Breast Assessment

Question 1

Inspection- size

Answer 1

• looking for IGT or hypoplasia - infant intake will be closely monitored
• large breasts - help with different positioning (semi-reclining), maintaining latch and open airway, finding a well fitting bra

Question 2

Inspection - symmetry

Answer 2

• small deviations are normal

- large variations may signal IGT

Question 3

Inspection - shape

Answer 3

• wide spacing between breasts
• dog-eared appeared
• thin tubular breasts
• prior breast surgeries- lateral incision at areolar margin where 4th intercostal nerve hits the skin
• dimpling,thickening - sign of tumor

Question 4

Scar tissue on breast

1. Causes
2. Effect

Answer 4

1. Burns, surgery, etc
2. Does not affect parenchymal tissue, but can affect sensitivity and elasticity requiring different positionings at breast, and decreased milk ejection

Question 5

Pinch test

Answer 5

Applying pressure between thumb and forefinger at bast of nipple

• will express milk
• will show action of nipple when compressed by baby’s mouth
• everted nipple can become inverted, or vice versa
• perform periodically throughout pregnancy

Question 6

Nipple function as seen with pinch test

1. Protraction
2. Retraction
3. Inversion

Answer 6

1. Protracting-
2. Retraction
   - minimal -infant with strong suck can pull nipple forward
   - moderate to severe - nipple retracts to level of areola or behind - intervention may be helpful to stretch nipple outward
3. Inversion - visual inspection shows all or part of nipple pulled behind areola
   - Simple - nipple moves outward to protraction with manual pressure
   - Complete - nipple does not respond to pressure due to adhesions