DOCSLIB.ORG

Overcoming Breastfeeding Concerns

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Overcoming Breastfeeding Concerns 9/21/2018 OVERCOMING BREASTFEEDING Presented by: CONCERNS- PART 1 Kary Johnson, IBCLC OVERVIEW • Latch Difficulties • Pain • Tongue Tie • Flat/Inverted Nipples • Engorgement • Mastitis 1 9/21/2018 LATCH DIFFICULTIES Goal is to preserve and protect the milk supply! • Remember, some newborns require additional time to recover from birth effects. • Why is this? (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013; WILSON-CLAY & HOOVER, 2005) LATCH DIFFICULTIES Interventions if newborn has not/is not latching effectively in the first 24 hours: • Promote frequent, uninterrupted skin to skin. • Attempt to breastfeed during quiet, alert times, whenever the infant is cueing or at least every 3 hours. • Limit attempts to 10 minutes or stop when infant gives negative cues. • Crying • Pushing away • Demonstrates withdrawal or avoidance behaviors - hiccupping, coughing, gagging, sneezing • If occurs, calm the infant and attempt later. (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) 2 9/21/2018 LATCH DIFFICULTIES • Avoid activities immediately prior to a feeding that can disrupt attachment reflexes. What activities might do this? • Encourage mother to perform breast massage and hand express colostrum on her nipple and baby’s mouth during attempts. • Encourage patience, practice and persistence. (MANNEL ET AL., 2013) LATCH DIFFICULTIES If the baby continues to feed poorly: • Continue to perform breast massage and hand expression with each attempt. • Assist in obtaining a quality, double electric breast pump for use until the baby latches and breastfeeds effectively. • Encourage the mother to express milk: •A minimum of 8 times daily •For 15 minutes until milk flow stops •Manually to completely empty the breast •Consistently, even during the night (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) 3 9/21/2018 PAIN Pain is the #1 reason why mother’s quit breastfeeding 4 9/21/2018 PAIN – WHAT’S NORMAL? • Nipple tenderness is normal in pregnancy and early postpartum due to heightened nipple sensitivity. •Peaks on days 3-6 postpartum and is relieved when milk volume increases. • Mothers feel discomfort as collagen fibers are stretched with early sucking. •Decreases as nipple flexibility increases. • Increased vascularity of the nipple can occur with a good latch, still resulting in tenderness. (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) PAIN – WHAT’S NORMAL? Transient Nipple Soreness: • Many mothers are told breastfeeding should not be painful, but often experience pain early on. • Initial tenderness that resolves within the 1st week postpartum • Occurs with initial latch and resolves after the first few sucks (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) 5 9/21/2018 PAIN – WHAT’S NOT NORMAL? • Any severe nipple pain is NOT normal including: • discomfort that last longer than 1 week • discomfort felt throughout a feeding • There is no association between nipple pain and skin color, hair color, prenatal preparation, or limiting sucking time at the breast. • Pain during a feeding is most commonly a result of incorrect latch. (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) PAIN Assess: • Pain quantity • Pain type • Nipple Appearance • Latch & Positioning • Infant’s oral anatomy Picture source: https://www.momjunction.com/articles/breastfeeding-memes-to-get-you-through-that-nursing-session_00441453/ (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) 6 9/21/2018 NIPPLE APPEARANCE • Intact • Cracked • Pinched • Abraded • Creased • Bleeding • Scabbed • Bruised (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013; WILSON-CLAY & HOOVER, 2005) GENERAL PAIN MANAGEMENT • Go back to the basic latch techniques • Skin to skin before latching The goal is to • Manual expression of milk before latching continue • Feed on least sore breast first breastfeeding • Apply colostrum to nipples and air dry after while making it feeding less painful! • Lanolin or Soothies (gel pads) for comfort • Do not use simultaneously • For cracks/open wounds, a polysporin cream may be needed – MD order 7 9/21/2018 TONGUE TIE - ANKYLOGLOSSIA • Should be routinely assessed for on all newborns • Thin membrane that attaches the tongue to the floor of the mouth • Appears as a “heart shape” of the tongue Results in: Management: • Decrease in tongue peristalsis • Use a semi-reclined position • Reduced milk transfer • Difficult achieving or maintaining latch • Compress the breast when latching • Nipple pain and/or trauma • Notify MD for treatment & referral • Long, ineffective feedings • Frenotomy (ACADEMY OF BREASTFEEDING MEDICINE, N.D.; WILSON-CLAY & HOOVER, 2005) FLAT OR INVERTED NIPPLES • Perform the “nipple pinch test” to determine nipple type • Flat or short shanked nipple: • very short to no shank or erectness • Inverted nipple: •More rare, retract at rest and with stimulation (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013; WILSON-CLAY & HOOVER, 2005) 8 9/21/2018 FLAT/INVERTED NIPPLE MANAGEMENT • Assess latch and need for intervention, if any. • Manually roll the nipple to stimulate nipples to evert. • Pump breast for 1-2 minutes before latching. • If infant still will not latch or cannot maintain latch, consult an IBCLC for nipple shield application, sizing and use. (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) BREAST SHELLS • Indications: • Flat or inverted nipples • Sore nipples • How often are they used? • Limited and insufficient data on effectiveness (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) 9 9/21/2018 NIPPLE SHIELD Nipple shields are not a first line intervention and should not be used to prevent or manage nipple pain. (WILSON-CLAY & HOOVER, 2005) NIPPLE SHIELD Appropriate uses include: • Infants with decreased muscle strength/tone (late preterm, SGA) • Short tongue • Tongue tie • High palate • Flat/inverted nipples • Transition to breastfeeding from a bottle • Cleft lip/palate • NICU: small oral cavity, ineffective suck (LAUWERS & SWISHER, 2016) 10 9/21/2018 NIPPLE SHIELD CONSIDERATIONS • Material • Design • Size • Placement • Application • Weaning • Care/Cleaning http://www.breastfeedingmaterials.com/vid eo/J8DB74-nipple-shield/ (LAUWERS & SWISHER, 2016; WILSON-CLAY & HOOVER, 2005) ENGORGEMENT Normal Physiologic Fullness Engorgement • Occurs as part of increased tissue • Painful swelling that occurs when the vascularization and the normal breasts become overfull from failure transition from colostrum to full milk to remove milk adequately or production. frequently enough. • Symptoms begin around 3-5 days postpartum & resolve by • Excess fluid causes increased approximately 10 days postpartum pressure on alveoli & milk ducts. with: • Causes: • Unlimited, on-demand, exclusive breastfeeding • Missed or infrequent feedings • 24/7 rooming in • Inadequate milk removal (LAUWERS & SWISHER, 2016) 11 9/21/2018 ENGORGEMENT Signs & Symptoms: May result in: •Firm and hard •Decreased milk production •Tenderness •Inadequate letdown r/t edema & •Warm or hot to the touch pain •Shiny, transparent skin •Plugged ducts •Flattened nipples •Mastitis (LAUWERS & SWISHER, 2016; WILSON-CLAY & HOOVER, 2005) ENGORGEMENT MANAGEMENT • Frequent nursing, at least every 2 hours • Moist heat 5 minutes (or less) before feeding • Breast massage and hand expression • Use of breast pump prior to latching to soften, elongate the nipple and make it easy for baby to grasp • Cold therapy for 10 minutes after feeding (LAUWERS & SWISHER, 2016) 12 9/21/2018 PLUGGED NIPPLE PORE Small white dot on the face of Symptoms: nipple • Painful to touch and with feedings (Aka nipple bleb, milk blister) Interventions: Causes: •Soak nipple in warm water to soften •Plugging of nipple opening with plug milk •Place olive oil soaked cotton ball •Overgrowth of skin over opening over nipple between feedings •Refer to physician (LAUWERS & SWISHER, 2016; WILSON-CLAY & HOOVER, 2005) PLUGGED DUCT Hard, localized area in the breast Causes: •Incomplete milk removal •Outside pressure on specific areas of the breast which inhibits free flow of milk Treatment: •Regular, frequent feedings •Hand massage in the direction of the plug •Positioning infant’s chin over the plugged area during feedings •Beginning feeding on the side with plug •Moist heat and massage (LAUWERS & SWISHER, 2016) 13 9/21/2018 MASTITIS Inflammation of the breast • Usually caused by a bacterial infection • Occurs most often in the first 12 weeks postpartum •Fatigue is highest •Immunity is lowest (LAUWERS & SWISHER, 2016; HOOVER-CLAY & WILSON, 2005) MASTITIS Causes: • Maternal stress, fatigue, illness, lack of support • Infant illness • Infrequent, scheduled, limited duration, and/or missed feedings • Milk stasis and engorgement • Overproduction of milk • Pressure on the breast • Nipple damage, bleb, or blister • Plugged duct (LAUWERS & SWISHER, 2016) 14 9/21/2018 MASTITIS Signs and Symptoms: May result in: • Sudden onset • Decreased milk supply • Redness or red streaking of the • Abscess breast •Abrupt cessation of breastfeeding* • Tender and hot to the touch • Firm lump in the breast • Fever, chills, flu-like symptoms (LAUWERS & SWISHER, 2016; WILSON-CLAY & HOOVER, 2005) MASTITIS MANAGEMENT • Refer to OBGYN for antibiotic tx • Heat: warm, moist compresses to inflamed area before and during • Frequent, on demand, unscheduled feeding feedings • Warm shower before feeding • Begin feedings on affected breast • Cold packs to affected area after • Breast compression and massage feeding or pumping to reduce pain • Hand express or pump milk to drain and edema the breast if infant will not nurse and • Increase rest and fluids after feedings to fully drain breast • OTC anti-inflammatory pain reliever
Load more

Recommended publications
  • Breastfeeding Management in Primary Care-FINAL-Part 2.Pptx
    Breastfeeding Management in Primary Care Pt 2 Heggie, Licari, Turner May 25 '17 5/15/17 Case 3 – Sore nipples • G3P3 mom with sore nipples, baby 5 days old, full term, Breaseeding Management in yellow stools, output normal per BF log, 5 % wt loss. Primary Care - Part 2 • Mother exam: both nipples with erythema, cracked and scabbed at p, areola mildly swollen, breasts engorged and moderately tender, mild diffuse erythema, no mass. • Baby exam: strong but “chompy” suck, thick ght frenulum aached to p of tongue, with restricted tongue movement- poor lateral tracking, unable to extend tongue past gum line or lower lip, minimal tongue elevaon. May 25, 2017, Duluth, MN • Breaseeding observaon: Baby has deep latch, mom Pamela Heggie MD, IBCLC, FAAP, FABM Addie Licari, MD, FAAFP with good posioning, swallows heard and also Lorraine Turner, MD, ABIHM intermient clicking. Mom reports pain during feeding. Sore cracked nipple Type 1 - Ankyloglossia Sore Nipples § “Normal” nipple soreness is very minimal and ok only if: ü Poor latch § Nipple “tugging” brief (< 30 sec) with latch-on then resolves ü LATCH, LATCH, LATCH § No pain throughout feeding or in between feeds ü Skin breakdown/cracks-staph colonizaon § No skin damage ü Engorgement § Some women are told “the latch looks ok”… but they are in pain and curling their toes ü Trauma from pumping ü § It doesn’t maer how it “looks” … if mom is uncomfortable Nipple Shields it’s a problem and baby not geng much milk…set up for low ü Vasospasm milk supply ü Blocked nipple pore/Nipple bleb § Nipple pain is
    [Show full text]
  • Bleb Protocol
    Milk Blisters/Blebs A nipple bleb, sometimes referred to as milk blister, is a raised white or yellow spot that forms anywhere on the surface of the nipple. A bleb is formed when milk stagnates and clogs inside the milk duct just behind the nipple pore on the surface of the nipple. This is often due to a suboptimal latch. Sometimes a bleb is associated with a blocked duct somewhere in the breast. If the bleb is not causing any pain, generally it should be left alone. If the bleb is painful, or if you have a bleb along with a blocked duct, the following strategies will help to release and resolve the bleb. For more information about blocked ducts, see the www.ibconline.ca. Sometimes a blister filled with clear fluid will form on the nipple this is usually due to a suboptimal latch. If you have a blister, but not a bleb, follow the directions in #4 (below) to help it resolve. 1. Apply the All Purpose Nipple Ointment (APNO) sparingly after each feeding. APNO with ibuprofen powder mixed in can help to further ease the pain associated with nipple blebs. 2. Apply a warm, wet compress (like a washcloth soaked in clear, warm water) to the nipple before nursing your baby. Keep the compress as warm as you can tolerate without burning the skin. Massage the nipple with coconut oil to try to remove the skin surrounding the blocked pore and then, if possible, nurse your baby. There is no need to remove the coconut o s causing baby to slip while trying to latch.
    [Show full text]
  • 1. Saline Rinses/Soaks A. Saline Is Neutral Ph and Is Just Like Tears. It Is Used to Clean Wounds and Soothe Soothe Throats and Well Now Nipples
    1. Saline rinses/soaks a. Saline is neutral ph and is just like tears. It is used to clean wounds and soothe soothe throats and well now nipples. It will not burn or sting when applied. b. Mix 1 mug of water and ½ teaspoon salt. Keep near nursing area and covered. c. After each feeding, saturate clean cotton balls with the solution and sit on nipples for 1-2 minutes. You can also fill 2 shot glasses with solution and either compress the cups over the nipples/areola for a soak or lean or the glass to soak the nipples. d. Throw out the use solution and wash out the glass after soaking. e. Make new saline solution every 24 hours or keep in fridge for 3 days. 2. Silverette nipple cups. Silver is a natural anti-inflammatory and anti microbial. Do not use ointments while using theses. http://amzn.to/2ofG9Sw https://silveretteusa.com/ ​ ​ ​ 3. Medihoney gel: This honey is irradiated and contains no botulism spores. It is ​ anti-microbial and anti-inflammatory and safe to use with breastfeeding. As part of nipple wound care, wash this off with mild soap before breastfeeding. Apply after every feeding, if possible. http://amzn.to/2pQMwf6 ​ 4. Non-Stick gauze pads: Wear on top of scabbed nipples and under breast pads http://amzn.to/2oxhll6 5. Nipple ointment: Choose one, there is no evidence that shows one works better than another. a. MotherLove: http://amzn.to/2oU87Sp ​ b. EarthMammaAngelBaby: http://amzn.to/2oU87Sp ​ 6. Soft breast pads: http://amzn.to/2ofW8zY ​ 7.
    [Show full text]
  • New Mothers' Perceptions of Breastfeeding, the Transition to Parenthood, and the Ap Rtner Alliance: a Grounded Theory Study Jennifer Amy Munch
    University of North Dakota UND Scholarly Commons Theses and Dissertations Theses, Dissertations, and Senior Projects January 2016 New Mothers' Perceptions Of Breastfeeding, The Transition To Parenthood, And The aP rtner Alliance: A Grounded Theory Study Jennifer Amy Munch Follow this and additional works at: https://commons.und.edu/theses Recommended Citation Munch, Jennifer Amy, "New Mothers' Perceptions Of Breastfeeding, The rT ansition To Parenthood, And The aP rtner Alliance: A Grounded Theory Study" (2016). Theses and Dissertations. 2051. https://commons.und.edu/theses/2051 This Dissertation is brought to you for free and open access by the Theses, Dissertations, and Senior Projects at UND Scholarly Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. NEW MOTHERS’ PERCEPTIONS OF BREASTFEEDING, THE TRANSITION TO PARENTHOOD, AND THE PARTNER ALLIANCE: A GROUNDED THEORY STUDY by Jennifer A. Munch MA, University of North Dakota, 2012 BA, University of British Columbia, 2006 A Dissertation Submitted to the Graduate Faculty of the University of North Dakota In partial fulfillment of the requirements for the degree of Doctor of Philosophy Grand Forks, North Dakota December 2016 Copyright 2016 Jennifer A. Munch ii iii PERMISSION Title: New Mothers’ Perceptions of Breastfeeding, the Transition to Parenthood, and the Partner Alliance: A Grounded Theory Study Department: Counseling Psychology Degree: Doctor of Philosophy In presenting this dissertation in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, I agree that the library of this University shall make it freely available for inspection.
    [Show full text]
  • How to Deal with Blocked Nipple Pores Donna Murray, RN, BSN A
    How to Deal With Blocked Nipple Pores Donna Murray, RN, BSN A nipple bleb or milk bleb is a tiny white or yellow spot that forms on the nipple at the end of a milk duct or nipple pore. These small, milk-filled cysts or blockages are thought to be created by breast milk that has become thick and hard. If you have a milk bleb, it might look like a smooth, shiny, singular white dot (similar to a whitehead pimple). Milk blisters are often associated with a plugged milk duct, but they can 2 A nipple bleb can cause extreme pain during breastfeeding, or it might not bother you at all. If it isn't painful, leave the blister alone and breastfeed as you normally would. If a milk bleb is painful, you might not want to breastfeed. However, frequent breastfeeding is necessary to maintain your breast milk supply and can help dislodge the bleb, as well as prevent clogged ducts, breast engorgement, and mastitis. If the pain is bearable, continue to breastfeed as often as you can. If it's too painful, pump your breast milk. A quality breast pump may help remove the bleb. If you get a nipple bleb, you'll want to minimize the discomfort while you wait for it to get better. There are a few things you can do to relieve any pain you might have and help the bleb heal. • Breastfeed often and with proper technique. You can help prevent milk ducts from clogging by using proper breastfeeding techniques, nursing often, alternating breastfeeding positions, and avoiding tight tops and underwire bras.
    [Show full text]
  • 3/9/2019 © 2019 1
    3/9/2019 th 40 National Conference Disclosures on Pediatric Health Care March 7-10, 2019 ∙ New Orleans • Dr. Scott has no relevant nonfinancial relationships to disclose Helping the Breastfeeding Mother Succeed: You • Financial disclosure: None CAN Make a Difference! • Often accused of being “opinionated” about breastfeeding by Allison Scott, DNP, CPNP‐PC, IBCLC my students ©2019 ©2019 Learning Objectives Learning Objectives • Following this Intensive Workshop the learner will: • Utilize current breastfeeding legislation in counseling mothers – Obtain the needed knowledge to perform a comprehensive breastfeeding under the Affordable Care Act assessment of the mother‐baby dyad & provide professional support • Assess positioning, latch and effective milk transfer – Coordinate services with a LC; other professionals as needed • Understand lactation reimbursement strategies for the APRN • Identify potential breastfeeding barriers & understand management of: – Sore nipples – Engorgement – Mastitis – Poor weight gain ©2019 ©2019 Why You? What does NAPNAP say? • “PNPs are in an ideal position to promote exclusive • Breastfeeding Education: Current Position Statement‐ updated, breastfeeding as an infant feeding choice and to support 2018. breastfeeding mothers; however, little is known about the • https://www.napnap.org/breastfeeding‐education‐sig amount of evidence‐based breastfeeding education that is – Great resources incorporated into masters‐level education for pediatric NP – https://doi.org/10.1016/j.pedhc.2018.08.11 programs” (Boyd & Spatz, Journal of Pediatric Health Care, 2013). • NEW position statement – Join our SIG! ©2019 ©2019 © 2019 1 3/9/2019 NAPNAP Key lactation support strategies Do you know? • TRI‐CORE model • Questions/Answers – Maternal Self‐Efficacy‐ mom’s perceived confidence & ability to manage problems *WHAT is #1 reason mothers wean earlier than intended? – Maternal & Professional Lactation Support – improve duration & exclusivity rates.
    [Show full text]
  • Challenging the Expectations of Modern Motherhood Through Drama
    University of Calgary PRISM: University of Calgary's Digital Repository Graduate Studies The Vault: Electronic Theses and Dissertations 2018-06-26 When She Was Good: Challenging the Expectations of Modern Motherhood Through Drama Taylor-Parry, Meredith Taylor-Parry, M. (2018). When She Was Good: Challenging the Expectations of Modern Motherhood Through Drama (Unpublished master's thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/32300 http://hdl.handle.net/1880/107078 master thesis University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. Downloaded from PRISM: https://prism.ucalgary.ca UNIVERSITY OF CALGARY When She Was Good: Challenging the Expectations of Modern Motherhood Through Drama by Meredith Taylor-Parry A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF FINE ARTS GRADUATE PROGRAM IN DRAMA CALGARY, ALBERTA JUNE, 2018 © Meredith Taylor-Parry 2018 Abstract The following manuscript and accompanying artist’s statement examine the process of developing the play When She Was Good. It explores the cultural idealization of the modern mother along with the journey to create a drama that illustrates its harmful implications. ii Preface This thesis is original, unpublished, independent work by the author, Meredith Taylor-Parry. iii Acknowledgments I would like to thank Professor Clem Martini for his superb guidance and instruction throughout this process.
    [Show full text]
  • Overcoming Breastfeeding Concerns
    Overcoming Breastfeeding Concerns PRESENTED BY KARY JOHNSON, RN, IBCLC Frequent Breastfeeding Issues Nipple pain Engorgement Flat and inverted nipples Mastitis and plugged milk ducts Plugged nipple pores Milk supply concerns Pumping only moms Tongue tie Pain with Breastfeeding The #1 reason mother’s quit breastfeeding Many mother’s are told breastfeeding should not be painful, but often experience pain early on To ensure breastfeeding is mutually beneficial what are some things a health provider should assess? Assess Pain Type (per mother’s report) Tugging and Pulling? (breastfeeding is often a new sensation) Sharp? Biting? Pinching? Chewing? Assess Nipple Intact? Pinched/Creased? Bruising? Cracks? Abraded/Bleeding? Assess Latch Gape Lips Swallows Common Sources of Nipple Pain and Poor Latching Shallow Latch Lips rolled in Poor positioning Flat/inverted nipples Tongue Tie Breast Engorgement/Mastitis Common Treatments for Sore Nipples Go back to basic latch techniques Skin to skin prior to latching Express milk prior to latch using hand expression Rinse with clear water and air dry after feeding Nurse on least sore side first Lanolin or Soothie gel pads for comfort • Do not use them simultaneously Goal is to continue breastfeeding while making it less painful! Ensuring a correct and pain free latch, promotes healing while stimulating milk production! Engorgement Fullness or swelling of breasts due to increased tissue vascularization and transition of colostrum to early milk Symptoms occur between days
    [Show full text]
  • An Exploration of Online Breastfeeding Support 1
    AN EXPLORATION OF ONLINE BREASTFEEDING SUPPORT 1 AN EXPLORATION OF ONLINE SOCIAL SUPPORT GROUPS FOR BREASTFEEDING MOTHERS by Amanda Wagg Canterbury Christ Church University Thesis submitted For the Degree of Doctor of Philosophy July 2020 AN EXPLORATION OF ONLINE BREASTFEEDING SUPPORT 2 Acknowledgements I would like to thank my family for supporting me financially, emotionally and for believing in me. I would like to thank Alex Hassett and Margie Callanan for their continued supervision and encouragement, and for challenging me to think differently. I would also like to thank Chloe Griggs, who has been on this journey with me completing her own studies, for her endless encouragement and motivation, and the research team for all their support during the learning sets, you are truly inspirational. I would also like to thank Anglia Ruskin University for part funding my research studies and providing study leave. Lastly, I would like to thank all the mothers that came forward and participated in the interviews, and my friends and colleagues that aided with recruitment and provided a listening ear. AN EXPLORATION OF ONLINE BREASTFEEDING SUPPORT 3 Thesis Summary This thesis provides a portfolio of research that focuses on online social support groups for breastfeeding mothers. The aim of this thesis is to explore how and why online breastfeeding support group are being used, how breastfeeding mothers make sense of and interpret their experiences, and how they perceive the impact on their breastfeeding journey. Acquiring new breastfeeding skills at the same time as being becoming a mother is stressful and experiencing stress may lead some mothers to seek support.
    [Show full text]
  • Physician's Toolkit
    PHYSICIAN’S TOOLKIT B R E AS TF E E DING Q U I C K R E F E R E N C E G U I D E P H Y S I C I A N ’S B R E A S T F E E D I N G T O O L K I T The Physician’s Breastfeeding Toolkit: Evidence-informed Practice for Newfoundland & Labrador 2014 (Revised 2016). Revised with permission by Renfrew County and District Health Unit, January 2020. This toolkit is designed to assist health care providers in providing optimal care and consistent information to breastfeeding families. The toolkit is based on current evidence and reflects best practice in the care of breastfeeding families. Topics include initiating and sustaining breastfeeding, management of common concerns, medication safety, establishing a breastfeeding-friendly practice environment and local support resources. Acknowledgements The development of this resource was initiated by the Baby-Friendly Council of Newfoundland & Labrador in an effort to promote evidence-informed practices for breastfeeding. The Baby-Friendly Council of Newfoundland and Labrador acknowledges the contribution of the two consultants for this project, Dr. Amanda Pendergast, BSc (Hons), MD, CCFP, FCFP and Janet Fox-Beer BN, RN, IBCLC. Their professional knowledge, clinical expertise and commitment to this project are exemplary. Thank you also to members of the advisory committee for their guidance in the development and review of the resources for the toolkit. Members of the advisory committee include: Dr. Rebecca Rudofsky MD, CCFP Janet Murphy Goodridge RN, MN, IBCLC Clare Bessell RN, BVoc Ed Dr.
    [Show full text]
  • Overcoming Breastfeeding Concerns
    OVERCOMING BREASTFEEDING Presented by: CONCERNS Sue Harmon, IBCLC OVERVIEW • Latch Difficulties • Pain • Tongue Tie • Flat/Inverted Nipples • Engorgement • Mastitis • Pacifiers • Low Milk Supply • Supplementation LATCH DIFFICULTIES Goal is to preserve and protect the milk supply! • Remember, some newborns require additional time to recover from birth effects. • Why is this?* (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013; WILSON-CLAY & HOOVER, 2005) LATCH DIFFICULTIES Interventions if newborn has not/is not latching effectively in the first 24 hours: • Promote frequent, uninterrupted skin to skin. • Attempt to breastfeed during quiet, alert times, whenever the infant is cueing or at least every 3 hours. • Limit attempts to 10 minutes or stop when infant gives negative cues. •Crying •Pushing away •Demonstrates withdrawal or avoidance behaviors. What are these?* •If occurs, calm the infant and attempt later. (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) LATCH DIFFICULTIES Continued… • Avoid activities immediately prior to a feeding that can disrupt attachment reflexes. What activities might do this?* • Encourage mother to perform breast massage and hand express colostrum on her nipple and baby’s mouth during attempts. • Encourage patience, practice and persistence. (MANNEL ET AL., 2013) LATCH DIFFICULTIES If the baby continues to feed poorly: • Continue to perform breast massage and hand expression with each attempt. • Assist in obtaining a quality, double electric breast pump for use until the baby latches and breastfeeds effectively.* • Encourage the mother to express milk: •A minimum of 8 times daily •For 15 minutes until milk flow stops •Manually to completely empty the breast •Consistently, even during the night (LAUWERS & SWISHER, 2016; MANNEL ET AL., 2013) PAIN Pain is the #1 reason why mother’s quit breastfeeding PAIN – WHAT’S NORMAL? • Nipple tenderness is normal in pregnancy and early postpartum due to heightened nipple sensitivity.
    [Show full text]
  • 601 CERP Milk Supply Slides
    10/4/2015 Disclosure Milk Supply Triage... or I have no commercial interests What’s going on with my milk or relationships to disclose in supply? this presentation. Debbie Albert, PhD, BSN, IBCLC (c) Debbie Albert, PhD, BSN, IBCLC 2015 3 The Program A Bad Latch With the increasing percentage of high risk infants who survive, and the increasing number of women who have to work, the laws of supply and demand get a bit jostled at times. Be prepared for an interactive program that will help you get to the bottom of milk supply dilemmas. (c) Debbie Albert, PhD, BSN, IBCLC 2015 4 5 What causes supply A Good, Maintained Latch issues? Maternal Health Concerns- anemia, PCOS, DM, IGT, thyroid, difficult delivery, obesity, smoking, etc. Poor feeding start—lack of stimulation in first days Supplementation—medically ordered or not Bottle, pacifier, nipple shield use Scheduled and timed feeds Sleepy, unhealthy, or anatomical problem baby 6 (c) Debbie Albert, PhD, BSN, IBCLC 2015 7 1 10/4/2015 BREAST TYPES--IGT Ankyloglossia Breast types classified by physical characteristics. (Adapted from Heimburg DV, et al, 1996 and Huggins KE, et al, 2000). Type 1 Round breasts, normal lower medial and lateral quadrants Type 2 Hypopolasia of the lower medial quadrant Type 3 Hypoplasia of the lower medial and lateral quadrants Type 4 Severe constrictions, minimal breast base Conclusion—Hypoplasia can affect milk supply. Wide spacing is one way to identify it. 8 9 Insufficient Milk Transfer Insufficient Milk Transfer Weight loss… Output Continued weight loss after 4 days Less than 3 stools each 24 hours after 3 Below birth weight after 10-14 days days Days 5 to 3 months –less than 20 grams Dark green stools after 4-5 days per day or less than 5 oz per week.
    [Show full text]