![]() ![]() My favorite “tools” in this group are the Postpartum Planning Tool and the Postpartum Healthcare Visit Checklist. This project has a very helpful Toolkit for pregnant moms to review. The University of North Carolina Jordan Institute for Families has a good set of resources for their 4th Trimester Project. Many 4th Trimester programs and medical practices are being established throughout the United States. Mothers also may be hesitant to make their needs known to a pediatrician - for fear of seeming selfish or like a bad mother. Pediatricians may not routinely screen for anxiety and depression, and visits are largely focused on infants. Despite this, women generally have only one or two visits with their ob/gyn in the first six weeks and no scheduled exams thereafter. While much attention is given to mothers during pregnancy, they actually need more support AFTER the baby arrives. The healthcare system and the American College of Obstetrics and Gynecology (ACOG) recognizes the significance of supporting new moms, infants, and families in their “4th Trimester” after birth. I also co-authored a manuscript that summarizes the application of physical therapy pain relief techniques in lactation. I developed a handout demonstrating the technique of lymphatic drainage. If this does not resolve your swelling, or if you only have one breast that is affected, you should seek evaluation with your healthcare provider. You also can perform light lymphatic drainage yourself. If you do experience symptoms, you should be evaluated by a breast specialist to ensure the changes are consistent with normal breast growth versus another process such as granulomatous mastitis (which is not caused by pregnancy or lactation, but can occur in women of childbearing age). ![]() It is also very uncommon to develop mastitis during pregnancy. Mastitis results from factors such as inflammation in the ducts, imbalance of healthy versus unhealthy bacteria, overproduction of milk, and non-physiologic milk removal such as that which occurs with pumping - NOT from external compression. It is a myth that tight fitting bras cause breast problems or mastitis after the baby is born. ![]() The first step is to obtain a very supportive bra, as tight fitting as you can handle with comfort (similar to compression stockings for your calves). This is called breast “lymphedema” (similar to swelling of ankles when sitting for too long). Significant breast growth can be painful, and cause the lower parts of the breasts to swell and develop a pink or reddish color. ![]()
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