A nurse is educating a pregnant client about the differences between Braxton Hicks contractions and true labor contractions.
Which statement should the nurse include?

Choice A rationale

Symmetrical breast swelling with a sudden increase in milk production is characteristic of normal postpartum breast engorgement as lactation is established, not mastitis. Mastitis is usually localized to one breast.

Choice B rationale

Swelling and redness in one breast, accompanied by flu-like symptoms such as fever, chills, and body aches, are classic signs and symptoms of mastitis, an infection or inflammation of the breast tissue.

Choice C rationale

Bilateral breast tenderness and engorgement without fever are typical findings of normal postpartum breast engorgement, which occurs due to increased blood flow and milk production. Fever is a key indicator of infection, such as mastitis.

Choice D rationale

A white patch on a nipple is more indicative of thrush (candidiasis), a fungal infection that can occur during breastfeeding, affecting the nipple and the baby's mouth. While uncomfortable, it is distinct from mastitis.

Choice A rationale

Massaging the breasts in a circular motion before and during breastfeeding can stimulate milk flow by encouraging the release of oxytocin, which triggers the milk ejection reflex (let-down). This action helps to empty the breasts more effectively, reducing pressure and relieving engorgement pain. The physical manipulation also improves circulation within the breast tissue.

Choice B rationale

Applying warm compresses to the breasts before breastfeeding helps to dilate the milk ducts, making it easier for milk to flow. The warmth also increases blood flow to the breast tissue, which can help to soften the areola and nipple, facilitating latch for the infant and easing discomfort associated with engorgement.

Choice C rationale

Frequent breastfeeding or regular pumping helps to remove milk from the breasts, which is the primary way to relieve engorgement. As milk accumulates, it causes pressure and pain. Regular emptying signals the body to regulate milk production and prevents further engorgement. Maintaining a consistent milk removal schedule is crucial.

Choice D rationale

Applying cold compresses to the breasts after breastfeeding helps to reduce swelling and inflammation. The cold temperature causes vasoconstriction, which decreases blood flow to the breast tissue, thereby alleviating pain and discomfort associated with engorgement. This is particularly helpful in between feedings.

Choice E rationale

Encouraging the client to wear a tight-fitting bra throughout the day is contraindicated for breast engorgement. Tight bras can restrict milk flow by putting pressure on the milk ducts, potentially worsening engorgement and increasing discomfort. Supportive but not restrictive bras are recommended.

Choice F rationale

Advising the client to limit fluid intake to reduce milk production is not recommended and can be harmful. Adequate hydration is essential for overall health and for maintaining milk supply. Limiting fluids will not effectively reduce engorgement and could lead to dehydration. Frequent milk removal is the key to managing engorgement.