Medical Complications of Mothers

Lawrence, Ruth A.

doi:10.1016/b978-1-4377-0788-5.10016-1

Cited by 9 publications

(12 citation statements)

References 234 publications

(172 reference statements)

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“…Drainage is also required if a galactocoele becomes inflamed (or activates), risking an abscess. 20,80…”

Section: Inactivated End-stage (Non-malignant or Benign) Lactation-re...mentioning

confidence: 99%

Re-thinking benign inflammation of the lactating breast: Classification, prevention, and management

Douglas

2022

Womens Health (Lond Engl)

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Despite the known benefits of breastfeeding for both infant and mother, clinical support for problems such as benign inflammation of the lactating breast remain a research frontier. Breast pain associated with inflammation is a common reason for premature weaning. Multiple diagnoses are used for benign inflammatory conditions of the lactating breast which lack agreed or evidence-based aetiology, definitions, and treatment. This article is the second in a three-part series. This second review analyses the heterogeneous research literature concerning benign lactation-related breast inflammation from the perspectives of the mechanobiological model and complexity science, to re-think classification, prevention, and management of lactation-related breast inflammation. Benign lactation-related breast inflammation is a spectrum condition, either localized or generalized. Acute benign lactation-related breast inflammation includes engorgement and the commonly used but poorly defined diagnoses of blocked ducts, phlegmon, mammary candidiasis, subacute mastitis, and mastitis. End-stage (non-malignant) lactation-related breast inflammation presents as the active inflammations of abscess, fistula, and septicaemia, and the inactive condition of a galactocoele. The first preventive or management principle of breast inflammation is avoidance of excessively high intra-alveolar and intra-ductal pressures, which prevents strain and rupture of a critical mass of lactocyte tight junctions. This is achieved by frequent and flexible milk removal. The second preventive or management principle is elimination of the mechanical forces which result in high intra-alveolar pressures. This requires elimination of conflicting vectors of force upon the nipple and breast tissue during milk removal; avoidance of focussed external pressure applied to the breast, including avoidance of lump massage or vibration; and avoidance of other prolonged external pressures upon the breast. Three other key preventive or management principles are discussed. Conservative management is expected to be effective for most, once recommendations to massage or vibrate out lumps, which worsen micro-vascular trauma and inflammation, are ceased.

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“…Drainage is also required if a galactocoele becomes inflamed (or activates), risking an abscess. 20,80…”

Section: Inactivated End-stage (Non-malignant or Benign) Lactation-re...mentioning

confidence: 99%

Re-thinking benign inflammation of the lactating breast: Classification, prevention, and management

Douglas

2022

Womens Health (Lond Engl)

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“…These include anemia and necrotic damage or shock to the pituitary gland from hypovolemia. Pituitary dysfunction affects secretion of key lactation hormones, including prolactin necessary for milk production [ 46 ]. Labor complications associated with preeclampsia, including inductions, cesarean sections, and prolonged labors are also risk factors for postpartum hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Delayed Lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: a case series

Demirci

Schmella

Glasser

et al. 2018

BMC Pregnancy Childbirth

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BackgroundPreeclampsia is a multi-system, hypertensive disorder of pregnancy that increases a woman’s risk of later-life cardiovascular disease. Breastfeeding may counteract the negative cardiovascular sequela associated with preeclampsia; however, women who develop preeclampsia may be at-risk for suboptimal breastfeeding rates. In this case series, we present three cases of late-onset preeclampsia and one case of severe gestational hypertension that illustrate a potential association between hypertensive disorders of pregnancy and suboptimal breastfeeding outcomes, including delayed onset of lactogenesis II and in-hospital formula supplementation.Case presentationAll cases were drawn from an ongoing pilot randomized controlled trial investigating the impact of antenatal milk expression versus an education control on breastfeeding outcomes. All study participants were healthy nulliparous women recruited at 34–366/7 gestational weeks from a hospital-based midwife practice. The variability in clinical presentation among the four cases suggests that any effect of hypertensive disorders on breastfeeding outcomes is likely multifactorial in nature, and may include both primary (e.g., preeclampsia disease course itself) and secondary (e.g., magnesium sulfate therapy, delayed at-breast feeding due to maternal-infant separation) etiologies. We further describe the use of antenatal milk expression (AME), or milk expression and storage beginning around 37 weeks of gestation, as a potential intervention to mitigate suboptimal breastfeeding outcomes in women at risk for preeclampsia and other hypertensive disorders of pregnancy.ConclusionsAdditional research is needed to address incidence, etiology, and interventions, including AME, for breastfeeding issues among a larger sample of women who develop hypertensive disorders of pregnancy.

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“…Engorgement is a normal stage of lactogenesis defined as “the swelling and distension of the breasts, usually in the early days of initiation of lactation, caused by vascular dilation as well as the arrival of the early milk.”45 The physiology of engorgement is thought to be alveolar distention leading to compression of surrounding ducts and resulting vascular and lymphatic congestion 46. Engorgement should be differentiated from breast edema, which is accumulation of fluid in the interstitial space which theoretically impair early lactation.…”

Section: Disorders Of Lactogenesismentioning

confidence: 99%

Common Complications of Breastfeeding and Lactation: An Overview for Clinicians

Radke¹

2022

Clinical Obstetrics &Amp; Gynecology

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Lactation and breastfeeding are core components of reproductive health care and obstetrical providers should be familiar with common complications that may arise in lactating individuals. While many breastfeeding challenges are best addressed by a lactation consultant, there are conditions that fall out of their scope and require care from a clinician. The objective of this chapter is to review common complications of breastfeeding and lactation including inflammatory conditions, disorders of lactogenesis, dermatologic conditions, and persistent pain with lactation.

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Medical Complications of Mothers

Cited by 9 publications

References 234 publications

Re-thinking benign inflammation of the lactating breast: Classification, prevention, and management

Re-thinking benign inflammation of the lactating breast: Classification, prevention, and management

Delayed Lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: a case series

Common Complications of Breastfeeding and Lactation: An Overview for Clinicians

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