What will you do if a day 3 postpartum woman complains of hard tender breasts and fever of 100 degree fahrenheit?

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Express breast milk

Rationale:

The condition described in the question—hard, tender breasts with fever in a postpartum woman—is most likely due to breast engorgement. Breast engorgement occurs when the breasts become overly full with milk, leading to swelling, pain, and sometimes a mild fever.
Expressing breast milk is the correct management in this situation because it helps to relieve the engorgement by emptying the milk from the breasts. This reduces pressure, softens the breast tissue, and alleviates discomfort.
Milk expression can be done manually or with a breast pump. It is important to encourage the mother to continue breastfeeding, as frequent feeding also helps prevent further engorgement and ensures the baby receives adequate nutrition.
Engorgement can also increase the risk of mastitis, a more serious breast infection, if not managed promptly. Regular milk expression and continued breastfeeding are key preventive measures.

Explanation of Other Options:

Ask her to wear a tight bra for support

Rationale: Wearing a tight bra is not recommended for managing breast engorgement as it can further restrict milk flow and worsen the condition. Instead, a well-fitting, supportive bra is advisable to provide comfort without compressing the breasts.

Stop breastfeeding for 2 days

Rationale: Stopping breastfeeding is not a correct approach. It can exacerbate engorgement because milk continues to be produced and accumulates in the breasts. Frequent breastfeeding is the best way to manage and prevent engorgement.

Start antibiotics

Rationale: Antibiotics are not indicated for simple breast engorgement. They are only necessary if there is a confirmed infection, such as mastitis, characterized by localized redness, significant pain, and high fever (usually above 101°F).

Additional Information:

Breast engorgement is a common issue during the early postpartum period, especially when milk production begins to increase (typically around day 3-5).
To prevent or manage engorgement, mothers should be encouraged to breastfeed frequently (every 2-3 hours), ensure proper latch, and alternate feeding positions to empty all areas of the breast.
Applying warm compresses before breastfeeding can help milk flow, while cold compresses after feeding can reduce swelling and discomfort.
If symptoms persist or worsen despite these measures, further evaluation is necessary to rule out complications like mastitis or abscess formation.