A patient delivers a 3,400-gram baby boy and is transferred to the postpartum unit. On the second postpartum day, the patient experiences tenderness and breast engorgement from breastfeeding. To relieve the patient's discomfort between feedings, the nurse should encourage her to


• Cold compresses should be applied to the breasts to reduce discomfort between feedings. This is appropriate for breastfeeding mothers and those who wish to formula feed.

• Administer analgesics as prescribed if this comfort measure is unsuccessful.

• Breast milk forms in response to the fall of estrogen and progesterone levels that follows delivery of the placenta. When milk production begins, the milk ducts become distended. The breasts become fuller, larger, and firmer. The distention is not limited to the milk ducts; it also occurs in the surrounding tissue.

• The feeling of tension in the breasts on the third or fourth day is termed primary engorgement.

• Incorrect: Warm compresses will increase perfusion and stimulate let-down, increasing engorgement and discomfort between feedings. A warm compress may be used just prior to feedings.

• Incorrect: Do not discontinue breastfeeding. Primary engorgement fades as the infant begins effective sucking and empties the breasts of milk.

• Incorrect: Do not remove the bra because a supportive bra provides pain relief and comfort to engorged breasts.

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