Nursing Component Task
Nursing procedures & clinical learning

Midwifery (RM)

Breast Examination of a Pregnant Woman/Client

Breast examination assesses normal pregnancy changes, nipple condition, masses, tenderness, infection, skin changes, and readiness for breastfeeding. The examination is performed with consent, privacy, sensitivity, and referral of abnormal findings.

Purpose

  • Assess breast and nipple health during pregnancy
  • Identify problems that may affect breastfeeding or require investigation
  • Provide education and reassurance about normal changes

Indications

  • Antenatal breast assessment
  • Breast pain, lump, discharge, skin change, or nipple concern
  • Preparation for breastfeeding and health education

Equipment

  • Private examination room and drapes
  • Gloves if contact with secretions or broken skin is expected
  • Good light
  • Hand-hygiene supplies
  • Antenatal record and referral materials

Preparation

  • Ensure good lighting and a private room.
  • Review relevant history and explain that the woman can stop the examination at any time.

Procedure steps

  • Explain the purpose and intimate nature of the examination, obtain consent, and offer a chaperone according to policy.
  • Ensure privacy, ask about pain, previous surgery, breastfeeding history, lumps, discharge, and family history.
  • Inspect both breasts with the woman’s arms relaxed, raised, and pressed against the hips for asymmetry, skin, veins, scars, and retraction.
  • Inspect nipples for shape, fissures, inversion, discharge, lesions, or infection without unnecessary manipulation.
  • Palpate systematically with consent, including breast tissue and axillary areas, noting a mass, tenderness, warmth, or nodes.
  • Do not squeeze the nipple routinely; collect or test discharge only when clinically indicated and authorized.
  • Explain normal pregnancy changes and assess breastfeeding questions or concerns.
  • Escalate a suspicious mass, bloody discharge, infection, skin retraction, severe pain, or persistent abnormality.
  • Help the woman dress and provide emotional support.
  • Document consent, findings, education, referrals, and follow-up.

Precautions

  • Preserve privacy and use a chaperone where required or requested.
  • Do not dismiss a new or persistent lump as a normal pregnancy change.
  • Avoid unnecessary nipple manipulation and follow referral protocols for abnormal findings.
  • Use gloves for broken skin, body-fluid exposure, or infection risk.

Aftercare

  • Explain when and where follow-up will occur.
  • Provide breastfeeding support or specialist referral when needed.

Nursing considerations

  • Use culturally sensitive, trauma-informed care and respect bodily autonomy.
  • Coordinate imaging or specialist review through the authorized pathway.

Patient education

  • Explain normal breast changes and the importance of reporting a new lump, persistent pain, bloody discharge, or infection.
  • Discuss breastfeeding preparation without recommending harmful nipple manipulation.

Documentation

  • Record examination findings, breast or nipple symptoms, education, chaperone, referrals, and plan.
  • Document urgent escalation and the woman’s response.

References and further reading

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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