Postpartum breast tenderness is a common problem in obstetrics. Simple breast tenderness usually occurs 2d or 3d postpartum. Because breast milk secretion cannot be discharged in time or the postpartum mammary ducts are blocked, causing breast fullness, overfilling, and induration formation. When breast tenderness gets worse, it can also affect the mother’s arm movements. Because the breast is too full and the local skin tension is too high, the areola also hardens and the nipples become flat, making it difficult for the newborn to contain it, causing difficulty in sucking and breastfeeding problems. Mastitis may occur if left untreated. In the past, local hot compresses and milking techniques were commonly used in clinical practice, but the maternal felt abnormal pain and the results were not good. The mother easily lost confidence and was unwilling to cooperate with treatment to cause a vicious circle. Nutrient soup will aggravate breast tenderness, which will directly affect the postpartum mood of mothers and the supply of breast milk nutrition, which will also reduce the confidence of breastfeeding. In order to alleviate the pain of pregnant women with breast tenderness and enhance the confidence of breastfeeding, the undergraduate has adopted cactus external application combined with a breast pump to treat breast tenderness since October 2006 and achieved satisfactory results. The results reported below.

1 Research objects

A total of 120 women with postpartum breast pain from October 2007 to April 2009 were selected and divided into two groups according to the order of their hospitalization. There were 60 patients in the experimental group, aged 21 to 32 years, with an average of 28.2 years; breast tenderness occurred from 28 to 79 hours postpartum, with an average of 48.8 hours, 25 cases of cesarean section, and 35 cases of natural delivery; .2 to 3.9 kg, with an average of 3.6 kg. There were 60 cases in the control group, aged from 22 to 32 years, with an average of 28.5 years; breast tenderness occurred from 32 to 81 hours after delivery, with an average of 49.9 hours; 28 cases were delivered by cesarean section, and 32 cases were delivered by nature; ~ 3.8kg, with an average of 3.7kg. Both groups were those with normal judgment and normal language communication. Both pregnancy complications, nipple depression, and mastitis were excluded. Newborns have the ability to suck. There were no significant differences in age, delivery style, postpartum days, and newborn body weight between the two groups. See Table 1 for a comparison of breast tenderness and induration index before intervention in the two groups.

2 methods

Nursing interventions were performed by a designated skilled nurse after the mother was diagnosed with pure postpartum breast tenderness. After 24 hours, the pain and breast stiffness of the two groups were observed.

2.1 Experimental group

Milking was performed by the external application of a cactus combined breast pump. Take an appropriate amount of fresh cactus, wash it, smash it and smash it. After baking (preferably not hot), cover the breast in a ring shape, about 2mm thick. The areola part is not covered. The smashed cactus is sticky and can be easily fixed to On the breast, use a bra when it cannot be fixed. Apply for 10 to 15 minutes, then remove the cactus, clean the breasts with a hot towel, massage the breasts and milk with a breast pump, 4 times a day. Pay attention to clean the cactus and remove the thorns to avoid skin swelling, pain, and itching after being stabbed. Before using the external application of cactus, you should carefully check the skin around the breast for ulcers and damage. If you have the above phenomenon, you should avoid using it on the affected area, so as not to increase the pain and increase the psychological burden of the mother.

2.2 Control group

Use the traditional method to apply a hot towel to the breast with a wet towel for 10-15 minutes, then massage the breast by hand and milk it 4 times a day.

 2.3 Observation indicators

① Evaluation of breast tenderness: A digital pain assessment method [2] is used to divide a straight line into 10 segments. The left end 0 represents no pain, and the right end 10 represents the strongest pain. Let the mother choose one of the numbers that can represent her pain. The degree of pain is 1 to 4 for mild pain, 5 to 7 for moderate pain, and 8 to 10 for severe pain. ② Breast hardness is 3 degrees [3], Ⅰ degree touch like lips, normal or mild pain; Ⅱ degree touch like the nose, moderate breast pain; Ⅲ degree touch like forehead, severe pain.

2.4 Statistical processing

All the data were entered into the computer, and statistical analysis was performed using SPSS13.0 statistical software. Grade data were analyzed using Edit.

3 results

Comparison of breast tenderness and hardness scale between the two groups after the intervention (see Table 2)

4 Discussion

4.1 Chinese medicine believes that postpartum women are prone to stagnation, heat, and swelling due to liver stagnation, qi stagnation, and weakness in qi and blood. Cactus is also known as fairy palm, Guanyin palm, Guanyin thorn, Pingyao grass, etc. It contains dandelion acetone and ketone [4], three posts, malic acid, succinic acid, potassium carbonate, etc. Its taste is bitter, cold, cold Non-toxic. It is classified into three meridians of heart, lung, and stomach, and has the functions of qi and blood circulation, detoxification, swelling and pain relief [5]. It has been proved to be effective for the treatment of breast pain, mumps, bloated and other swelling and pain [6]. Prickling cactus into a paste for the external application can promote the patency of the mammary glands, increase the resistance and toughness of the breast skin, prevent nipple cracking, and stimulate the production of prolactin and the formation of ejection reflexes. Local lumps become softer and smaller. After 24 hours, breast tenderness and breast stiffness in the experimental group were significantly reduced compared with the control group (p <0.05). Maternal confidence in the external application of cactus to eliminate breast tenderness has increased, and she is happy to cooperate with the treatment.

4.2 Some studies have shown that the milking machine is more direct than milking by hand, and the amount of milk obtained is significantly increased [7]. It is clinically found that those who do not see breasts by squeezing the breasts by hand, use sucking breast pump It can be seen that milk flows out through the mammary gland duct. After being stopped, and then squeezed by hand, no milk flow is still seen. This phenomenon is common in clinical experiments. The test mothers underwent such experiments and believed that they had milk, increasing their confidence in breastfeeding. The new breast pump has the advantages of compact structure, easy operation, no power supply, strong suction power, and milk juice can be stored. Clinical observations have shown that after breastfeeding cactus, the effect of using a breast pump to clear the mammary glands is better than other methods.

4.3 Necessity of discharge guidance Because symptoms such as breast tenderness and mastitis can occur within 1 month after delivery, professional nursing staff should teach family members how to care for the breast, including hot compresses and correct massages before the mother leaves the hospital. And milking methods; those with insufficient milk, guide them to a reasonable diet, breastfeeding on demand and correct breastfeeding methods. At the same time, a doctor-patient contact card was established, a consultation phone was opened, and the breast tenderness of the discharged mothers was followed up. If there were any problems, they could seek medical treatment in time.

 4.4 This research method is simple and easy to carry out, according to local conditions, will not consume a lot of manpower and material resources, only a nurse can complete all. Because the time is short, the sample size is small, and the principle of convenient sampling is adopted, the data obtained are not comprehensive enough, and the sample size should be expanded in future research.

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