Literature review for - Flourish Paediatrics

more frequently prior to the recurrence of severe breast engorgement. All new mothers
should also be instructed in the technique of manual breast expression.”
“Anticipatory guidance regarding the occurrence of breast engorgement should be given to all
breastfeeding mothers prior to hospital discharge. In many countries where women may have
longer hospital stays engorgement may occur in the birth hospital. However, many women
are discharged before the expected time of peak symptomatic engorgement. Mothers should
be counselled about symptomatic treatment options for pain control. Paracetamol and
ibuprofen are both safe options for nursing mothers to take in appropriate doses.
Additionally, contact information for breastfeeding supportive advice should be provided.
Healthcare personnel seeing either the newborn or mother after discharge should routinely
inquire about breast fullness and engorgement.”
PREVALENCE OF BREAST ENGORGEMNT DURING LACTATION
What is the prevalence of breast engorgement in lactating women?
Draft Evidence Statement Approximately 40% of lactating women experience
moderate-severe symptoms of breast engorgement
Draft Grade
D
Component Rating Notes
Evidence Base Poor 2 studies; 1 cohort, 1 cross-sectional (both 0)
Consistency Satisfactory Cross-sectional study found 44.2% of lactating women
experienced breast engorgement and leakage between 0
and 5 months postpartum, Cohort study found 46.5% of
women reached the very firm- very tender level (highest
rating on scale) during the first 14 days post-partum
Clinical impact Satisfactory Engorgement is common problem experienced by
breastfeeding women
Generalisability Satisfactory 1 study conducted in Hong Kong, 1 study conducted in
US
Applicability
Satisfactory Results are applicable to Australian women
The cohort study conducted in Iowa assessed engorgement in 114 breastfeeding women.
Authors developed a six point engorgement scale to determine level of engorgement, mothers
were asked to report their breast changes twice daily during the first 1-14 days postpartum.
Engorgement symptoms occurred most commonly during days 3-5 postpartum. For the
majority of women initial engorgement peaked at day 5 however for some women
engorgement symptoms did not occur until day 14. Of the women in the study 72% had some
form of breast tenderness at day 5 (Hill and Humenick 1994).
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