Relationship between antepartal breast care and postpartum breast engorgement

Breast engorgement occurs in both mothers who are breast feeding and mothers who are not breast feeding. When engorgement occurs there is frequently discomfort to the mother. Breast engorgement may often be a factor in hindering and/or discouraging breast feeding mothers. If breast engorgement can be prevented or decreased the comfort and well being of the mother during the postpartum period will be enhanced. The purpose of the present study was (1) to determine if antepartal instruction in breast care would affect the amount and degree of breast engorgement experienced by the breast feeding mother during the onset of lactation and by the non-breast feeding mother during the postpartum period and (2) to test some objective methods of measuring breast engorgement. An experimental group consisting of both breast feeding and non-breast feeding mothers received instruction in antepartal breast care and a control group did not„ Antepartal breast care included breast massage,, expression of colostrum and nipple rollingo Three measures of breast engorgement were used: chest circumference, skin tension, and skin temperature. With the exception of one breast feeding mother in the control group all of the mothers in the study exhibited some clinical evidence of breast engorgement. The majority of mothers had an increase in chest circumference with clinical evidence of breast engorgement. There was no clearly defined evidence of either an increase or decrease in the temperature of the skin in relation to clinical breast engorgement with the method used. There was a decrease in skin tension rather than an increase. Although there was a greater increase both in chest circumference and skin temperature in the control group these differences were not significant The experimental group showed more decrease in skin tension than the control group but the difference was not significant. In order to better evaluate the effectiveness of antepartal breast care the study should be repeated using reliable measures of breast engorgement in a more representative sample of the population. The pressure gauge used by Geissler (1967) may be of greater value in measuring tension in breast engorgement than the tonometer used in this study. The tape was felt to be accurate. More study needs to be done with the Body Temperature Indicator before its reliability can be assessed. Any future study should include a larger group of women. A method should be devised to mark the areas to be measured so that they would remain constant throughout the study.