A nurse is caring for a postpartum client who has chosen to exclusively formula feed her newborn for medical reasons and is experiencing breast engorgement. What should the nurse teach regarding relief of breast engorgement?

Question

A nurse is caring for a postpartum client who has chosen to exclusively formula feed her newborn for medical reasons and is experiencing breast engorgement.  What should the nurse teach regarding relief of breast engorgement?

Quizplus · Accepted Answer

Breast engorgement is often painful. The management of engorgement varies based on the client's breastfeeding status; for clients who choose not to breastfeed, treatment focuses on managing symptoms while promoting reduced milk production. Comfort measures include: Applying ice packs to both breasts for 15-20 minutes every 3-4 hours to reduce blood flow and swelling Applying chilled, fresh cabbage leaves to both breasts, replacing with fresh leaves after they wilt. The mechanism of action is unclear but may be related to the cool temperature or to phytoestrogens from the leaves (Option D). Taking an anti-inflammatory analgesic (eg, ibuprofen) as directed to reduce pain Maintaining firm breast support (eg, supportive bra, breast binder) until milk flow is diminished (Option A) Heat application increases blood flow and worsens engorgement. Although running warm water over the breasts may make milk leak and temporarily relieve pressure, more milk is produced later, which is counterproductive in a client who has chosen not to breastfeed. (Options B and C) Breastfeeding is a supply-and-demand process. Massaging the breasts or manually expressing milk stimulates milk production, which exacerbates engorgement if the client is not breastfeeding. Educational objective: Stimulation of milk production (eg, manual milk expression, breast massage) is avoided in clients who intend to exclusively formula feed. Comfort measures for breast engorgement include application of ice packs and chilled, fresh cabbage leaves; analgesics; and firm breast support.

A Nurse Is Caring for a Postpartum Client Who Has