A woman gave birth 48 hours ago to a healthy infant girl.
She has decided to bottle feed.
During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation.
Which guidance should the nurse provide to the client at this time?

Choice A rationale

Expressing milk when bottle-feeding can stimulate further milk production, which would exacerbate the engorgement and discomfort. The goal is to discourage milk production.

Choice B rationale

While a supportive bra is generally recommended for comfort, a loose-fitting bra might not provide adequate support to reduce swelling and discomfort associated with engorgement. A firm, supportive bra is usually advised.

Choice C rationale

Cold packs cause vasoconstriction, which helps to reduce blood flow to the breasts, thereby decreasing swelling, inflammation, and pain associated with engorgement. This provides symptomatic relief without stimulating milk production.

Choice D rationale

Warm water can stimulate milk flow, which is counterproductive when trying to suppress lactation in a bottle-feeding mother experiencing engorgement. Warmth increases blood flow and can worsen swelling and discomfort.

• White blood cell count: Expected—mild leukocytosis is normal postpartum due to physiological stress.
• Blood clot size: Expected—small clots, like a pea-sized clot, are common and not concerning unless excessive bleeding occurs.
• Uterine findings: Expected—firm and midline uterus indicating effective involution.
• Lochia findings: Expected—progressing normally without signs of infection (no foul odor).
• Calf findings: Expected—a single varicose vein without tenderness or swelling is not concerning.
• Blood pressure: Expected—within normal postpartum range.