Exhibits

Which education by the nurse will help resolve the issue for the client? Select all that apply.

A.    Wear an underwire bra around the clock. Tight-fitting bras, especially underwire bras, can contribute to milk stasis by restricting milk flow and increasing the risk of clogged ducts. Instead, the client should wear a well-fitted, supportive bra without underwire to promote comfort and adequate milk drainage.
B.    Apply warm compresses to affected area before feeding. Warm compresses help increase circulation, promote milk let-down, and relieve pain in cases of mastitis. Applying warmth before breastfeeding can help soften the breast and improve milk flow, reducing milk stasis.
C.    Pump breasts if feeding will be missed, due to absence from the infant. Milk stasis occurs when the breast is not emptied regularly, increasing the risk of mastitis. Pumping or hand-expressing milk when unable to breastfeed prevents engorgement and reduces the likelihood of infection.
D.    Pump breastmilk and feed it to infant instead of nursing. Direct breastfeeding is preferred unless the pain is too severe or an abscess has formed. Pumping can be beneficial to relieve engorgement, but exclusive pumping is not necessary in mastitis unless advised by a healthcare provider. Continued direct breastfeeding helps clear infection by draining the affected breast.
E.    Finish antibiotics even if symptoms improve. Mastitis is commonly treated with antibiotics, and completing the full course prevents recurrence and antibiotic resistance. Stopping antibiotics early can lead to incomplete eradication of bacteria and persistent infection.
F.    Maintain activity due to the risk of blood clots with extra rest. Rest is essential for recovery from infection, and while postpartum clients have a slightly higher risk for blood clots, moderate rest should be encouraged. The client should engage in light activity as tolerated but should not avoid rest, as fatigue can contribute to a weakened immune response.
G.    Wash hands before handling the breast. Mastitis can be caused by bacterial contamination from the skin, baby’s mouth, or hands. Proper hand hygiene before breastfeeding or pumping reduces the risk of introducing bacteria into milk ducts and worsening the infection.
H.    Start infant on the unaffected side, so there is less pain when infant is the hungriest. Babies suck more vigorously at the beginning of a feeding. Starting on the unaffected side reduces pain and discomfort in the affected breast while ensuring the infant is still able to empty both breasts adequately.
I.    Vary breastfeeding positions at each feeding. Different nursing positions help ensure all milk ducts are effectively drained, reducing the risk of continued milk stasis. Positions such as cradle hold, football hold, or side-lying nursing can improve drainage in different areas of the breast.