DOCSLIB.ORG

Physician's Toolkit Quick Reference Guide

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Physician's Toolkit Quick Reference Guide PHYSICIAN’S TOOLKIT BREASTFEEDING QUICK REFERENCE GUIDE PHYSICIAN’S BREASTFEEDING TOOLKIT INTRODUCTION The Physician’s Breastfeeding Toolkit: Evidence-informed Practice for Newfoundland & Labrador 2014 (Revised 2016). This Resource consists of this Quick Reference Guide supported by a detailed Reference Manual. The toolkit is designed to assist physicians in providing optimal care and consistent information to breastfeeding families. The toolkit is based on current evidence and reflects global best practice in the care of the breastfeeding mother-baby dyad. Topics include initiating and sustaining breastfeeding, management of common concerns, medication safety, establishing a breastfeeding-friendly practice environment and local and national 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. Anne Drover MD, FRCPC Designed and Produced by Fonda Bushell Inc. www.babyfriendlynl.ca Exclusive breastfeeding for the first six months and continue up to two years and beyond. PHAC, 2012 HEALTH OUTCOMES ASSOCIATED WITH BREASTFEEDING MOTHER BABY Breast and Otitis media/LRTI ovarian cancer Obesity Diabetes Diabetes Osteoporosis Childhood cancer CVD Gastro Rate of return to pre-pregnancy state SIDS NEC Asthma, atopy IQ PHYSICIAN’S BREASTFEEDING TOOLKIT TABLE OF CONTENTS What are the Signs of a Good Latch? ......................................................1 Influence of Latch & Milk Production on Breastfeeding Outcomes .........3 Signs of Effective Breastfeeding ..............................................................5 Factors that May Impact Lactation ...........................................................6 Questions to Consider when Assessing Breast & Nipple Pain .................9 Diagnosis & Treatment of Common Breastfeeding Concerns ..................10 Management of Poor Infant Weight Gain ................................................16 Medical Indications for Supplementation ................................................19 Guidelines for Supplementation ..............................................................20 Breastfeeding Medication Safety .............................................................22 Lactation Consultants & Public Health Nurses .........................................29 Photo Credits ...........................................................................................34 WHAT ARE THE SIGNS OF A GOOD LATCH? L LIPS FLANGED OUT Wide, gaping mouth to accommodate areola and nipple A ASYMMETRIC LATCH More areola visible above the baby’s top lip T TUMMY TO MUMMY Baby’s ears, shoulders and hips in alignment C CHIN TOUCHING BREAST Nose free in the sniffing position H HAVE A LISTEN & WATCH Active suckling and swallowing indicates milk transfer 1 BREASTFEEDING SUCCESS • EARLY & OFTEN • EFFECTIVE (OPTIMAL LATCH) • EXCLUSIVE (NO SUPPLEMENTS) PHYSICIAN’S BREASTFEEDING TOOLKIT INFLUENCE OF LATCH & MILK PRODUCTIO N ON BREASTFEEDING OUTCOMES Note: If the latch is optimal, even a reduced milk production can lead to a healthy infant weight gain. LATCH Milk Outcomes for Mother & Baby Production • Excellent weight gain • Pain free feeding Optimal Optimal • Efficient feeding • Satisfied baby • Good weight gain Adequate Optimal • Pain free feeding • Longer & more frequent feedings • Good weight gain Optimal Adequate • Pain free feeding • Efficient feeding • Satisfied baby • Slower weight gain • Lower milk production Poor Optimal • Longer feeds • Possible weight loss • Sore nipples • Slow weight gain • Longer feeds Poor Adequate • Growth concerns • Fatigue (mom & baby) • Sore nipples 3 PHYSICIAN SUPPORT IS KEY TO SUCCESSFUL BREASTFEEDING UNNECESSARY SUPPLEMENTATION UNDERMINES BREASTFEEDING PHYSICIAN’S BREASTFEEDING TOOLKIT SIGNS OF EFFECTIVE BREASTFEEDING First 6 week s • Exhibits readiness to feed at least 8 or more times in 24 hours • Suckles and swallows effectively to transfer milk and stimulate production • Has alert periods • Settles after a feeding • Yellow, seedy bowel movements and clear urine (see stool & urine output chart) • Back to birth weight by day 14 • Weight gain at least 113 grams (4 ounces) per week * • No pain with breastfeeding *It may be acceptable for a healthy baby to have a slower weight gain pattern. INFANT STOOL & URINE OUTPUT CHART INFANT AGE WET DIAPERS / DAY STOOLS / DAY Days 1 to 2 1 - 2 clear or pale yellow 1+ meconium (colostrum) Days 3 to 4 3+ clear or pale yellow 3+ green, brown or yellow (milk coming in) After 1st week 6+ clear or pale yellow 3+ soft, yellow, loose, seedy (milk is in) After 4 weeks 6+ clear or pale yellow Varies. 1 or more soft, large or may go several days without a BM ** ** An occasional green stool is not unusual. 5 PHYSICIAN’S BREASTFEEDING TOOLKIT FACTORS THAT MAY IMPACT LACTATION OBSERVATION AND EVALUATION INFANT OF BOTH MOTHER & BABY WHILE BREASTFEEDING IS ESSENTIAL. NEWBORN HISTORY • Preterm or late preterm • SGA • IUGR • Multiple gestation • Congenital anomalies • Ankyloglossia • Traumatic delivery FIRST DAYS OF LIFE • Weight loss >10% • Failure to regain birth weight by day 14 • Signs of illness: jaundice, fever, lethargy, hypoglycemia • Separation from mother • Resuscitation FEEDING HISTORY • Ineffective latch • Early introduction of artificial nipples/pacifiers • Non-medical supplementation • State around feedings (e.g., fussy, sleepy, unsettled) A complete history and physical of mother and baby is necessary when assessing problems such as low milk production or slow weight gain. 6 PHYSICIAN’S BREASTFEEDING TOOLKIT FACTORS THAT MAY IMPACT LACTATION PREGNANCY HISTORY MOTHE R • Infertility • Hypertension SOCIAL HISTORY • Gestational diabetes • Primiparous • Depression/anxiety • Inadequate social supports • Anemia • Uninvolved partner • Early return to work or school LABOUR & DELIVERY • Uncertain feeding goals • Gestation • Adolescent or older mother • Induction of labor • Physical or sexual abuse • Prolonged labor • Unrealistic postpartum expectations • Assisted delivery or C/S • Hx of previous breastfeeding challenges POSTPARTUM MEDICAL HISTORY • Infection • Breast surgery • Hemorrhage • PCOS • Retained placenta • Thyroid dysfunction • Delayed lactogenesis • Some medications • Breast or nipple pain • Flat or inverted nipples • Inadequate milk production • Obesity • Hormonal contraception before • Endocrine disorders breastfeeding well established • Anemia • Thyroid dysfunction Ankyloglossia Premature baby Inverted nipple 7 BREASTFEEDING PRIORITIES 1. FEED THE BABY 2. PROTECT THE MILK PRODUCTION 3. FIX THE PROBLEM Frequent removal of milk from the breasts is the trigger for ongoing milk production. USE IT OR LOSE IT! 8 PHYSICIAN’S BREASTFEEDING TOOLKIT QUESTIONS TO CONSIDER WHEN ASSESSING BREAST & NIPPLE PAIN NOTE: IT IS IMPORTANT TO ASSESS IF THE BREAST / NIPPLE PAIN IS UNILATERAL OR BILATERAL. QUESTION POSSIBLE DIAGNOSIS BREAST PAIN • Palpable, tender mass or lump? Blocked duct or Mastitis • Fever, malaise and erythema? YES: Mastitis NO: Blocked duct • Palpable, tender, red lump not responding Breast abscess to mastitis or blocked duct RX? • Persistent breast fullness and pain? Engorgement • Shiny, taut skin and nipple effaced? (more common if < 1 week PP) • Baby choking on feeds? • Strong letdown, hypersensitive nipples, very full breasts? Overproduction NIPPLE PAIN • Soreness or pain with no skin breakdown? Sore nipples • Nipple pain with skin breakdown? (nipple compressed, crease or blanching across the tip, Abrasion/cracked nipple ecchymosis, shallow or deep fissure) • Erythema and crusting? Infected abrasion/cracked nipple • Shooting or burning pain worse with feeding, itchy nipples? Candida • Nipple blanching, blue/red colour changes? Vasospasm/Raynaud’s • Dry, flaking skin, pruritus and erythema? Dermatitis/Eczema • Painful, white lesion? Bleb or sebaceous cyst 9 PHYSICIAN’S BREASTFEEDING TOOLKIT DIAGNOSIS & TREATMENT OF COMMON BREASTFEEDING CONCERNS DIAGNOSIS SYMPTOM SIGN TREATMENT • Engorgement • Generalized • Hard, tight, red, • BEFORE feeding : facilitate over fullness, shiny breasts milk let-down with: breast • Usually bilateral • warm compresses to tightness and breast or warm shower pain • Nipple effaced • gentle hand massage • Areola firm and expression (Peaks days 3-5) • Difficulty latching • reverse pressure softening (see below) • Poor let-down • DURING feeding : • optimize latch • frequent feedings with breast compression (see below) • AFTER feeding : • hand expression • cool compresses to breast • NSAIDs prn REVERSE PRESSURE SOFTENING (RPS) 1. Apply gentle, but firm, positive pressure inwards towards the chest wall, on the areola at the base of the nipple for 40-60 seconds prior to latching the baby. 2. Apply pressure with the fingertips moving around the circumference of the areola. This softens a 1 inch area of the areola, by pushing back interstitial fluids, reducing edema, and facilitating
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]
  • 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]
  • Or Treat Mastitis Natural Ways to Avoid
    pregnancy & new baby By Tiffany Brown* mastitis:top 5 natural ways to avoid or treat mastitis Breastfeeding is indeed a labour of love, with one in three of us lactating mums suffering from mastitis at some point as a consequence of our commitment. Mastitis is an infection of breast tissue caused by a blockage in one of the milk ducts. What can we do at home to avoid or treat it? Mastitis may arise from poor feeding if your suckling baby done with an infant to care for, but now is the time to enlist she doesn’t get into bad habits. If a blockage occurs, try is incorrectly latched. This creates uneven milk flow, and in help. Take to your bed and give your body a chance to do changing feeding positions to encourage milk flow. If at all turn can cause a blockage. Oversupply or gaps in your its best for you. possible, direct baby’s chin towards the blocked area. Using feeding schedule may also cause the problem, as milk the ‘football’ hold, lying sideways or even leaning forward over collects and puts pressure on the ducts. Pressure on the 3. massage and heat baby can all help stimulate flow and ease milk duct breasts (for instance, from wearing a poorly-fitting bra) may congestion. Take a look at your clothing and make sure you Applying heat to the area can promote drainage of the haven’t been wearing anything too constricting that might be also result in a mastitis infection, as might over-tiredness affected duct, so get a wheat bag or hot water bottle onto causing blocked ducts.
    [Show full text]
  • The Ins and Outs of Inverted Nipple Repair
    The Ins and Outs of Inverted Nipple Repair plasticsurgerypractice.com/2009/11/the-ins-and-outs-of-inverted-nipple-repair/ The proper appearance of the breast and the nipple can be very important to women and men alike. An inverted nipple, something that women may notice increasing at the onset of puberty, is something that can be rectified with a simple 15-minute surgical procedure. PSP recently spoke with M. Mark Mofid, MD, FACS, a plastic surgeon in La Jolla, Calif, about the various techniques of inverted nipple surgery as well as nipple reduction. Mofid is a staff surgeon at several California hospitals, including Scripps Memorial Hospital in La Jolla, Palomar Medical Center in Escondido, and Sharp Chula Vista Medical Center. In addition, he serves on the clinical faculty of the University of California, San Diego, Division of Plastic Surgery. He earned his undergraduate degree magna cum laude from Harvard University. He then attended The Johns Hopkins University School of Medicine, where he completed his medical degree training in general surgery and plastic surgery, and well as completed an advanced craniofacial research fellowship. PSP: How new is the inverted nipple procedure, and how popular is it? Mofid: Numerous techniques have been described over the last several decades for inverted nipple repair. In my own practice, at least one to two patients per month request this procedure. PSP: Are there different types of inverted nipple surgery and different ways of performing the surgery? Mofid: Virtually all techniques involve some variation of a release of the nipple from its basilar attachments. Fixation (whether internal or external) prevents the nipple from re-retracting during the healing process.
    [Show full text]
  • The First Answer (A) Is Correct! 1
    The first answer (A) is correct! 1. 2. A 32 y.o. woman consulted a gynecologist about having abundant long menses within 3 months. Bimanual investigation: the body of the uterus is enlarged according to about 12 weeks of pregnancy, distorted, tuberous, of dense consistence. Appendages are not palpated. Histological test of the uterus body mucosa: adenocystous hyperplasia of endometrium. Optimal medical tactics: A. Surgical treatment B. Hormonetherapy C. Phytotherapy D. Radial therapy E. Phase by phase vitamin therapy 2. 3. A woman was hospitalised with fullterm pregnancy. In survey: the uterus is morbid, the abdomen is tense, heart sounds of the fetus are not auscultated. What is the most probable complication of pregnancy? A. Premature detachment of the normally posed placenta B. Preterm labour C. Back occipital presentation D. Acute hypoxia of a fetus E. Hydramnion 3. 4. By the end of the 1st period of physiological labour the clear amniotic waters were given vent. Contractions lasted 35-40 sec every 4-5 min. Palpitation of the fetus is 100 bpm. The AP is 140/90 mm Hg. Diagnosis: A. Acute hypoxia of the fetus B. Labors before term C. Premature detachment of normally posed placenta D. Back occipital presentation E. Hydramnion 4. 6. Which gestational age gives the most accurate estimation of weeks of pregnancy by uterine size? A. Less that 12 weeks B. Between 12 and 20 weeks C. Between 21 and 30 weeks D. Between 31 and 40 weeks E. Over 40 weeks 5. 7. A number of viable fetuses per 1000 women at the age between 15 and 44 is determined by: A.
    [Show full text]
  • Cracked Nipples
    UNICEF UK BABY FRIENDLY INITIATIVE GUIDANCE FOR PROVIDING REMOTE CARE FOR MOTHERS AND BABIES DURING THE CORONAVIRUS ( COVID - 19) OUTBREAK GUIDANCE SHEET 5 B ( CHALLENGES ) : SORE , PAINFUL A N D / O R CRACKED NIPPLES Delivering Baby Friendly services at this time can be difficult. However, babies, their mothers and families deserve the very best care we can provide. This document on management of sore, painful and/or cracked nipples is part of a series of guidance sheets designed to help you provide care remotely. THE MOTHER HAS SORE, PAINFUL AND/OR CRACKED NIPPLES ▪ Sore, painful and/or cracked nipples are signs of ineffective positioning and attachment of the baby at the breast. Therefore, revisiting positioning and attachment are the top priorities. ▪ Other causes include restricted tongue movement in the baby (tongue tie) or infection of the breast, e.g. thrush. PREPARING FOR THE CONVERSATION ▪ Plan a mutually agreed appointment with the USEFUL RESOURCES mother and consider using video so that you can watch a feed and see the mother and baby ▪ Breastfeeding assessment tools ▪ Refer to Guidance Sheet 1 before you start (midwives, health visitors, neonatal or ▪ Be aware that parents may be feeling vulnerable and mothers) frightened because of Covid-19, so sensitivity and ▪ Unicef UK support for parents active listening are important overcoming breastfeeding problems ▪ Take the parent’s worries seriously as they can often ▪ Knitted breast and doll (if video call) sense when something is wrong. DURING THE CALL Introduce yourself and confirm consent for the call ▪ Ask the mother to describe her feeding journey so far.
    [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]
  • Benign Breast Diseases1
    BENIGN BREAST DISEASES PROFFESOR.S.FLORET NORMAL STRUCTURE DEVELOPMENTAL/CONGENITAL • Polythelia • Polymastia • Athelia • Amastia ‐ poland syndrome • Nipple inversion • Nipple retraction • NON‐BREAST DISORDERS • Tietze disease • Sebaceous cyst & other skin disorders. • Monder’s disease BENIGN DISEASE OF BREAST • Fibroadenoma • Fibroadenosis‐ ANDI • Duct ectasia • Periductal papilloma • Infective conditions‐ Mastitis ‐ Breast abscess ‐ Antibioma ‐ Retromammary abscess Trauma –fat necrosis. NIPPLE INVERSION • Congenital abnormality • 20% of women • Bilateral • Creates problem during breast feeding • Cosmetic surgery does not yield normal protuberant nipple. NIPPLE INVERSION NIPPLE RETRACTION • Nipple retraction is a secondary phenomenon due to • Duct ectasia‐ bilateral nipple retarction. • Past surgery • Carcinoma‐ short history,unilateral,palpable mass. NIPPLE RETRACTION ABERRATIONS OF NORMAL DEVELOPMENT AND INVOLUTION (ANDI) • Breast : Physiological dynamic structure. ‐ changes seen throught the life. • They are ‐ developmental & involutional ‐ cyclical & associated with pregnancy and lactation. • The above changes are described under ANDI. PATHOLOGY • The five basic pathological features are: • Cyst formation • Adenosis:increase in glandular issue • Fibrosis • Epitheliosis:proliferation of epithelium lining the ducts & acini. • Papillomatosis:formation of papillomas due to extensive epithelial hyperplasia. ANDI & CARCINOMA • NO RISK: • Mild hyperplasia • Duct ectasia. • SLIGHT INCREASED RISK(1.5‐2TIMES): • Moderate hyperplasia • Papilloma
    [Show full text]
  • Breastfeeding Matters
    Breastfeeding Matters An important guide for breastfeeding families ACKNOWLEDGEMENTS Best Start by Health Nexus would like to thank the Public Health Units of Ontario who supported the creation and development of this provincial resource and generously shared their resources and expertise. We would also like to thank the parents and the experts who provided input for this booklet. Final review was done by Marg La Salle, RN, BScN, IBCLC, and BFI Lead Assessor. The information in this booklet is current at the time of production but information can change over time. Every effort will be made to ensure the information remains current. Throughout this resource, gender-specific language such as “woman”, “women” and “mother” is used in order to accurately cite the research referred to. We intend these terms to refer to all childbearing individuals, regardless of their gender identity or sexual orientation. Funded by the Government of Ontario. Table of Contents SECTION 1 .......................... 3 SECTION 4 ........................ 27 The Importance of Breastfeeding Important Things to Know • Risks of Not Breastfeeding • Waking a Sleepy Baby • Your Breastfeeding Rights • Calming a Fussy Baby • The Baby-Friendly Initiative • Burping Your Baby • Making an Informed Decision • Growth Spurts • Family Support • Sore Nipples • Peer Support • Using a Pacifier (Soother) • Engorgement SECTION 2 ........................ 11 • Storing Your Breast Milk Helping Your Baby Get a Good Start • Skin-to-Skin SECTION 5 ........................ 33 • Safe Positioning
    [Show full text]
  • ABSTRACT Background: the Benefits of Breast Milk Are Greatly Enhanced If Breastfeeding Starts Within One Hour After Birth
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by International Journal of Health and Biological Sciences International Journal of Health and Biological Sciences Vol. 2, No. 3; 2019:16-41 e-ISSN: 2590-3357; p-ISSN:2590-3365 DOI: https://doi.org/10.30750/ IJHBS.2.3.2 Breast Feeding Knowledge and Practices Among Primiparous Women with Caesarean Section: Impact on Breast Engorgement in Upper Egypt Hanan Elzeblawy Hassan 1* , Galal Ahmed EL-Kholy2, Aziza Ahmed Ateya3, Amal Ahmed Hassan4 1 Maternal and Newborn Health Nursing Department, Faculty of Nursing, Beni- Suef University, Egypt. 2 Professor of obstetrics & gynecology, Faculty of Medicine, Benha University, Egypt. 3Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Ain Shams University, Egypt. 4 Professor of Obstetrics and Women’s’ Health Nursing department, Benha University, Egypt. ABSTRACT Background: The benefits of breast milk are greatly enhanced if breastfeeding starts within one hour after birth. Hunan milk contains a host of dynamic and unique feeding properties. Breast engorgement is one of the most common minor discomforts confronting nursing women after delivery, especially Primiparous. The aim of the study was to investigate the breastfeeding knowledge and practices among primiparous women with a cesarean section and its impact on breast engorgement in Upper Egypt. The study was conducted in the postnatal unit of Beni-Suef University Hospital. The study design was a descriptive study. The type of sample was a simple random sample. The study comprised 90 Primiparous cesarean section mothers; suffer from breast engorgement. Tools of Data Collection were interview questionnaire sheet, knowledge assessment sheet, observational checklist, and engorgement assessment scale.
    [Show full text]
  • Overcoming Difficulties (PDF)
    Breastfeeding Overcoming Difficulties ® Only a phone call away! See your local telephone directory Breastfeeding is a gift only you can give to your baby. A healthy full-term baby is likely to know instinctively what to do at the breast. For many mothers and babies breastfeeding goes well right from the start, for others it can take a little longer to learn. Common problems can be minimized or avoided entirely if a mother has accurate and consistent breastfeeding information and support. “Breastfeeding is a long term commitment. In order to succeed, a mother needs the encouragement and companionship of other mothers. La Leche League succeeded in the beginning and continues to work well because it meets the dual need for sound practical information and loving support. Babies don’t change and neither do mothers, though the circumstances in which they find themselves differ from one generation to the next.” Mary Ann Cahill, Founder LLL Sore Nipples Many mothers experience some nipple tenderness at the beginning of a feed during the first two to three days of breastfeeding, however, breastfeeding should not hurt. If you have continued discomfort or pain while breastfeeding or have discomfort or pain between breastfeeds, some adjustment or treatment may be needed. Research shows that good positioning of the baby at the breast will help prevent and heal sore nipples. Positioning Baby at the Breast There are a number of ways to hold your baby while breastfeeding. Getting your baby started at the breast smoothly and easily will soon become second nature to you. Nursing a baby at the breast is actually much less involved than any description of the process.
    [Show full text]