DOCSLIB.ORG

Making More Milk Presented by Diana West, BA, IBCLC

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Making More Milk Presented by Diana West, BA, IBCLC Making More Milk Presented by Diana West, BA, IBCLC Making More Milk GET A HEAD START: MAXIMIZING MILK Presented by PRODUCTION Diana West, BA, IBCLC [email protected] CAPABILITY MAXIMIZE MILK PRODUCTION CAPABILITY LUTEAL PHASE DEFECT ! Especially when there is a known risk factor !Not enough progesterone in second half of menstrual cycle " Hormonal problems # PCOS, thyroid, luteal phase defect, insulin resistance, Type I diabetes !Common cause of miscarriage " Hx breast surgery, breast injury/trauma " High risk of infant hypoglycemia !The higher the progesterone levels # Mother is Type I diabetic in pregnancy, the better the milk " Hx of prior milk production problems production is postpartum (Ingram, 1999) POLYCYSTIC OVARIAN LUTEAL PHASE DEFECT SYNDROME (PCOS) ! Many informal reports of progesterone ! Multiple ovarian cysts (Glueck, 2004) supplementation during pregnancy connected to ! Incidence: 4-12% better milk production ! Can cause high levels of ! Case report of woman with LPD (Bodley, 1999) testosterone, estrogen, and insulin " First successful pregnancy, no breast growth, very ! Can cause low progesterone little milk ! Can cause infertility " Second pregnancy, progesterone treatment, milk ! Possible symptoms: " Hirsutism (excess body hair) production normal " Alopecia (balding) " Obesity ! Progesterone inhibits prolactin, so treat only " Masculine characteristics during pregnancy " Insulin resistance " Hypoplasia (insufficient glandular tissue) # Risk factor for low supply Copyright © 2012 by Diana West, BA, IBCLC 1 Making More Milk Presented by Diana West, BA, IBCLC POLYCYSTIC OVARIAN THYROID DYSFUNCTION SYNDROME (PCOS) ! Treatment with Metformin often increases milk ! All three types can reduce milk production production (Gabbay, 2003) " Hyperthyroid " Hypothyroid "Both during pregnancy and after delivery " Postpartum thyroiditis "Safe for baby (Hale, 2010) ! Rat studies give new clues why (Marasco, 2006; Hapon, 2003; Varas, 2002, Varas, 2005) " Reduced milk ejection from oxytocin inhibition " Not inhibited milk synthesis EXPRESS MILK BEFORE HYROID YSFUNCTION T D BABY IS BORN ! Commonly associated with anemia and pp ! Old method rediscovered hemorrhage in Australia " Both risk factors for low supply (Chapman, 2012, Chapman, 2012, Cox, 2006; Cox 2010) ! Need comprehensive (not screening) test (TSH + Total or Free T3 + Total or Free T4) " Practice instituted for hypoglycemic infants of " TSH range for fertility/pregnancy: .5-3.0 or even .5-2.5 (Mandel, 2005) Type I diabetic mothers ! Even borderline cases tend to improve with treatment ! Gentle hand expression ! Monitor closely during pregnancy once or twice a day ! If out of range, test frequently postpartum EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN ! Express Milk Before Baby is Born !Many authors " Begin from 34th week of pregnancy " Each day after taking hot shower when breasts are warm recommended " Stop expressing if cramps or contractions for antenatal " Use 1-3 mm or periodontal syringes to draw up expressed colostrum breast care and " Use same syringe for 48 hours, refrigerating in between improved " Freeze syringes in zip-close bag " Bring to hospital to use as supplementation breastfeeding # Defrost under warm running water (Ingelman, 1958; Myles, 1964; Applebaum, 1969; Eiger and Olds, 1973; Messenger, 1983) Copyright © 2012 by Diana West, BA, IBCLC 2 Making More Milk Presented by Diana West, BA, IBCLC EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN ! Significant benefits ! Significant benefits "Collected colostrum can be used as " Increases comfort supplementation in touching and handling her "Additional colostrum ! energy for feeding breasts (Llewellyn- "Better feeding $ better milk removal Jones, 1983) "Better milk removal $ more milk " Teaches hand production expression! " Validates mothers’ "May hasten Lactogenesis II need to prepare for breastfeeding EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN !Safety concerns !Safety concerns "Preterm labor??? "Preterm labor??? # Prenatal nipple # Many activities are precursors for oxytocin release: stimulation while — Eating expressing colostrum ! Particularly foods with phenyethylamines such as chocolate) can NOT induce — Laughing premature labor — Kissing (Cox, 2010) — Hugging — Masturbation and sexual intercourse ! Oxytocin surges MUCH stronger with orgasm! EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN !Safety concerns !Safety concerns "Preterm labor??? "No evidence for causing preterm labor # Cox (2006) reviewed a group of studies in which # Oxytocin surges will pregnant women experienced varying but long only induce labor if periods of nipple stimulation (Di Lieto et al, 1989; Stein there are sufficient et al, 1990; Curtis et al, 1999) oxytocin receptors in # None of the studies showed significant effects in the middle layer of inducing labor the uterine wall (myometrium) (Blackburn, 2003) Copyright © 2012 by Diana West, BA, IBCLC 3 Making More Milk Presented by Diana West, BA, IBCLC EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN ! Safety concerns??? ! Safety concerns??? "No evidence for causing preterm labor "No evidence for causing preterm labor # 2009 pilot study by Forster et al # 2009 study by Ishii "43 women hand expressed 2x/day from —110 women continued breastfeeding week 36 through pregnancy compared to 774 women who did not breastfeed during "No evidence of fetal compromise pregnancy " Despite this, authors recommend antenatal —No statistically significant difference in labor expression should cease until efficacy can be initiation tested in randomized controlled trial (RCT) # An RCT would be unethical (some babies would not receive colostrum) EXPRESS MILK BEFORE EXPRESS MILK BEFORE BABY IS BORN BABY IS BORN !2009 pilot study by Forster et al !Safety concerns "Tandem Nursing is Safe " At 6 weeks pp, 95% were positive # Study of 57 women who had continued to about their experience breastfeed during pregnancy of prenatal milk # Infants born to these mothers were healthy and expression appropriate for gestational age (Moscone and Moore,1993) " They would do it again MAXIMIZE MILK REMOVAL MAXIMIZE MILK REMOVAL TO IN THE CALIBRATE HIGH LACTATION FIRST TWO WEEKS CAPABILITY " Hormonal receptors seem to be established in the breast in first 2-3 weeks in response to milk removal " The more milk that is removed, the higher milk production capability will be for this baby # Calibration process restarts for each baby " Extra milk removal even if only just during this time helps create the highest possible “set point” Copyright © 2012 by Diana West, BA, IBCLC 4 Making More Milk Presented by Diana West, BA, IBCLC HORMONES AND FACILITATE RECEPTORS BREASTFEEDING ! Hormones need receptors ! Delay bathing of mothers and babies as long as possible to act on a target organ " Babies placed on their mothers’ chests immediately after ! Each hormone has its birth with their hands free smear amniotic fluid onto the own receptor breasts as they use their hands and face to find them Hormone (Varendi, 1996; Varendi, 1997) ! There are receptors in Receptor each organ of our body " Smell of amniotic fluid orients to breasts like tracking beacon ! The more receptors, the more effective hormones are " Critical biological sequence # Helps babies cue into their natural latching instincts " Obviously less effective for water births # BUT water birth babies tend to orient more easily to breast "Not enough receptors $ hormones less effective BABY-LED LATCHING SKIN TO SKIN ! A reclined position allow baby to use ! Enhances metabolism of brown adipose tissue breastfeeding reflexes to latch himself (Colson, 2008) $ increase gluconeogenesis and ketogenesis " “Biological Nursing” (Suzanne Colson) $ decreases risk of hypoglycemia requiring " Also known as “Laid Back Breastfeeding” supplementation (Christensson et al 1992) ! Mom leaning back so gravity helps ! Promotes physiologic stability for better feeding (Bauer, 1997; Bier, " NOT fully flat 1996; Bohnhorst, 2001; Cattaneo, 1998; Gaxxolo, 2000; Tornhage, 1998; Whitelaw, 1994 %TIP OF CITATION ICEBURG) ! Gravity holds baby firmly against mom in " Regulates baby’s body temperature (thermoregulation) VENTRAL position Increases blood oxygenation " Stabilizes pulmonary function " Increases baby’s sense of stability & security ! Increases maternal milk supply, breastfeeding duration (Bier, 1996) BABY-LED LATCHING BABY-LED LATCHING !Releases baby’s AND mother’s natural reflexes and instincts ! Snuggle baby high up between mom's breasts !Baby impresses mother with his ! Mother automatically strokes baby’s back competency ! Baby begins woodpecker motion and !Helps improve milk transfer and bobbing down to a breast to self-attach painless latching ! Mother only needs to support, not to guide !Does not require any hands-on ! More info: Baby-Led Breastfeeding video help from lactation helper biologicalnurturing.com !Mother feels more confident Copyright © 2012 by Diana West, BA, IBCLC 5 Making More Milk Presented by Diana West, BA, IBCLC HAND EXPRESS COLOSTRUM HAND EXPRESS COLOSTRUM (IN ADDITION TO NURSING) (IN ADDITION TO NURSING) !Hand expression more effective !2009 study by Dr. Jane Morton and to remove colostrum in first 48 hours Colleagues at Stanford (Ohyama, 2010) " Expressing colostrum at least 6x/day in first 3 days pp Moves thick colostrum more easily through breast increases later milk production by avg 45% (Morton, " Pumps pull fluid into the areola 2009) # Compounds LGII areolar edema
Load more

Recommended publications
  • Spectrum of Benign Breast Diseases in Females- a 10 Years Study
    Original Article Spectrum of Benign Breast Diseases in Females- a 10 years study Ahmed S1, Awal A2 Abstract their life time would have had the sign or symptom of benign breast disease2. Both the physical and specially the The study was conducted to determine the frequency of psychological sufferings of those females should not be various benign breast diseases in female patients, to underestimated and must be taken care of. In fact some analyze the percentage of incidence of benign breast benign breast lesions can be a predisposing risk factor for diseases, the age distribution and their different mode of developing malignancy in later part of life2,3. So it is presentation. This is a prospective cohort study of all female patients visiting a female surgeon with benign essential to recognize and study these lesions in detail to breast problems. The study was conducted at Chittagong identify the high risk group of patients and providing regular Metropolitn Hospital and CSCR hospital in Chittagong surveillance can lead to early detection and management. As over a period of 10 years starting from July 2007 to June the study includes a great number of patients, this may 2017. All female patients visiting with breast problems reflect the spectrum of breast diseases among females in were included in the study. Patients with obvious clinical Bangladesh. features of malignancy or those who on work up were Aims and Objectives diagnosed as carcinoma were excluded from the study. The findings were tabulated in excel sheet and analyzed The objective of the study was to determine the frequency of for the frequency of each lesion, their distribution in various breast diseases in female patients and to analyze the various age group.
    [Show full text]
  • The Key to Increasing Breastfeeding Duration: Empowering the Healthcare Team
    The Key to Increasing Breastfeeding Duration: Empowering the Healthcare Team By Kathryn A. Spiegel A Master’s Paper submitted to the faculty of the University of North Carolina at Chapel Hill In partial fulfillment of the requirements for the degree of Master of Public Health in the Public Health Leadership Program. Chapel Hill 2009 ___________________________ Advisor signature/printed name ________________________________ Second Reader Signature/printed name ________________________________ Date The Key to Increasing Breastfeeding Duration 2 Abstract Experts and scientists agree that human milk is the best nutrition for human babies, but are healthcare professionals (HCPs) seizing the opportunity to promote, protect, and support breastfeeding? Not only are HCPs influential to the breastfeeding dyad, they hold a responsibility to perform evidence-based interventions to lengthen the duration of breastfeeding due to the extensive health benefits for mother and baby. This paper examines current HCPs‘ education, practices, attitudes, and extraneous factors to surface any potential contributing factors that shed light on necessary actions. Recommendations to empower HCPs to provide consistent, evidence-based care for the breastfeeding dyad include: standardized curriculum in medical/nursing school, continued education for maternity and non-maternity settings, emphasis on skin-to-skin, enforcement of evidence-based policies, implementation of ‗Baby-Friendly USA‘ interventions, and development of peer support networks. Requisite resources such as lactation consultants as well as appropriate medication and breastfeeding clinical management references aid HCPs in providing best practices to increase breastfeeding duration. The Key to Increasing Breastfeeding Duration 3 The key to increasing breastfeeding duration: Empowering the healthcare team During the colonial era, mothers breastfed through their infants‘ second summer.
    [Show full text]
  • Breastfeeding and Women's Mental Health
    BREASTFEEDING AND WOMEN’S MENTAL HEALTH Julie Demetree, MD University of Arizona Department of Psychiatry Disclosures ◦ Nothing to disclose, currently paid by Banner University Medical Center, and on faculty at University of Arizona. Goals and Objectives ◦ Review the basic physiology involved in breastfeeding ◦ Learn about literature available regarding mood, sleep and breastfeeding ◦ Know the resources available to refer to regarding pharmacology and breast feeding ◦ Understand principles of psychopharmacology involved in breastfeeding, including learning about some specific medications, to be able to counsel a woman and obtain informed consent ◦ Be aware of syndrome described as Dysphoric Milk Ejection Reflex Lactation Physiology https://courses.lumenlearning.com/boundless-ap/chapter/lactation/ AAP Material on Breastfeeding AAP: Breastfeeding Your Baby 2015 AAP Material on Breastfeeding AAP: Breastfeeding Your Baby 2015 A Few Numbers ◦ About 80% of US women breastfeed ◦ 10-15% of women suffer from post partum depression or anxiety ◦ 1-2/1000 suffer from post partum psychosis Depression and Infant Care ◦ Depressed mothers are: ◦ More likely to misread infant cues 64 ◦ Less likely to read to infant ◦ Less likely to follow proper safety measures ◦ Less likely to follow preventative care advice 65 Depression is Associated with Decreased Chance of Breastfeeding ◦ A review of 75 articles found “women with depressive symptomatology in the early postpartum period may be at increased risk for negative infant-feeding outcomes including decreased breastfeeding duration, increased breastfeeding difficulties, and decreased levels of breastfeeding self-efficacy.” 1 Depressive Symptoms and Risk of Formula Feeding ◦ An Italian study with 592 mothers participating by completing the Edinburgh Postnatal Depression Scale immediately after delivery and then feeding was assessed at 12-14 weeks where asked if breast, formula or combo feeding.
    [Show full text]
  • Vasospasm of the Nipple
    Vasospasm of the Nipple A spasm of blood vessels (vasospasm) in the nipple can result in nipple and/or breast pain, particularly within 30 minutes after a breastfeeding or a pumping session. It usually happens after nipple trauma and/or an infection. Vasospasms can cause repeated disruption of blood flow to the nipple. Within seconds or minutes after milk removal, the nipple may turn white, red, or purple, and a burning or Community stabbing pain is felt. Occasionally women feel a tingling sensation or itching. As the Breastfeeding nipple returns to its normal color, a throbbing pain may result. Color change is not Center always visible. 5930 S. 58th Street If there is a reason for nipple damage (poor latch or a yeast overgrowth), the cause (in the Trade Center) Lincoln, NE 68516 needs to be addressed. This can be enough to stop the pain. Sometimes the (402) 423-6402 vasospasm continues in a “vicious” cycle, as depicted below. While the blood 10818 Elm Street vessels are constricted, the nipple tissue does not receive enough oxygen. This Rockbrook Village causes more tissue damage, which can lead to recurrent vasospasm, even if the Omaha, NE 68144 (402) 502-0617 original cause of damage is “fixed.” For additional information: (Poor Latch or Inflammation) www ↓ Tissue Damage ↙ ↖ Spasm of blood vessels → Lack of oxygen to tissues To promote improved blood flow and healing of the nipple tissue: • See a lactation consultant (IBCLC) or a breastfeeding medicine specialist for help with latch and/or pumping to reduce future nipple damage. • When your baby comes off your nipple, or you finish a pumping session, immediately cover your nipple with a breast pad or a towel to keep it warm and dry.
    [Show full text]
  • Sexuality Education for Mid and Later Life
    Peggy Brick and Jan Lunquist New Expectations Sexuality Education for Mid and Later Life THE AUTHORS Peggy Brick, M.Ed., is a sexuality education consultant currently providing training workshops for professionals and classes for older adults on sexuality and aging. She has trained thousands of educators and health care professionals nationwide, is the author of over 40 articles on sexuality education, and was formerly chair of the Board of the Sexuality Information and Education Council of the United States (SIECUS). Jan Lunquist, M.A., is the vice president of education for Planned Parenthood Centers of West Michigan. She is certified as a sexuality educator by the American Association of Sex Educators, Counselors, and Therapists. She is also a certified family life educator and a Michigan licensed counselor. During the past 29 years, she has designed and delivered hundreds of learning experiences related to the life-affirming gift of sexuality. Cover design by Alan Barnett, Inc. Printing by McNaughton & Gunn Copyright 2003. Sexuality Information and Education Council of the United States (SIECUS), 130 West 42nd Street, New York, NY 10036-7802. Phone: 212/819-9770. Fax: 212/819-9776. E-mail: [email protected] Web site: http://www.siecus.org 2 New Expectations This manual is dedicated to the memory of Richard Cross, M.D. 1915-2003 “What is REAL?” asked the Rabbit one day, when they were lying side by side near the nursery fender before Nana came to tidy the room. “Does it mean having things that buzz inside you and a stick-out handle?” “Real isn’t how you are made,” said the Skin Horse.
    [Show full text]
  • Unilateral Galactorrhea Associated with Low-Dose Escitalopram
    Case Report Unilateral Galactorrhea Associated with Low-dose Escitalopram P. Bangalore Ravi, K. G. Guruprasad1, Chittaranjan Andrade2 ABSTRACT Galactorrhea is a rare adverse effect of selective serotonin reuptake inhibitor treatment. We report a 27-year-old woman who developed unilateral breast engorgement with galactorrhea 18 days after initiation of escitalopram (10 mg/day). The symptom remitted 7 days after withdrawal of escitalopram and did not subsequently recur during maintenance therapy with agomelatine (25 mg/day). Key words: Agomelatine, escitalopram, galactorrhea, prolactin, selective serotonin reuptake inhibitor, unilateral breast engorgement INTRODUCTION about the future, low self-confidence, diminished interest in daily activities, and diminished interest in social life, Galactorrhea refers to the discharge of milk from the poor appetite, and poor sleep. These symptoms were breast, unassociated with recent childbirth or nursing. exacerbated by domestic stress and absence of social Galactorrhea occurs when serum prolactin levels are support. A diagnosis of moderate depression with raised for reasons ranging from pituitary tumors to drug somatic symptoms was made, and she was started on treatments. A number of drugs, including psychotropic escitalopram 5 mg/day along with clonazepam 0.75 mg/day. She was instructed to increase the dose of drugs, cause hyperprolactinemia, some doing so consistently escitalopram to 10 mg/day after 4 days and taper and (e.g., certain antipsychotics), and some, rarely (e.g., certain withdraw the clonazepam at the rate of 0.25 mg/week. antidepressants).[1,2] We herein report an unusual case of galactorrhea resulting from escitalopram use. After about 18 days of treatment, she developed painless engorgement of her left breast associated with CASE REPORT galactorrhea.
    [Show full text]
  • Breast Concerns
    Section 12.0: Preventive Health Services for Women Clinical Protocol Manual 12.2 BREAST CONCERNS TITLE DESCRIPTION DEFINITION: Breast concerns in women of all ages are often the source of significant fear and anxiety. These concerns can take the form of palpable masses or changes in breast contours, skin or nipple changes, congenital malformation, nipple discharge, or breast pain (cyclical and non-cyclical). 1. Palpable breast masses may represent cysts, fibroadenomas or cancer. a. Cysts are fluid-filled masses that can be found in women of all ages, and frequently develop due to hormonal fluctuation. They often change in relation to the menstrual cycle. b. Fibroadenomas are benign sold tumors that are caused by abnormal growth of the fibrous and ductal tissue of the breast. More common in adolescence or early twenties but can occur at any age. A fibroadenoma may grow progressively, remain the same, or regress. c. Masses that are due to cancer are generally distinct solid masses. They may also be merely thickened areas of the breast or exaggerated lumpiness or nodularity. It is impossible to diagnose the etiology of a breast mass based on physical exam alone. Failure to diagnose breast cancer in a timely manner is the most common reason for malpractice litigation in the U.S. Skin or nipple changes may be visible signs of an underlying breast cancer. These are danger signs and require MD referral. 2. Non-spontaneous or physiological discharge is fluid that may be expressed from the breast and is not unusual in healthy women. 3. Galactorrhea is a spontaneous, multiple duct, milky discharge most commonly found in non-lactating women during childbearing years.
    [Show full text]
  • A Chancre of Primary Syphilis on the Nipple
    The great imitator strikes: a chancre of primary syphilis on the nipple Falon V. Brown, DO 1, Mikél E. Muse, OMS IV2, James Appel, MD, FAAD1, Warren White, MD3 1Department of Dermatology; Campbell University School of Osteopathic Medicine, Buies Creek, NC | Sampson Regional Medical Center, Clinton, NC. 2Virginia College of Osteopathic Medicine, Blacksburg, VA 3Department of Dermatopathology; Coastal Carolina Pathology, Wilmington, NC Abstract Case Description Discussion Syphilis, the “great imitator,” presents with a wide range of § Past medical history: Gout mucocutaneous and systemic findings. The primary chancre • According to the CDC, there has been a drama4c increase in § Family medical history: Breast cancer (mother) the incidence of primary and secondary syphilis in the U.S. classically occurs in the genital region, however up to 6.33% • Physical exam: Erythematous, ulcerated, plaque with can be extragenital. Among the extragenital chancres • In 2016, a total of 27,814 cases reported 8.7 cases serosanguinous drainage and crusting at the 12 o’clock per 100,000 popula4on spanning equally across all reported in the literature, very few occurred on the breast, position of nipple. Tenderness with palpation noted. No and of these cases only 5% occurred in men. A 43-year-old regions of the country. palpable axillary or supraclavicular lymphadenopathy • An increase of 17.6% compared to 2015 healthy man visited our clinic complaining of drainage from noted. No penile ulceration was found. the right nipple for one month. Exam was notable for a • An increase of 74.0% compared to 2012 • Differential diagnosis: Nipple eczema, erosive • Ini4ally, increase in incidence was associated with men poorly defined, scaly erythematous plaque on the areola with a superficial erosion of the nipple.
    [Show full text]
  • Management of Prolonged Decelerations ▲
    OBG_1106_Dildy.finalREV 10/24/06 10:05 AM Page 30 OBGMANAGEMENT Gary A. Dildy III, MD OBSTETRIC EMERGENCIES Clinical Professor, Department of Obstetrics and Gynecology, Management of Louisiana State University Health Sciences Center New Orleans prolonged decelerations Director of Site Analysis HCA Perinatal Quality Assurance Some are benign, some are pathologic but reversible, Nashville, Tenn and others are the most feared complications in obstetrics Staff Perinatologist Maternal-Fetal Medicine St. Mark’s Hospital prolonged deceleration may signal ed prolonged decelerations is based on bed- Salt Lake City, Utah danger—or reflect a perfectly nor- side clinical judgment, which inevitably will A mal fetal response to maternal sometimes be imperfect given the unpre- pelvic examination.® BecauseDowden of the Healthwide dictability Media of these decelerations.” range of possibilities, this fetal heart rate pattern justifies close attention. For exam- “Fetal bradycardia” and “prolonged ple,Copyright repetitive Forprolonged personal decelerations use may onlydeceleration” are distinct entities indicate cord compression from oligohy- In general parlance, we often use the terms dramnios. Even more troubling, a pro- “fetal bradycardia” and “prolonged decel- longed deceleration may occur for the first eration” loosely. In practice, we must dif- IN THIS ARTICLE time during the evolution of a profound ferentiate these entities because underlying catastrophe, such as amniotic fluid pathophysiologic mechanisms and clinical 3 FHR patterns: embolism or uterine rupture during vagi- management may differ substantially. What would nal birth after cesarean delivery (VBAC). The problem: Since the introduction In some circumstances, a prolonged decel- of electronic fetal monitoring (EFM) in you do? eration may be the terminus of a progres- the 1960s, numerous descriptions of FHR ❙ Complete heart sion of nonreassuring fetal heart rate patterns have been published, each slight- block (FHR) changes, and becomes the immedi- ly different from the others.
    [Show full text]
  • Vaginal Health After Breast Cancer: a Guide for Patients
    Information Sheet Vaginal health after breast cancer: A guide for patients Key points • Women who have had breast cancer treatment before menopause may develop a range of symptoms related to low oestrogen levels, while post-menopausal women may have a worsening of their symptoms. • These symptoms relate to both the genital and urinary tracts. • A range of both non-prescription/lifestyle and prescription treatments is available. Discuss your symptoms with your specialist or general practitioner as they will be able to advise you, based on your individual situation. • Women who have had breast cancer treatment before menopause might find they develop symptoms such as hot flushes, night sweats, joint aches and vaginal dryness. • These are symptoms of low oestrogen, which occur naturally with age, but may also occur in younger women undergoing treatment for breast cancer. These changes are called the genito-urinary syndrome of menopause (GSM), which was previously known as atrophic vaginitis. • Unlike some menopausal symptoms, such as hot flushes, which may go away as time passes, vaginal dryness, discomfort with intercourse and changes in sexual function often persist and may get worse with time. • The increased use of adjuvant treatments (medications that are used after surgery/chemotherapy/radiotherapy), which evidence shows reduce the risk of the cancer recurring, unfortunately leads to more side-effects. • Your health and comfort are important, so don’t be embarrassed about raising these issues with your doctor. • This Information Sheet offers some advice for what you can do to maintain the health of your vagina, your vulva (the external genitals) and your urethra (outlet from the bladder), with special attention to the needs of women who have had breast cancer treatment.
    [Show full text]
  • Breast & Nipple Orgasms 101
    Breast & Nipple Orgasms 101: Embody Deeper Sensuality, Pleasure & Orgasmic Ecstasy through breast, heart & nipple awakening. WELCOME TO BREAST & NIPPLE ORGASMS! In this bonus module you'll uncover the true pleasure, sexual energy and orgasmic potential of your breasts and nipples. You'll discover techniques for pleasuring your breasts, awakening sensuality and feminine power PLUS how to stimulate your nipples and breasts to orgasm. You'll learn a Tantric Breast & Heart breathing technique, powerful Nipple Activation Meditation and how to penetrate the heart and soul of your partner or others through your devotional erotic love, sensuality and orgasmic power. YOUR BREASTS ARE THE FORCE FOR WHICH YOU PENETRATE THE WORLD & YOUR LOVER(S) HEART WITH YOUR DEVOTION, LOVE, PASSION & SEXUAL ENERGY THE BREAST & PUSSY CONNECTION There is an energetic channel that runs directly from the positive & penetrative pole in your breasts down to your vagina, the negative & receptive pole. Our breasts have a deep connection with our heart and with our pussy so the more you open, stroke and massage your breasts, the more you open your heart and your pussy. During sex a man penetrates, warms and softens a woman’s negative pole with his cock. She receives this cock energy in her vagina and raises it up her spine, transmuting it not only in her vagina, but in her heart, and through her breasts she penetrates her man’s heart with her breasts and heart. (S)He receives this love and warmth in his chest and heart, which flows down his spine into his cock only to be sent like an infinite loop of electrical current and energy between them.
    [Show full text]
  • Tips for Sore/Cracked Nipples
    Tips for Sore/Cracked Nipples Nipples can become sore and cracked due to many reasons such as a shallow latch, tongue-tie or other anatomical variations, thrush, a bite, milk blister, etc. Keep in mind that one of the most important factors in healing is to correct the source of the problem. Continue to work on correct latch and positioning, thrush treatment, etc. as you treat the symptoms, and talk to a board certified lactation consultant (IBCLC). During the nursing session • Breastfeed from the uninjured (or less injured) side first. Baby will tend to nurse more gently on the second side offered. • Experiment with different breastfeeding positions to determine which is most comfortable. • If breastfeeding is too painful, it is very important to express milk from the injured side to reduce the risk of mastitis and to maintain supply. Pump on a low setting. Salt water rinse after nursing This special type of salt water, called normal saline, has the same salt concentration as tears and should not be painful to use. To make your own normal saline solution: Mix 1/2 teaspoon of salt in one cup (8 oz) of warm water. Make a fresh supply each day to avoid bacterial contamination. • After breastfeeding, soak nipple(s) in a small bowl of warm saline solution for a minute or so–long enough for the saline to get onto all areas of the nipple. Avoid prolonged soaking (more than 5-10 minutes) that “super” hydrates the skin, as this can promote cracking and delay healing. • Pat dry very gently with a soft paper towel.
    [Show full text]