234 ) A 25-year old primi-para is evaluated for soreness in her breasts. She just started breast feeding her three day old male infant. She also reports low grade fever over the past few hours. On examination, her temperature is 99.2F. Her breasts are hard and swollen. They are warm to touch. She has pain on movement of the breast. Which of the following is the most likely cause of her clinical presentation?
A) Poor positioning of infant while feeding
B) Prolonged suckling
C) Inadequate feeding
D) Infection
E) Plugged ducts
Filed under: USMLE Test Prep | Tagged: archer obstetrics, archer pediatrics, breast feeding problems, obstetrics, usmle step 3 gynecology and obstetrics, usmle step 3 obstetrics, USMLE STEP3 PEDIATRICS |
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D
ANSWER : C
The breastfeeding problems are very common in first few days and must be differentiated from close differentials. These issues include breast engorgement, sore nipple, “normal” nipple sensitivity, infection. Breast engorgement occurs mainly because of inadequate emptying or inadequate feeding or waiting too long to initiate breast feeding. Usually occurs between 24 and 72 hours of delivery (early engorgement) , late engorgement occurs after 72 hrs. The patient in this question has delayed too long to initiate feeding
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