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  3. Managing Engorgement and Preventing Blocked Ducts
Course Content
Why Breastfeeding Matters (10 minutes)
Health and developmental benefits for infants Maternal benefits (physical and mental) Economic and community-level advantages Common myths and culturally specific misconceptions
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Health & Developmental Benefits for Infants from Breastfeeding
Maternal Benefits of Breastfeeding (Physical and Mental)
Economic and Community-Level Advantages of Breastfeeding
Common Myths and Culturally Specific Misconceptions about Breastfeeding
Newborn Feeding Cues & Anatomy (20 minutes)
Early vs. late hunger cues and what they mean Normal newborn feeding patterns and stomach capacity Brief breast anatomy (lobes, ducts, nipple, areola) in plain language Signs of effective feeding (swallowing, contentment, diaper output)
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Early vs. Late Hunger Cues in Infants
Normal Newborn Feeding Patterns and Stomach Capacity
Breast Anatomy (in Plain Language)
Signs of Effective Feeding in Breastfed Babies
Positions & Achieving a Good Latch (40 minutes)
Position options: cradle, cross-cradle, football/clutch, side-lying Stepwise approach to help baby latch (prepare — attach — assess) Signs of a good vs. poor latch (comfort, nipple shape, audible swallowing) Small-person adaptations (premature, small mouth, tongue-tie considerations) Safe positioning for mothers with C-section recovery
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Position Options for Breastfeeding
Stepwise Approach to Help Baby Latch
Signs of a Good vs. Poor Latch
Small-Person Adaptations in Breastfeeding
Safe Positioning for Mothers with C-Section Recovery
Protecting & Building Milk Supply (25 minutes)
Establishing supply in the first days and weeks (frequency, skin-to-skin) Night feeds and cluster feeding explained Lifestyle and medical factors that reduce supply (e.g., certain medications, stress) Relactation and increasing milk supply safely Nutrition and hydration myths vs. evidence
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Establishing Milk Supply in the First Days and Weeks
Night Feeds and Cluster Feeding
Lifestyle and Medical Factors That Reduce Supply
Relactation and Increasing Milk Supply Safely
Nutrition and Hydration Myths vs. Evidence in Breastfeeding
Expressing & Storing Breastmilk (20 minutes)
Hand-expression steps and common mistakes Choosing and using pumps (manual vs. electric) — practical tips Safe collection, labeling, storage, thawing and warming guidelines (low-resource options included) Cleaning and hygiene for bottles and storage containers Feeding expressed milk to infant (cup, spoon, paladai, bottle considerations)
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Hand-Expression Steps and Common Mistakes
Choosing and Using Breast Pumps (Manual vs. Electric)
Safe Breast Milk Handling
Cleaning and Hygiene for Bottles and Storage Containers
Feeding Expressed Milk to Infants
Common Problems & Practical Solutions (25 minutes)
Causes of sore nipples and immediate relief techniques Managing engorgement and preventing blocked ducts Recognising mastitis vs. normal engorgement and when antibiotics may be needed Low weight gain: assessment steps and feeding plan adjustments Non-judgmental approach to supplementation and safe short-term options
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Causes of Sore Nipples and Immediate Relief
Managing Engorgement and Preventing Blocked Ducts
Recognising Mastitis vs. Normal Engorgement
Low Weight Gain — Assessment and Feeding Plan Adjustments
Non-Judgmental Approach to Supplementation
Returning to Work or School; Feeding Outside the Home (15 minutes)
Creating an express-and-feed routine (timing, containers, transport) Practical storage and transport tips for different commute types Rights and workplace basics (general guidance; encourage local legal verification) Communicating with caregivers and preparing safe feeder notes Emotional coping and practical fallback plans
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Creating an Express-and-Feed Routine
Practical Storage & Transport Tips for Expressed Breast Milk by Commute Type
Rights and Workplace Basics for Breastfeeding Mothers
Communicating with Caregivers and Preparing Safe Feeder Notes
Emotional Coping and Practical Fallback Plans
Special Situations (20 minutes)
Feeding preterm or low-birthweight infants: kangaroo care, cup or tube feeding basics Managing twins/multiples: tandem feeding tips and time-saving routines Mothers on medication or with infectious illness: how to check drug safety and local guidelines (HIV, TB, etc.) Using donor milk or milk banks (where available) — safety basics
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Feeding Preterm or Low-Birthweight Infants
Managing Twins/Multiples — Tandem Feeding Tips and Time-Saving Routines
Mothers on Medication or with Infectious Illness — Drug Safety & Guidelines
Using Donor Milk or Milk Banks — Safety Basics
When to Seek Help & Building a Support Network (15 minutes)
Red flags for baby and mother (e.g., poor weight gain, fever, severe pain) Where to seek help: clinic, CHW, lactation consultant, emergency care Building a support network: partners, family, peer counsellors, community groups Using telephone/text supports, community groups, and referral pathways
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Red Flags for Baby and Mother
Where to Seek Help for Breastfeeding Challenges
Building a Support Network for Breastfeeding Mothers
Using Telephone/Text Supports, Community Groups, and Referral Pathways
Wrap-up, Resources & Final Assessment (15 minutes)
Key takeaways and common pitfalls to avoid Next steps: seeking local support, advanced training options How to use course materials beyond the course (groups, sharing, peer support) Final 20-question multiple-choice quiz (80% pass mark)
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Key Takeaways and Common Pitfalls to Avoid
Next Steps — Seeking Local Support & Advanced Training Options
How to Use Course Materials Beyond the Course
Final 20-question multiple-choice quiz (80% pass mark)
How to Breastfeed — Self-Paced, Evidence-Based Course for African Moms

Introduction

Engorgement and blocked ducts are common in the early weeks of breastfeeding. They cause discomfort, can reduce milk flow, and may progress to mastitis if not managed well. With simple, effective steps, mothers can relieve symptoms and prevent complications.

1. What is Breast Engorgement?

  • Definition: Painful swelling of the breasts when they are overly full of milk, blood, and fluid.

  • When it happens: Usually in the first week when milk “comes in,” or anytime milk is not removed often enough.

  • Symptoms:

    • Hard, swollen, shiny breasts.

    • Flattened nipples (making latching harder).

    • Tenderness, warmth, or throbbing pain.

2. What are Blocked Ducts?

  • Definition: A milk duct becomes narrowed or clogged, slowing milk flow.

  • Symptoms:

    • Small, hard lump in breast.

    • Pain or burning in one area.

    • No fever (unlike mastitis).

  • Causes: Infrequent feeds, tight bras/clothes, poor latch, stress.

3. Managing Engorgement

  • Frequent breastfeeding: Feed at least 8–12 times per 24 hours.

  • Good latch: Ensures milk is removed effectively.

  • Hand-express or pump briefly: Soften breast before feeding to help baby latch.

  • Warm compress or gentle massage before feeding: Helps milk let-down.

  • Cold compress after feeding: Reduces swelling and pain.

  • Cabbage leaves (folk method with some evidence): Chilled cabbage leaves inside bra can ease swelling.

4. Preventing and Managing Blocked Ducts

  • Frequent, effective feeding: Most important prevention.

  • Change positions: Vary holds so all areas of breast drain well.

  • Massage during feeds: Gently stroke toward nipple over the lump.

  • Avoid tight clothing/bras.

  • Rest and hydration: Reduces risk of inflammation.

  • If lump persists >48 hrs or fever develops: May be mastitis → seek medical help.

5. Common Mistakes to Avoid

  • Skipping or delaying feeds.

  • Binding breasts tightly (worsens swelling and clogs ducts).

  • Over-pumping (can increase engorgement by overstimulating supply).

  • Ignoring lumps — can progress to infection.

End of Lecture Quiz

Q1. Which of the following is NOT a good method for relieving engorgement?
A. Feeding frequently
B. Wearing a very tight bra
C. Hand-expressing to soften nipple
D. Warm compress before feeding

Answer: B. Wearing a very tight bra
Rationale: Tight bras worsen engorgement and can cause blocked ducts.

Q2. True or False: A blocked duct usually causes fever.
Answer: False
Rationale: Blocked ducts cause localized pain/lump without fever; fever suggests mastitis.

Q3. What is the best way to prevent blocked ducts?
A. Skip feeds occasionally
B. Feed frequently and ensure good latch
C. Avoid changing feeding positions
D. Use strong painkillers only

Answer: B. Feed frequently and ensure good latch
Rationale: Effective, regular emptying of the breast prevents clogs.

Curated Online Resources

Key Takeaways

  • Engorgement is common early on but manageable with frequent, effective feeding.

  • Blocked ducts usually mean a painful lump without fever — relieve with feeding, massage, and position changes.

  • Warm before, cold after feeding provides comfort and flow.

  • Ignored lumps or ongoing pain may progress to mastitis → seek help early.

Call to Action

  • Mothers: Don’t suffer in silence — ask for help if pain persists beyond a day or two.

  • Health workers: Teach prevention early, especially around milk “coming in.”

  • Communities: Support mothers with time and space to breastfeed often — it protects both mother and baby.

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