INTRODUCTION:

The relationship between a mother and her child is crucial. She plays a key part in the development of a child's growth, one of the most important of which is breast feeding. Breast milk keeps the baby healthy while also keeping the mother healthy. It is also easy to digest, which means no constipation, diarrhea, or stomach upset. Allergies, illness, obesity, cancer, and diabetes are all protected by it.

Breast feeding during the first hour or so after delivery is important because the baby begins to receive immunological effects from the colostrum, which protects against infection and sickness. These are all reasons why WHO promotes the importance of breast feeding. Breastfeeding benefits the nursing mother in a variety of ways, some of which are listed below. Burning calories and utilizing mom's fat storage for her breast milk, producing oxytocin, which helps contract the uterus back to its pre-pregnancy size, there will be less postpartum hemorrhage. Breast engorgement, retracted nipple, breast abscess, breastfeeding mastitis, and lactation failure are all common breast complications.¹

The benefits of breast feeding extend well beyond basic nutrition. In addition to vitamins and nutrients, the breast milk is packed with disease-fighting substances that protect the baby from illness. Breastfeeding has also been associated with cognitive development, preventing obesity and Insulin dependent Diabetes Mellitus. It therefore lowers the rate of illness and hospital admission among newborns. Numerous studies from around the world have shown that stomach viruses, lower respiratory illnesses, ear infections, and meningitis occur less often in breastfed babies and are less severe when they get it. Children who are breastfed have 20 per cent lower risk of dying between the ages of 28 days and 1 year than children who weren't breastfed.²

Breast feeding is the act of naturally feeding an infant with milk produced in the mother’s breast. Breast milk is the best food for a newborn, nothing comes even closer to provide all the nutrients that the baby will need later in life. Breastfeeding is an art and skills which need to be learnt and mastered. This skill has to be learnt and followed by mothers not only to feed their infants but also to avoid breastfeeding complications. One of the important steps in breastfeeding technique is helping the baby to latch on the breast correctly. A good latch eliminates the problem of sore nipples and proper breastfeeding reduces the chances of other breastfeeding complications. Some primiparous inexperienced mothers need some help and should be made aware about the importance of breastfeeding and its techniques during the antenatal period, so as to prevent complications in. the later periods.³

Breast engorgement is found equally evident in both normal delivery and caesarean section mothers. In caesarean section mothers, the incidence of breast engorgement is much greater than in the normal delivery as after caesarean section it can be tempting not to feed the baby overnight. Breast feeding after caesarean section is also testified to be difficult by many because of inappropriate positions adopted for establishing breast feeding. Breast engorgement usually happens within a week of the birth, but can occur later too. Primary engorgement occurs in the first few days after the baby is born but the secondary engorgement occurs later when the mother is not feeding as frequently.⁴

Everywhere on earth people use home remedies, this is having a great value and works as well as modern medicines or even better. They are often cheaper. It is evidenced that home remedies such as cooling therapy reduces the intensity of pain. The home remedies have no side effects and extra complications it can be practiced without the help of nurse-midwives.⁵

NEED FOR THE STUDY:

Approximately two days after giving birth the women’s breasts fill with milk, which is a normal process. This makes the breast heavy and swollen but under normal circumstances this should not be painful and hard. Breast engorgement develops in 72% to 85% in primipara postnatal mothers. It is a painful, unpleasant condition affecting large number of mothers during the early postpartum. During this time when mothers are coping with demands of the baby it may be particularly distressing. Breast engorgement quenches the development of successful breast feeding, leading to early breastfeeding cessation and is associated with more serious illness including breast infection.⁶

Breast engorgement usually develops when the breast switches off from colostrum to mature milk. When the milk oozes out for the first time swelling of breast tissue occurs due to flooding of lymph fluid and blood. As milk production increases over-distension of the alveoli causes the milk secreting cells to become flattened and occlude the capillary blood circulation surrounding the alveolar cells. Congestion contributes to edema and obstructs lymphatic drainage of the breasts, stagnating the system that rid the breasts of toxins and bacteria leading to mastitis.⁷

In very severe cases the pressure on the nerves due to edema extending to axilla can cause tingling of hands and numbness. In addition, a protein called Feedback Inhibitor of Lactation accumulates in the mammary gland during milk stasis. It acts as a major trigger of apoptosis that causes the involution of the milk- secreting glands collapse of the alveolar structures and the cessation of milk production.⁷

In this view the researcher felt that it is necessary to carry out an individualized postnatal care which is not harmful and it can be easily carried out by the caregiver or by the mother herself. This motivated the researcher to use a massage technique “Reverse Pressure Softening (RPS)” for relieving breast engorgement.⁸

OBJECTIVES OF THE STUDY:

1. To assess the level of pretest and posttest breast engorgement among the postnatal caesarean mothers admitted in selected hospital at Fatepura.

2. To evaluate the effectiveness of reverse pressure softening technique on level of breast engorgement among postnatal caesarean mothers.

3. To examine the association between post-test level of breast engorgement among postnatal mothers with their selected demographic variables.

HYPOTHESES:

H1: There will be a significant difference between mean pre and posttest level of breast engorgement of postnatal caesarean mothers.

H2: There will be a significant association between level of breast engorgement among postnatal mothers with their selected demographic variables.

METHODOLOGY:

RESEARCH APPEOACH:

Quantitative research approach

RESEARCH DESIGN:

Pre-experimental, one group pre-test and post-test design.

POPULATION:

· Target population: Target population for present study is postnatal cesarean mothers.

· Accessible population: Accessible population is postnatal mother with breast engorgement.

SAMPLE:

Sample of the present study is clients with complains of breast complication during postnatal period.

SAMPLE SIZE:

Population sample size refers to the subset of population that is selected to participate in the particular study. 40 postnatal cesarean mothers who had fulfilled the sampling criteria.

TECHNIQUE OF SAMPLE SELECTION:

Convenience nonprobability sampling technique.

DATA ANALYSIS PLAN:

The collected data was analyzed using both descriptive and inferential statistics.

RESULTS:

Major study findings include.

Findings related to demographic variables of the study:

1. The majority of 18(45%) the samples age is between 24-27years.

2. The majority of 25(62.5%) the samples are belonged to rural area.

3. The majority of 30(75%) the samples are belonged from nuclear family.

4. The majority of 16(40%) the samples are belonged to graduate.

5. The majority of 27(67.5%) the samples are vegetarian.

6. The majority of 18 (45%) the samples are gained social support from husband.

7. The majority of 33(82.5%) the samples had been single parity.

8. The majority of 21(52.5%) the samples are maternal indication for caesarean section.

The pre-test reported 32(80%) has sever, 8(20%) has moderate level of breast engorgement and there was nil reported on mild level of breast engorgement and after administration of reverse pressure softening technique in the Postnatal reported 17(42.5%) has moderate and 23(57.5) has mild level of breast engorgement and there was nil reported of sever level of breast engorgement.

The effectiveness of reverse pressure softening on level of breast engorgement was revealed in the post-test that there was significance improvement in health condition and reduce the level of breast engorgement with application reverse pressure softening techniques. The obtained “t-test” value for the level of knowledge on prevention and management of selected breast complication 53.768 that was highly significance at p<0.001 level the hypothesis was accepted.

CONCLUSION:

The main conclusion from this present study is that most of the breast engorgement patient admitted in selected Vardan maternity hospital. this shows the imperative need to understand the purpose of reverse pressure softening regarding reduction level of breast engorgement among postnatal mothers admitted in selected hospital and it will improve the quality of life which includes the stability in nutritional physiological, psychological, vocational and lifestyle aspect.

REFERENCES:

1. Mathew LA. [M.Sc. Thesis]. Sahyadri College of Nursing: Rajiv Gandhi University of Health Sciences. 2011.

2. Saini P, Saini R. Cabbage leaves and Breast Engorgement. Indian J Public Health. 2014; 58(4): 291-92. (Cited Oct 6, 2015).

3. Ruba A. Effectiveness of cabbage leaves application to relieve breast engorgement. Journal of Nightingale Nursing Times. 2009; 5(9): 48.

4. Sharma S, Chopra S. Practices related to breast feeding and weaning‖. The Indian Journal of India. 2000: 8.

5. Singh M. Everything about breast feeding that mother ought to know‖. Nightingale Nursing Times. 1991.

6. Kushu N K, Koyunchu F, Lacin S. Collaginace treatment of sore nipple‖. International Journal of Gynaecology and Obstetrics. 2002; 76: 81-2.

7. Mallikarkuna H B, Banapurmath C R. Breastfeeding problems in first six months of life in rural Karnataka‖, Indian Paediatrics. 2002; 39:861-4.

8. Padmashree S. R. Linda arghese Aswathy S. Krishnan. Effectiveness of prenatal teaching on prevention of breast engorgement, International Journal of Reproduction Contraception Obstetrics and Gynecology. 2017; 6(9); 3927- 3931.

Received on 09.03.2024 Modified on 25.03.2024

A and V Pub Int. J. of Nursing and Medical Res. 2024; 3(2):91-93.

DOI: 10.52711/ijnmr.2024.19