BACKGROUND: During the postpartum period, breast engorgement in preparation for lactation may trigger the onset of vulvar labial nodules that present with pain and discomfort. These labial nodules may originate from ectopic breast tissue and can rarely present in women during the postpartum period in the labia majora.
METHODS: A 37-year-old African American female, gravida 1 para 1, presented to the Loma Linda University Medical Center with complaints of new onset labial swelling worsening 6 days following her full term spontaneous vaginal delivery. Additionally, our respondent complained of difficulty breastfeeding due to intermittent lack of milk production. She reported bilateral breast engorgement with tenderness, despite frequent attempts at breastfeeding. The respondent\'s presentation did not meet the criteria for other common differentials due to the physical characteristics of the nodules. The location of the nodules along the milk line led physicians to believe that the respondent was presenting with engorged extra-mammary breast tissue in the labia majora.
RESULTS: The participant was told to observe her course over the next few days as she began to have milk production and ejection. The respondent was seen in clinic for her 6-week postpartum visit, and was no longer complaining of difficulty with breastfeeding. The labial nodules had resolved spontaneously.
CONCLUSIONS: A literature search yielded no case reports that described a case of an extra-mammary vulvar mass that self-resolved with resolution of breast engorgement. The infrequent presentation of extra-mammary vulvar tissue makes it difficult to conclude a guideline for diagnosis and management.

Dysphoric milk ejection reflex (D-MER) is characterized by an abrupt dysphoria, or undesirable feeling that occurs with the MER and continues for no more than a few minutes. After milk ejection, the dysphoria vanishes.
This case series provides a report of three women who have experienced D-MER. All three women described the sudden onset of negative feelings at the initiation of each breastfeeding session. The dysphoria vanished after each milk ejection.
Literature on D-MER is limited to one published qualitative research study and two published case reports. As a result, lactation professionals and other providers in the healthcare setting rarely recognize this condition.
The case studies presented here provide evidence for the presence of D-MER. Research is needed to better understand its pathophysiology, incidence, and treatment options.

暂无摘要。

BACKGROUND: Milk production is under the influence of autocrine control such that the rate of milk synthesis decreases as the breast fills with milk. Effective elimination of milk from the alveoli via the milk ejection reflex will therefore result in increased milk synthesis. It has been assumed that milk ejection occurs in all alveoli simultaneously; however, animal studies have indicated that full alveoli eject milk sooner than less full alveoli, suggesting heterogeneous emptying of the mammary gland.
OBJECTIVE: The aim of this study was to determine whether milk ejection occurs asynchronously in the human lactating breast.
METHODS: Retrospective analysis of videos made of ultrasound monitoring of milk ducts during pumping. Six video clips (4 women) of ultrasound monitored milk ejections showed obvious differences in the timing of milk flow between different main milk ducts. Duct diameter was simultaneously measured every second in 2 different ducts that drained 2 separate lobes of the breast.
RESULTS: For 5 of 6 ultrasound duct monitoring sessions, both duct dilation and visualization of milk flow in the 2 separate main milk ducts differed by 2 to 8 seconds. For the remaining woman, milk was observed to eject from 1 part of the lobe, and when not removed, it flowed in a retrograde fashion into a different part of the lobe.
CONCLUSIONS: Asynchrony of milk ejection occurs in the human lactating breast, suggesting that the timing of myoepithelial cell response differs, resulting in heterogeneous emptying of the gland.

BACKGROUND: The purpose of this study was to identify potential predisposing factors associated with human infectious mastitis.
METHODS: We conducted a case-control study among breastfeeding women, with 368 cases (women with mastitis) and 148 controls. Data were collected by a questionnaire designed to obtain retrospective information about several factors related to medical history of mother and infant, different aspects of pregnancy, delivery and postpartum, and breastfeeding practices that could be involved in mastitis. Bivariate analyses and multivariate logistic regression model were used to examine the relationship between mastitis and these factors.
RESULTS: The variables significantly- and independently-associated with mastitis were cracked nipples (P < 0.0001), oral antibiotics during breastfeeding (P < 0.0001), breast pumps (P < 0.0001), topical antifungal medication during breastfeeding (P = 0.0009), mastitis in previous lactations (P = 0.0014), breast milk coming in later than 24 h postpartum (P = 0.0016), history of mastitis in the family (P = 0.0028), mother-infant separation longer than 24 h (P = 0.0027), cream on nipples (P = 0.0228) and throat infection (P = 0.0224).
CONCLUSIONS: Valuable factors related to an increased risk of infectious mastitis have been identified. This knowledge will allow practitioners to provide appropriate management advice about modifiable risk factors, such as the use of pumps or inappropriate medication. They also could identify before delivery those women at an increased risk of developing mastitis, such as those having a familial history of mastitis, and thus develop strategies to prevent this condition.

Dysphoric milk ejection reflex (D-MER) results in waves of negative emotions that last from shortly before initial milk ejection until baby starts to feed vigorously Symptoms may decrease by 3 months or they may continue throughout the breastfeeding period. This report is a case study of an Australian mother who experienced D-MER with her fourth child.

暂无摘要。

Breast pumps are medical devices used to express milk and maintain the milk supply. The purpose of this study was to characterize adverse events reported to the United States Food and Drug Administration (FDA) on breast pumps. Thirty-seven adverse event reports on breast pumps were identified from the Manufacturer and User Facility Device Experience database between 1992 and 2003. Four additional reports were found in the Device Experience Network database from 1992 to 1996. The most commonly reported adverse events for electric breast pumps were pain, soreness, or discomfort; the need for medical intervention; and breast tissue damage. Most frequently reported problems for manual breast pumps were breast tissue damage and infection. Contamination of breast milk during pumping was also reported. Breast pump adverse events are likely underreported to the FDA. Reporting adverse events is important for improving the design and manufacture of breast pumps and subsequently decreasing adverse events.

Cases of sixteen sows treated for lactation failure in piggery farms in Ibadan are reported. Fifteen of them had no complication of mastitis or mammary gland teat blockade. The fifteen uncomplicated cases responded favourably to the treatment with oxytocin (15-20 I. U. per sow). Only two cases needed second treatment with oxytocin due to poor sustenance of flow from only one treatment. Milk flow was achieved in less than 5 minutes in all the treated sows after the intramuscular injection of the drug. The only sow with accompanying acute mastitis responded favourably to procaine penicillin injection. Early diagnosis and treatment of agalactia are important in the prevention and control of baby pig mortality. The favourable response of these sow lactation failures to treatment with oxytocin, confirms the hormonal imbalance as one of the major factors to be considered in the unknown aetiology of lactation failure or failure of milk ejection reflex.

Expressed breast milk used to feed preterm infants is precious and so, despite heterogeneity of composition, all available milk is used. A study of 274 samples of expressed breast milk supplied by preterm mothers and National Childbirth Trust donors showed pronounced variation in fat content as measured by the \"creamatocrit\" method. This was not due to differences between term and preterm mothers or between transitional and mature milk. The composition was affected by diurnal variation and method of collection. Substantial amounts of fat were also wasted as a result of continuous nasogastric feeding. Several milk samples did not contain enough fat to supply even a fraction of the recommended energy requirements of these infants. Some type of quality control over samples of expressed breast milk is clearly essential. The creamatocrit method is simple and feasible.