A Study to Assess the Effectiveness of Cabbage Leaf Application on Pain and Hardness in Breast Engorgement and its Effect on the Duration of Breast feeding among Postnatal mother in selected hospital at Dharampur

Dhoom Sushmaben, Janaki Maradiya, Jeenath Justin Doss. K.

B (II Year M.Sc. Nursing, MSN) Shri Anand Institute of Nursing, Opp. Ghanteshwar Park,

B/h Sainik Society, Jamnagar Road, Rajkot - 360006.

*Corresponding Author E-mail: sushmadhoom23091995@gmail.com

ABSTRACT:

Breast engorgement is a condition that affects breastfeeding mothers early in the postpartum. The discomfort and tenderness as a result of the engorgement is a major contributing factor to the early cessation of breastfeeding. The objective of the study is to examine the effectiveness of cabbage leaf treatment on pain and hardness of the engorged breasts of post-partum women and its influence on the duration of breastfeeding in women with breast engorgement. The research design adopted was Quasi experimental. The conceptual framework applied for this study was J.W.Kenny’ Open System model, 1990. The study was conducted in Shree Sainath hospital Dharampur. The sample size was 40 as an intervention the cabbage leave application for one day intervention. The collected data were analyzed by using inferential statistical method. t test was used to evaluate the effectiveness of cabbage leaves application to reduce level of pain, hardness and breastfeeding level in breast engorgement among postnatal mothers admitted in selected hospital. Study shows as the pre-test level of pain among selected 40 sample of breast engorgement patient admitted in selected hospital, reported 40(100%) of postnatal mother were having severe pain.pre-test level of breast engorgement among selected 40 sample of breast engorgement patient admitted in selected hospital, reported 24(60%) of postnatal mothers were having severe breast engorgement, 16(40%) of postnatal mothers were having moderate level of breast engorgement.The pretest reported 21(52.5%) of postnatal mothers were having poor breastfeeding, 19(47.5%) of postnatal mothers were having moderate level of breastfeeding. While in post-test 24(60%) had good level of breastfeeding and 16(40%) had moderate level of breastfeeding. Mean difference between the pre-test and post-test was 2.05 and the standard deviation of pre-test level was 0.80224 and post-test was 0.82275 and the calculated ‘t” value was 23.472 and the table value was 2.042 and this value is significant at <0.001 level hence the hypothesis was accepted. It is inferred that cabbage leave application therapy was effective in reducing the level of breast engorgement and improving the quality of life among patients of breast engorgement admitted in selected hospital. Improvement in breastfeeding level.

KEYWORDS: Breast engorgement, Postnatal.

INTRODUCTION:

To become mother is the greatest joy and pride for a woman. Becoming a mother is an experience which every woman cherishes. The bondage between them is not severed even after the life comes out from her womb for, she nourishes that life with a food which has found no substitute yet despite advances in science and technology, that pristine food is called “Mother’s Milk”.¹

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. Breastfeeding 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. Breast feeding is the act of naturally feeding an infant with milk produced in the mother’s breast.²

A wealthy nation is the one which has a healthy population, so to achieve that, all the physical, social and emotional need of a postnatal mother should be met properly. The duration of postnatal periodis six weeks. Even though as breastfeeding is practiced universally according to WHO in 2013 exclusive breastfeeding grate is 37%. In India within an hour of birth 96% of new-born are breast fed of that urban population is 29% and rural population is 21 % (Resmy et al., 2014).³

NEED FOR THE STUDY

Breast engorgement is a postnatal physiological unpleasant condition in which painful swelling, redness and hardness of the breasts is there due to sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema during a time when mothers are coping with the demands of a new baby.⁴

“Breast Milk is Nature’s Protection for the Baby”. One million infant lives can be saved by just breast feeding in the first hour following the birth of the child. If mothers and families comprehend the benefits of breast feeding for six months, it can save the life of 250,000 babies annually.⁵

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

Studies have revealed that 13.3% of non-breastfeeding mothers suffer from puerperal fever as a result of breast engorgement. Although there are several medications that go well with breastfeeding, minimizing the use of medication during breastfeeding is recommended. The incidence rate of breast engorgement all over the world is 1:8000 and in India, it is 1:6500. Symptoms of engorgement usually appear between days 3 and 5. Two thirds of mothers get tenderness on the fifth day but some may show tenderness as late as the ninth or tenth day. Two-thirds of women feel at least moderate symptoms. Engorgement reduces if the mother breastfeeds more during the first 48 hours. 20% of postnatal mothers, particularly primigravida mothers, suffer from breast engorgement as early as 0-4 days of the postnatal period.⁷

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.⁸

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.

Up to one-third of the mother who experience the complications such as infection mastitis, abscess which had resulted from inappropriate management of engorgement, may change to alternate methods of infant nutrition within the first six weeks of postpartum. Existing Global and Indian data show that breastfeeding promotes infant survival and growth protects the infant against infections and at the same time the mother also get natural protection from next pregnancy.

OBJECTIVES:

· To assess the level of pain in breast engorgement among postnatal mothers who are admitted in selected hospital at Dharampur.

· To assess the level hardness of breast engorgement among postnatal mothers who are admitted in selected hospital at Dharampur.

· To assess the level breastfeeding among postnatal mothers who are admitted in selected hospital at Dharampur

· To evaluate the effectiveness of cabbage leaf application therapy on pain and hardness in breast engorgement and its effect on the duration of breastfeeding among postnatal mother in selected hospital at Dharampur.

· To find out association between posttest level of breast engorgement among postnatal mother and their selected demographic variables.

HYPOTHESES:

H1_:There will be reduction in the level of pain and hardness in breast engorgement and improving level of breastfeeding after cabbage leave application among postnatal mothers of selected Hospital.

H2_:There will be a significant association between the posttest level of breast engorgement and their selected demographic variables among postnatal mothers of selected Hospital.

MATERIALS AND METHODS:

Research Approch:

Quantitative research approach.

RESEARCH DESIGN:

The research design for the present study is a pre-experimental approach one group pre-test and post-test.

Variables:

· Independent vriables:

The independent variable is the variable that stands alone and does not depend on any other. It is the presumed cause of action (treece and treece, 1988)

In this study application of cabbage leave is independence variable to reduce breast engorgement.

· Dependent variable:

The dependent variable is the effect of action of the independent variable and cannot exist by itself (treece and treece, 1988).

In this study, the dependent variable is level of pain, hardness and level of breast feeding among postnatal mothers.

Setting:

The Study will be conducted in selected Hospital at Dharampur.

Population:

Target population:

Target population for present study is postnatal mothers with complain of breast engorgement.

Accessible population:

Accessible population is postnatal mothers with complain of breast engorgement in selected hospital of Dharampur.

Sample:

Postnatal mothers with complains of breast engorgement of selected hospital Dharmpur. 40 mothers were selected for this study.

Sample Size:

40 Postnatal mothers with complain of breast engorgement were selected for present study.

Sampling Technique:

Non – probability convenient sampling technique is planned to selected samples.

A convenience sample is a type of non – probability method where the sample is taken from a group of people easy to contact or to reach.

Data Analysis:

The responses were analyzed through descriptive statistics (Frequency, percentage) and inferential statistics (t-test and Chi-Square).

DEMOGRAPHIC FINDINGS:

· According to the age distribution 16(40%) belong to 20-23 years, 15(37.5%) belong to 24-27 years and 9(22.5%) belong to 28-31 years.

· According to the area of living distribution 22(55%) belong to urban area and 18(45%) belong to rural area.

· According to the educational status distribution 7(17.5%) belong to illiterate, 12(30%) to primary school education, 15(37.5%) belong to secondary school education, and 6(15%) belong to graduate level of education.

· According to the dietary pattern distribution 24(60%) samples are vegetarian and 16(40%) samples are non- vegetarian.

· According to the type of family 28(70%) belong to the nuclear family and 12(30%) belong to the joint family.

· According to the parity distribution 19(47.5%) belong to the one parity, 12(30%) belong to the two parties and 9(22.5%) belong to the more than two parties.

· According to the social support distribution 7(17.5%) belong to the supporter from mother, 18(45%) belong to support from husband, 4(10%) belongs to support from friends and 11(27.5) belong to support from in-laws.

CONCLUSION:

The main conclusion from this present study is that most of the breast engorgement patient admitted in selected Shree Sainath Hospital. This shows the imperative need to understand the purpose of cabbage leave application 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.

REFERANCES:

1. Williams. Breast feeding and Engorgement. Obstetrics. 24th ed. McGraw-Hill Professional. 2014. pp. Chapter 37. ISBN 9780071798938.

2. Mangesi L, Dowswell T. Treatments for breast engorgement during lactation. Cochrane Database. Syst Rev. 2010 Sep; 8(9).

3. Wambach K, Campbel SH, Gill SL, et al. Clinical lactation practice: 20 years of evidence. Journal of Human Lactation. 2005; 21(3): 245-258. PMid:16113013. http://dx.doi.org/10.1177/08903 34405279001

4. Boskabadi H, Maamouri G, Ebrahimi M, et al. Neonatal hypernatremia and dehydration in infants receiving inadequate breastfeeding. Asia Pacific Journal of cLinical Nutrition. 2010; 19(3): 301.

5. Giugliani ER. Common problems during lactation and their management. Journal De Pediatria. 2004; 80(5): s147-s154.

6. Richard JS, Lisa E, Steven A, et al. Patient information Common breastfeeding problems Breastfeeding Problems Overview. 2010.

7. American Academy of Pediatrics, American College of Obstetricians and Gynecologists. Breastfeeding Handbook for Physicians. 2006. 1st ed. Washington DC: American Academy of Pediatrics.

8. Australian Breastfeeding Association. Engorgement. 2014. Available from: https://www.breastfeeding.asn.au/bf-info/comm on-concerns%E2%80%93mum/engorgement. Accessed at 9 October 2015.

Received on 11.03.2024 Modified on 26.03.2024

A and V Pub J. of Nursing and Medical Res. 2024; 3(2):67-70.

DOI: 10.52711/jnmr.2024.15