Breast Assessment of the Lactating Mother

Inspection

  • Size, symmetry and shape have little bearing on breastfeeding ability
  • hypoplasic breast tissue combined with large distance between breast is correlated with insufficient lactation
  • Skin of the breast should be inspected for any abormalities
  • Skin turgor and elasticity can be assessed by gently pinching the skin
  • assess for lateral inscision scars made during breast augmantation or reduction surgery
  • an incision in the vicinity of the cutaneous branch of the fourth intercostal nerve (5 oclock position on the left breast and 7 ocolock position of the right breast) may nerve dysfunction of this nerve path innervating the areola and nipple and hinder lactation
  • Assess for areas of skin thickening or dimpling of breast or nipple, this could be signs of neoplasia
  • Assess hormonal changes and breast tissue response to these changes with questions such as `Have your breasts grown during pregnancy` and `Have you experienced any tenderness or soreness`
  • Nipple inversion should be assessed for and functional infant nursing assessment should be performed
Palpation
  • wash hands prior to assessment
  • assess nipple by compressing or palpating the areola between forefinger and thumb just behind the base of the nipple
  • Nipple retraction inwardly when stimulated may be indicative of underlying connective tissue lesions
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