding positions should be varied, and try to empty the milk each time, which can be manually assisted; 4. Contain the nipple and most of the areola in the mouth while breastfeeding, and apply a small amount of milk on the nipple surface after breastfeeding to prevent chafing. 5.Nursing on demand to prevent sleeping with the nipple. If the symptoms have appeared, you can apply local heat and artificial drainage, and if the effect is not obvious, consult a hospital as soon as possible for early treatment.