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Dayan-Schwartz A, Yefet E, Massalha M, Hosari-Mhameed S, Remer-Gross C, Pasand E, Nachum Z. The efficiency of cabergoline vs pyridoxine for lactation inhibition-a randomized controlled trial. Am J Obstet Gynecol 2024; 230:561.e1-561.e8. [PMID: 37827268 DOI: 10.1016/j.ajog.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Some mothers may seek lactation inhibition on personal, social, or medical grounds. The common drug used for lactation inhibition is cabergoline. Several adverse effects and contraindications are known for this drug. Its use is contraindicated for patients with hypertensive disorders and fibrotic, cardiac, or hepatic diseases. In addition, pyridoxine (vitamin B6) has been used for this indication, with no significant adverse effect, following studies that demonstrated its efficacy. OBJECTIVE This study aimed to compare the efficiency of cabergoline vs pyridoxine for lactation inhibition. STUDY DESIGN A randomized controlled trial was conducted. Postpartum patients who requested lactation inhibition were randomly allocated to receive either cabergoline (1 mg once on postpartum day 1 or divided to 0.25 mg twice a day for 2 days thereafter, according to the departmental protocol, which is in line with the manufacturer recommendations) or pyridoxine (200 mg 3 times a day for 7 days). The patients enrolled were free of diseases in which contraindications to cabergoline are present. All patients completed a questionnaire for assessing breast engorgement, breast pain, and milk leakage on a scale of 0 (no symptom) to 5 (severe symptom) on days 0, 2, 7, and 14. The primary outcome was lactation inhibition success, defined as a score of 0 for both engorgement and pain on day 7. The secondary outcomes included the assessment of milk leakage, adverse effects, fever, mastitis, and treatment discontinuation or alteration. RESULTS Of note, 45 and 43 patients received cabergoline or pyridoxine, respectively, and were included in the analysis following the intention-to-treat principle. Cabergoline was superior to pyridoxine in inhibiting lactation at day 7 (78% vs 35%, respectively; P<.0001). Mild symptoms, defined as a score of 0 to 2 for breast engorgement and pain, at day 7 were 40 (89%) in the cabergoline group and 29 (67%) in the pyridoxine group (P=.01). The incidence of milk leakage was lower in the cabergoline group after 7 and 14 days than in the pyridoxine group (9% vs 42% [P=.0003] and 11% vs 31% [P=.02], respectively). Cabergoline had more adverse effects than pyridoxine (31% vs 9%, respectively; P=.01), but all adverse effects were mild. The rates of mastitis and fever that were related to engorgement were similar in the cabergoline and pyridoxine groups (4 [9%] vs 2 [5%], respectively; P=.67). Furthermore, 9 patients (21%) in the pyridoxine group switched to or added cabergoline because of treatment failure. Accordingly, on day 7, the pyridoxine success rate was reduced from 35% (15 women) to 28% (12 women) and from 67% (29 women) to 53% (23 women) for a score of 0 and 0 to 2 for both engorgement and pain, respectively. CONCLUSION Cabergoline was superior to pyridoxine in inhibiting lactation. Cabergoline had more adverse effects, but no major adverse effect was documented in either treatment group. As pyridoxine inhibited lactation successfully in previous studies and in 67% of patients in this study, its use should be considered in women with contraindications for cabergoline.
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Affiliation(s)
- Adi Dayan-Schwartz
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
| | - Enav Yefet
- Department of Obstetrics and Gynecology, Tzafon Medical Center, Poriya, Israel; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Women's Health Center, Clalit Health Services, Afula, Israel
| | - Manal Massalha
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | | | - Chen Remer-Gross
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
| | - Eliran Pasand
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel
| | - Zohar Nachum
- Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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Alshakhs FH, Katooa NE, Badr HA, Thabet HA. The Effect of Alternating Application of Cold and Hot Compresses on Reduction of Breast Engorgement Among Lactating Mothers. Cureus 2024; 16:e53134. [PMID: 38420104 PMCID: PMC10899808 DOI: 10.7759/cureus.53134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Breast engorgement is a common issue that affects breastfeeding initiation and continuation. Engorgement can cause exhaustion, making it difficult to care for and feed the infant, and it can cause a mother to wean her baby before she intends to initiate breastfeeding. This study aimed to determine the effectiveness of the alternating application of cold and hot compresses in reducing breast engorgement among lactating mothers. Design, sample size and setting: A quasi-experimental study design is used to conduct this study. A purposeful sample of 100 lactating mothers was screened in the postnatal ward for the presence of breast engorgement. The 100 mothers with engorgement were divided into two equal groups of 50 mothers each - the first group (the intervention) and the second group (the control) - at the postnatal ward of King Abdulaziz Hospital-National Guard in Alahsa City. Sampling and tools: The data collection was conducted over five months, from January 2023 until May 2023. Data collection was done through a structured interview questionnaire sheet. The questionnaire was divided into six parts: socio-demographic data, obstetric and initial women assessment, the six-point engorgement scale (SPES), the visual analog scale (VAS), the LATCH breastfeeding charting scale, and the Infant Breastfeeding Assessment Tool (IBFAT). RESULT The present study found no statistically significant difference between the study intervention and control groups in breast engorgement, LATCH level, or overall level of breastfeeding assessment before the intervention. While, in terms of breast engorgement, pain level, attachment, and LATCH, the overall levels of infant breastfeeding assessment across study time had a statistically significant variance among the study and control groups after the intervention at p values=<0.001. CONCLUSION AND RECOMMENDATIONS The alternating application of cold and hot compresses can have a significant role in reducing breast engorgement among lactating mothers. Women should be encouraged to use hot compresses and cold gel packs as an alternative treatment to reduce engorgement and promote comfort. In addition, the study results can be utilized to aid Saudi Arabian nurses and midwives in understanding the advantages of applying a cold gel pack and a hot compress and to decrease levels of engorgement, improve latch, and relieve discomfort.
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Affiliation(s)
- Fatimah H Alshakhs
- Faculty of Nursing, Maternity and Child Health Department, King Abdulaziz University, Jeddah, SAU
| | - Nouran E Katooa
- Faculty of Nursing, Maternity and Child Health Department, King Abdulaziz University, Jeddah, SAU
| | - Hanan A Badr
- Faculty of Nursing, Maternity and Child Health Department, King Abdulaziz University, Jeddah, SAU
| | - Hala A Thabet
- Faculty of Nursing, Women's Health and Midwifery Nursing Department, Mansoura University, Mansoura, EGY
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Moura SO, Borges LCDC, Carneiro TMDA, Silva APSD, Araújo RMD, Ferreira GLC, Morais SDC, De Matheo LL, Andrade PRD, Pereira WCDA, Maggi LE. Therapeutic Ultrasound Alone and Associated with Lymphatic Drainage in Women with Breast Engorgement: A Clinical Trial. Breastfeed Med 2023; 18:881-887. [PMID: 37971376 DOI: 10.1089/bfm.2022.0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction: Breast engorgement (BE) is a problem that affects many women, especially in the first days of breastfeeding, producing inflammatory symptoms. Nonpharmacological therapies are inexpensive, safe, and can produce symptom relief. Objective: This study aims to analyze the safety of therapeutic ultrasound regarding possible risks of overheating and the effects of its use alone and associated with lymphatic drainage (LD) in women. Material and Methods: Effectiveness is measured through thermography, visual analog scale, and six-point scale of BE. This is a nonrandomized clinical trial with a sample of 34 in the ultrasound group (G1), 28 in the ultrasound and LD group (G2), and 37 in the control group (G3). Results: The mean reduction for engorgement was 1.3 ± 0.8 to G1, 1.4 ± 1.0 to G2, and 1.2 ± 0.9 to G3 according to the six-point scale. The mean reduction for pain level was 3.6 ± 2.1 to G1, 4.0 ± 3.1 to G2, and 4.0 ± 2.2 to G3 according to the visual analogue scale. Conclusion: It was observed that all therapies were effective in reducing the level of engorgement, according to the six-point scale. However, combined ultrasound and LD therapy has been shown to be more effective in reducing the level of pain. Brazilian Registry of Clinical Trials (RBR-6btb6zz).
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Affiliation(s)
| | | | | | | | | | | | | | - Lucas Lobianco De Matheo
- Laboratório de Ultrassom/PEB/COOPE/Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Wagner Coelho de Albuquerque Pereira
- PPGCSAO, CCBN, Universidade Federal do Acre, Rio Branco, Brazil
- Laboratório de Ultrassom/PEB/COOPE/Universidade Federal de Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis Eduardo Maggi
- PPGCSAO, CCBN, Universidade Federal do Acre, Rio Branco, Brazil
- Laboratório de Biofísica/CCBN/Universidade Federal do Acre, Rio Branco, Brazil
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N A, D P. Gua-Sha therapy on breast engorgement among Indian postnatal mothers. Bioinformation 2023; 19:853-859. [PMID: 37908615 PMCID: PMC10613815 DOI: 10.6026/97320630019853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 11/02/2023] Open
Abstract
Many women experience breast engorgement in the first few weeks after giving birth. Breast engorgement that is somewhat severe. It is characterized by full, tense, heated, and tender breasts that are painfully throbbing and aching. Therefore, it is of interest to evaluate the effect of Gua-Sha therapy on breast engorgement in reducing pain among postnatal mothers. A "non-randomized pre-test post-test control group design" was used for this study. "Purposive sampling techniques" were used to obtain 60 postnatal mothers who satisfied the inclusion criteria. Six point engorgement scale and visual analog scale were used for data collection. After pre-test Gua-Sha therapy was given 30 minutes in one cycle twice a day depending on upon the severity. Reassessment was done immediately after the procedure. The result shows that the post test score of breast engorgement in experimental group was 1.1 (± 0.305), where in control group 4.16 (±2.152). The 't' test value of breast engorgement was 9.869. The result shows that Gua-Sha therapy for breast engorgement in reducing pain was significant effect (p <0.05). The study concluded that the Gua-Sha therapy is an effective for reducing breast engorgement and pain among post natal mothers.
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Affiliation(s)
- Amudha N
- />Department of Obstetrics and Gynecology Nursing, Indira College of Nursing, Trichy-621105, Tamil Nadu, India
| | - Prakash D
- />Department of Medical Surgical Nursing, Nootan College of Nursing, Sankalchand Patel University, Visnagar, Gujarat-384315, India
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Sarwar S, Sajid F, Wasim AU, Waleed MS, Thada PK. Pyoderma Gangrenosum Precipitated by Breast Engorgement Following Lactation Discontinuation: A Rare Case Report. Cureus 2023; 15:e42203. [PMID: 37602127 PMCID: PMC10439785 DOI: 10.7759/cureus.42203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Pyoderma gangrenosum (PG) is an inflammatory disease characterized by recurrent painful ulcers, eventually leading to cribriform scars. PG is mostly a diagnosis of exclusion with neutrophilic skin infiltration. We present a case of a 35-year-old female patient whose first presentation of PG occurred in the first trimester of pregnancy, which recurred after discontinuation of breastfeeding. The patient also had a history of taking prolonged IM and IV analgesics for her chronic migraines. The patient was initially treated with steroids and necessary wound care, during which symptoms remained controlled. However, a year later, the patient presented with an acute flare-up of the disease in her postpartum period, mainly involving her breasts bilaterally. Extensive wound debridement was performed due to the severity of her necrotic ulcers and failure to respond to conservative management, which was followed by partial thickness skin grafting.
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Affiliation(s)
- Sarosh Sarwar
- Medicine and Surgery, Fazaia Medical College, Islamabad, PAK
- Research, Larkin Community Hospital, Miami, USA
| | | | - Asad Ullah Wasim
- Medicine and Surgery, Fazaia Medical College, Islamabad, PAK
- Research, Larkin Community Hospital, Miami, USA
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Huda MH, Chipojola R, Lin YM, Lee GT, Shyu ML, Kuo SY. The Influence of Breastfeeding Educational Interventions on Breast Engorgement and Exclusive Breastfeeding: A Systematic Review and Meta-Analysis. J Hum Lact 2022; 38:156-170. [PMID: 34229526 DOI: 10.1177/08903344211029279] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Breast engorgement and breast pain are the most common reasons for the early cessation of exclusive breastfeeding by mothers. RESEARCH AIMS (1) To examine the influence of breastfeeding educational interventions on breast engorgement, breast pain, and exclusive breastfeeding; and (2) to identify effective components for implementing breastfeeding programs. METHODS Randomized controlled trials of breastfeeding educational interventions were searched using five English and five Chinese databases. Eligible studies were independently evaluated for methodological quality, and data were extracted by two investigators. In total, 22 trials were identified, and 3,681 participants were included. A random-effects model was used to pool the results, and a subgroup analysis and meta-regression analysis were conducted. RESULTS Breastfeeding education had a significant influence on reducing breast engorgement at postpartum 3 days (odds ratio [OR]: 0.27, 95% CI [0.15, 0.48] p < .001), 4 days (OR: 0.16, 95% CI [0.11, 0.22], p < .001), and 5-7 days (OR: 0.24, 95% CI [0.08, 0.74], p = .013) and breast pain (standardized mean difference: -1.33, 95% CI [-2.26, -0.40]) at postpartum 4-14 days. Participants who received interventions had higher odds of exclusive breastfeeding. Breastfeeding educational interventions provided through lecture combined with skills practical effectively reduced breast engorgement (OR: 0.21; 95% CI [0.15, 0.28]; p = .001) and improved exclusive breastfeeding at postpartum 1-6 weeks (OR: 2.16; 95% CI [1.65, 2.83]; p = .001). CONCLUSIONS Breastfeeding educational interventions have been effective in reducing breast engorgement, breast pain, and improved exclusive breastfeeding. A combination of knowledge and skill-based education has been beneficial for sustaining exclusive breastfeeding by mothers.
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Affiliation(s)
- Mega Hasanul Huda
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Roselyn Chipojola
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yen Miao Lin
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Gabrielle T Lee
- 6221 Applied Psychology, Faculty of Education, Western University, London, ON, Canada
| | - Meei-Ling Shyu
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yu Kuo
- 38032 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Coban A, Bayraktar S, Yıldız N, Tunçel D, Gökçay G, Ince Z. A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? J Hum Lact 2021; 37:414-418. [PMID: 33030995 DOI: 10.1177/0890334420962073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation. MAIN ISSUE The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor. MANAGEMENT The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status. CONCLUSIONS The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother-infant pair are essential for preserving lactation.
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Affiliation(s)
- Asuman Coban
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.,37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
| | - Sema Bayraktar
- 221265 Bezmialem Vakıf University, Faculty of Health Sciences, Nursing, Istanbul, Turkey
| | - Nevin Yıldız
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Duygu Tunçel
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey
| | - Gülbin Gökçay
- 37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
| | - Zeynep Ince
- 37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.,37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey
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Ketsuwan S, Baiya N, Paritakul P, Laosooksathit W, Puapornpong P. Effect of Herbal Compresses for Maternal Breast Engorgement at Postpartum: A Randomized Controlled Trial. Breastfeed Med 2018; 13:361-365. [PMID: 29688768 DOI: 10.1089/bfm.2018.0032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Maternal breast engorgement is one of the most common problems in the postpartum period. There are several alternative treatments, but there have not been any randomized controlled trial studies about the effects of herbal compresses for breast engorgement. OBJECTIVE The objective is to investigate the effects of herbal compresses for maternal breast engorgement. MATERIALS AND METHODS A randomized controlled trial was conducted. The postpartum mothers who had breast engorgement were randomly assigned to herbal or hot compress treatments. The breast engorgement pain scores were assessed by visual analog scales pre- and post-treatment. The pain reduction scales of the herbal compress treatments were analyzed and compared with the hot compress treatments. The adverse effects of each treatment were recorded and collected after 24 hours from treatments. RESULTS The data from 500 postpartum mothers with breast engorgement were available for analyses, 250 from the herbal compress group and 250 from the hot compress group. The baseline characteristics of both groups were similar except baseline breast engorgement pain score (herbal compress group higher than hot compress group). There were statistically significant mean differences of breast engorgement pain before and after treatment between the herbal and hot compress groups. No serious complications were found after treatment from herbal compresses. CONCLUSION Among the postpartum mothers who had breast engorgement, the herbal compresses could decrease breast engorgement pain. The pain reduction after herbal compresses was found to be greater than with the hot compresses.
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Affiliation(s)
- Sukwadee Ketsuwan
- 1 Obstetrics and Gynecology Nursing Department, HRH Princess Maha Chakri Sirindhorn Medical Center , Nakhon Nayok, Thailand
| | - Nongyao Baiya
- 1 Obstetrics and Gynecology Nursing Department, HRH Princess Maha Chakri Sirindhorn Medical Center , Nakhon Nayok, Thailand
| | - Panwara Paritakul
- 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand
| | - Wipada Laosooksathit
- 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand
| | - Pawin Puapornpong
- 2 Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University , Nakhon Nayok, Thailand
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Khosravan S, Mohammadzadeh-Moghadam H, Mohammadzadeh F, Fadafen SAK, Gholami M. The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women: A Randomized Clinical Trial. J Evid Based Complementary Altern Med 2017; 22:25-30. [PMID: 26603219 PMCID: PMC5871197 DOI: 10.1177/2156587215617106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 11/16/2022] Open
Abstract
Breast engorgement affects lactation. The present study was conducted to determine the effect of hollyhock combined with warm and cold compresses on improving breast engorgement in lactating women. Participants included 40 women with breast engorgement divided into intervention and control groups, with participants in both groups being applied routine interventions and warm compress before nursing and a cold compress after nursing; however, the intervention group was also applied hollyhock compress. Both groups received these treatments 6 times during 2 days. The data collected were analyzed in SPSS-16 using a generalized estimating equation. According to the results, a significant difference was observed in the overall breast engorgement severity in the intervention group (P < .001). The severity of breast engorgement was also found to have a significant relationship with time (P < .001). According to the findings, hollyhock leaf compress combined with performing routine interventions for breast engorgement can improve breast engorgement.
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Affiliation(s)
- Shahla Khosravan
- Social Determinants of Health Research Centre, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Hossein Mohammadzadeh-Moghadam
- Department of Iranian Traditional Medicine, School of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Mohammadzadeh
- Department of Basic Sciences, Faculty of Paramedicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | | - Malihe Gholami
- Kashmar Nursing Faculty, Kashmar University of Medical Sciences, Kashmar, Iran
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Witt AM, Bolman M, Kredit S, Vanic A. Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis. J Hum Lact 2016; 32:123-31. [PMID: 26644422 DOI: 10.1177/0890334415619439] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/04/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many women in developed countries do not meet their breastfeeding goals and wean early because of breast pain. OBJECTIVE This study aimed to describe clinical response to therapeutic breast massage in lactation (TBML) in the management of engorgement, plugged ducts, and mastitis. METHODS Breastfeeding women presenting with engorgement, plugged ducts, or mastitis who received TBML as part of their treatment were enrolled (n = 42). Data collected at the initial visit included demographic, history, and exam data pre-TBML and post-TBML. Email surveys sent 2 days, 2 weeks, and 12 weeks following the initial visit assessed pain and breastfeeding complications. A nested case control of engorged mothers (n = 73) was separately enrolled to compare engorgement severity. RESULTS Reasons for the visit included engorgement (36%), plugged ducts (67%), and mastitis (29%). Cases, compared to controls, were significantly more likely to have severe engorgement (47% vs 7%, P < .001). Initial mean breast pain level among those receiving TBML was 6.4 out of 10. Following TBML, there was significant improvement in both breast (6.4 vs 2.8, P < .001) and nipple pain (4.6 vs 2.8, P = .013). All women reported immediate improvement in their pain level. At the 12-week survey, 65% found the massage treatment very helpful. The majority of the women with a new episode of mastitis or plugged duct during the study follow-up found the techniques learned during the office visit very helpful for home management of these episodes. CONCLUSION In office, TBML is helpful for the reduction of acute breast pain associated with milk stasis. Mothers find TBML helpful both immediately in-office and for home management of future episodes.
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Affiliation(s)
- Ann M Witt
- Breastfeeding Medicine of Northeast Ohio, Cleveland, OH, USA Senders Pediatrics, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA
| | - Maya Bolman
- Breastfeeding Medicine of Northeast Ohio, Cleveland, OH, USA Senders Pediatrics, Cleveland, OH, USA
| | | | - Anne Vanic
- Breastfeeding Medicine of Northeast Ohio, Cleveland, OH, USA Senders Pediatrics, Cleveland, OH, USA
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Abstract
OBJECTIVE To explore the experiences of lactation suppression (LS) among Taiwanese women who experienced stillbirth after 20-weeks gestation. DESIGN Qualitative research combining practitioner ethnography and the observ-view method (participant observation and unstructured interviews while caring for participants). SETTING Participants were recruited from a medical center in central Taiwan between June 2013 and November 2014. PARTICIPANTS Seven Taiwanese women who had stillbirths. METHODS Data were collected by the observ-view method. Recorded interviews were analyzed by content analysis. RESULTS Participants described three core experiences: deciding to use LS without careful deliberation; psychological pain is substantially stronger than physical pain; and not regretting their choice regarding method of LS. CONCLUSION Physical pain often remains unaddressed because of the greater psychological pain following fetal death. Therefore, LS should be an essential component of follow-up care as part of the discharge plan. Follow-up should be for at least 14 days. More research is needed on nonpharmacological LS to address cultural differences and personal beliefs about methods of LS.
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