When the inflammation so far progresses as to require that the breast be opened and drained, the subsequent nursing care will be outlined by the doctor to meet the needs of each case. It is a painful operation and often a serious one, for the destruction of breast tissue may be extensive enough to render the breasts valueless as milk-producing organs. The healing is slow and altogether the occurrence is a most lamentable one.
Fig. 126.—Y bandage in Fig. [125] seen from the opposite side.
The nurse’s part in preventing this complication is cleanliness and gentleness in her attentions; unremitting watchfulness; immediate application of a suspensory bandage and either heat or cold, upon the first sign of engorgement and prompt reporting to the doctor.
Fig. 127.—Indian Binder used at The Montreal Maternity Hospital for supporting heavy breasts. The tapering ends tie in a knot in front.
If the patient’s nipples have not been toughened during pregnancy or if flat or retracted nipples have not been satisfactorily brought out, it may be necessary for the nurse to employ the treatment to these ends which were described in the chapter on pre-natal care. In the meantime the baby may have to nurse through a shield until the nipple is brought out prominently enough for him to grasp it well.
Stripping. Sometimes in cases of depressed nipples, which the baby cannot grasp, or when the baby is too feeble, to nurse at the breast, milk is withdrawn from the breast by means of so-called “stripping.” The nurse should scrub her hands thoroughly with hot water and soap and dry them on a sterile towel before beginning. The breast is grasped by placing the thumb and forefinger of the right hand on the areola on opposite sides of the nipple but well below it. The nipple is then raised from the breast by a quick, lifting and rolling motion of the thumb and finger, accompanied by slight pressure. A sterile medicine glass should be held in position to receive the milk which spurts from the nipple, but the glass should not touch the breast. (Fig. [128].)
Fig. 128.—Position of thumb and finger below nipple on areola, in stripping breasts. (From photograph taken at The Long Island College Hospital.)