Implementation of an education package on breast engorgement aimed at lactation consultants and midwives to prevent conflicting information for postnatal mothers.

AIM: The aim of this evidence-based practice project was to improve local practice in the treatment of breast engorgement in postnatal mothers and to ensure the treatment of engorgement in postnatal mothers is performed according to the best available evidence. METHODS: This evidence-based practice project took place in a 28-bed postnatal ward in a large metropolitan tertiary hospital. Twenty midwives and 20 in-patients were recruited for the project. The project utilized an audit and feedback design. Midwives were asked a series of questions to test their knowledge on engorgement, and mothers were asked questions relating to the breastfeeding and engorgement care they received. The project was conducted in three phases: preparation for quality audit, implementation of best practice and postimplementation audit. RESULTS: Comparison of Audit 1 (preimplementation) and Audit 2 (postimplementation) results shows significant improvements in all eight audit criteria. An increase of 80% was achieved for the criteria 'midwives received formal education on engorgement' on completion of the project. A 20% increase in 'consistency of education regarding latch' was reported by the mothers, and there was a 30% increase in 'information given to mothers on prevention and signs of engorgement'. Sixty-five percent of midwives were able to correctly identify and manage engorgement, a significant improvement from 5% at baseline. CONCLUSION: This evidence-based practice project successfully identified and utilized best practice in the management of breast engorgement care in mothers in our clinical setting. With effective breast engorgement interventions in place, mothers could continue to successfully breastfeed their babies. The major challenges identified during the conduct of the project included: time constraints on the midwives to attend education sessions and to educate mothers on prevention. At the completion of this project, a closer relationship was forged between the lactation consultant team and the midwives in the project setting. This increased the satisfaction and productivity of the midwives, and motivated them to deliver high-quality care, which contributed to an improvement in mother's confidence and reduction in conflicting information.

[Study of an antioxidant dietary supplement "Karinat" in patients with benign breast disease]. / Izuchenie antioksidantnoi biologicheski aktivnoi dobavki k pishche "Karinat" u bol'nykh s fibroadenomatozom molochnykh zhelez.

A randomized double blind placebo-controlled trial of efficiency of a dietary supplement "Karinat" in patients with benign breast disease was carried out. Karinat contains beta-carotene 2.5 mg, alpha-tocopherol 5 mg, ascorbic acid 30 mg and garlic powder 150 mg per one tablet. Out of 66 patients, 33 patients were given karinat, 33 were given placebo. The patients reccived a tablet of karinal or placebo twice a day during 6 months. Examinations of the patients included clinical estimation of symptoms of mastopathy and dysalgomenorrhea, breast sonography and mammography. It was found that karinat reduced the severity of mastalgia, premenstrual syndrome, dysmenorrhea and algomenorrhea and caused regression of palpable symptoms of the breast fibromatosis. On the whole karinat had positive action in 75.8% that was significantly greater by 45.5% as compared with placebo. Karinat may be useful for the treatment of patients with benign breast disease.

Trifolium pratense for breast disease: a case series.

A series of cases in which Trifolium pratense was used in breast disease with hyperoestrogenic symptoms is reported. Several patients with cystic mastosis and breast cancer appeared to do well. The 'picture' of Trifolium is discussed.

Promoting gynecologic health in young and middle-age women.

A holistic approach to gynecologic health addresses more than the physical problems associated with the reproductive organs and breasts. The article presents information about selected gynecologic health issues for young and middle-age women (17 to 60 years) in a context that considers other aspects of the client, such as the woman's age, life style, health behaviors, culture and ethnicity, and education. Strategies to promote gynecologic health are discussed in relation to these aspects.

Carotenoids in cancer, mastalgia, and AIDS: prevention and treatment--an overview.

In 1980, two carotenoids, beta-carotene (BC) and canthaxanthine (CX) with and without pro-vitamin A activity, respectively, were orally administered to female Swiss albino mice and were found to substantially prevent skin carcinogenesis induced by benzo(a)pyrene (BP). This preventive effect was observed in darkness by means of photocarcinogenic enhancement (PCE) following UV (300 to 400 nm) irradiation. In 1984, the same experiment produced antitumorigenic activity when applied to breast carcinogenesis induced in mice by 8-methoxypsoralen (8-MOP) plus UV-A light and, in 1985, when directed toward gastric carcinogenesis induced in rats by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). These data suggested a rationale for human intervention to prevent, by carotenoid supplementation, a second primary malignancy after the primary malignancy has been radically excised. In the 1980s, a pilot clinical study (15 cases) showed a longer than expected disease-free interval in all surviving patients. It was also subsequently found that, if treated daily with 20 mg of BC and intermittently with retinol 150 to 300,000 IU daily for seven days just prior to menses, women suffering from cyclical mastalgia were relieved from pain, without any toxic side effects. When BC was given in high daily doses (60 mg) to 60 drug addicts suffering from AIDS-related complex (ARC), they recovered from their objective and subjective symptoms (but not from lymphadenopathy) with improvement in their general health and increased performance status. At higher doses, BC (with or without hyperthermia) was effective even in patients in advanced stages of AIDS. A debate has arisen concerning a recent statement by the U.S. Government that "beta-carotene supplements do not protect Americans against cancer or heart disease, and may actually increase the risk of deadly lung tumors in smokers".

Preparación de pezones con calostro materno para prevenir problemas mamarios Centro Universitario de Salud Pedro P.Díaz 1995

El presente estudio, se realizó en el C.U.S.P.P.D. durante los meses de marzo, abril y mayo de 1995, en primigestas del octavo mes de embarazo con pezones normales y presencia de calostro tomando como muestra 70 primigestas distribuidas en; grupo experimental y grupo control. El objetivo de este estudio fue: establecer la influencia de la preparación de pezones lubricados con calostro materno para la prevención de irritación, grietas, ductos bloqueados y mastitis en el primer mes de lactancia materna. Para el fortalecimiento de la piel de los pezones se utilizó el calostro materno producto natural económico, accesible, eficiente por su contenido de vitamina "A". Por lo tanto se propuso comprobar o rechazar la hipótesis que dice: La preparación de pezones con lubricación de calostro materno influye en la prevención de problemas mamarios en el primer mes de lactancia materna. Para la recolección de la información se utilizó los siguientes instrumentos: Guía de entrevista prenatal, guía de entrevista post-natal, guía de preparación de pezones, guía de observación. Por tratarse de un estudio cuasi-experimental con diseño de dos grupos equivalentes se utilizó el ji cuadrado para descartar diferencias significativas con ambos grupos y para el análisis estadístico de comprobación de hipótesis, expresando los resultados en 11 cuadros y 2 tablas. Según los resultados del estudio muestra que el grupo control tiene mayor número de madres afectadas en un 82.9 por ciento, asimismo muestra que el promedio de problemas es de uno a más. A diferencia del grupo experimental que sólo un 37.1 por ciento presentaron un solo problema que es irritación de los pezones lubricados con calostro evita los problemas mamarios en el primer mes de lactancia. Además muestra que la preparación de pezones con lubricación de calostro influye en la lactancia materna ya que el 100 por ciento del grupo experimental que recibieron preparación continuaron la lactancia materna exclusiva a diferencia del grupo control en donde se identificó el 24.1 por ciento suspendieron la lactancia materna. Se demostró que la preparación de pezones lubricados con calostro materno evita los problemas mamarios y contribuye en el mantenimiento de la lactancia materna exclusiva.