Tongue tied breast feeder - ANS✔✔--complete feeding assessment and suggest
ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
What is a fissure straight down the nipple evidence of? - ANS✔✔-A symmetric
latch. Top lip needs to have good seal, moist part of lip should be touching
nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? - ANS✔✔-If nipple not stretched
deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk
digested quicker = not enough time for baby to make enough lactase to digest
lactose in milk.
nursing strike - ANS✔✔-sudden, lots of milk not being taken out, not the end of
breastfeeding but may thought to be the end
-reason for strike may be obscure but there is something wrong in baby's life
(stuffy nose, teething, ear infection, prefers bottle, biting/yelling, reaction to
being left unattended/cry it out, family stress, separation
to end a nursing strike - ANS✔✔--identify/resolve problem
-lots of support
-lots of skin contact
-don’t force it
-avoid bottle
-offer breast to sleeping baby
-try peer pressure (being around other babies who BF)
,sleeping throughout night - ANS✔✔--regulatory problems such as crying,
feeding, sleeping co-evolve, particularly in first 4 months
-from four months of age, sleep consolidated in night time, although many still
have night feedings
-behavioural intervention programs fail to help may increase stress
-babies who breastfeed in evening and or at night sleep an average of 40-45 min
more than parents of infants given formula and reported less sleep disturbance
6-9 months and sleeping at night - ANS✔✔-no difference in night waking or night
feedings compared to formula fed infants
infants who received more milk or solid feeds during day were... - ANS✔✔-less
likely to feed at night but not less likely to wake
SIDS - ANS✔✔--safe sleep, on back
-breastfeeding protective beginning at 2 months and increasing over time
-EBF @ 1 month of age halved risk of SIDS
-gut microbiome in babies who died from SIDS offers one explanation: C diff in
guts of 27% of babies who died
10 steps to successful breastfeeding for hospitals - ANS✔✔--outlined by
WHO/UNICEF
1) have a written breastfeeding policy for all staff
2) train all healthcare staff to implement this policy
3) inform all pregnant women about benefits/mgmt of EBF
4) help mothers BF within 1 hr post birth
5) show moms how to BF/maintain BF even if separated from infants
6) give newborn infants no food/drink other than BM unless medically indicated
7) practice rooming in 24 hrs/day
8) encourage BF AL
9) No pacifiers or teats
10) foster establishment of BF support groups and refer mothers to them on d/c
from hospital
,-support for international code built into BFHI
parenting dimensions of responsive parenting - ANS✔✔-feeding
soothing
sleep
physical activity
10 steps of successful breastfeeding led to... - ANS✔✔-more likely to BF at 12
months
more likely to EBF @ 3 and 6 months
less GI infections
less atopic eczema
implementation of the baby friendly hospital initiative may be the fast-track
option to a foundation of... - ANS✔✔-enhanced public health
hypothyroid and lactation - ANS✔✔-can cause low milk supply, can cause poor
weight gain
-but breastfeeding is fine, just be cautious of this
hyperthyroidism and lactation - ANS✔✔-not a contraindication
exceedingly low levels of excess thyroid hormones pass into breastmilk
Post birth warning signs- call 911 - ANS✔✔-pain in chest (blood clot or heart
problem?)
obstructed breathing or SOB (blood clot?)
seizures (Eclampsia)?
thoughts of hurting yourself or baby (PPD?)
post birth warning signs- call PCP - ANS✔✔--bleeding, soaking through one
pad/hour, blood clots larger than size of egg (haemorrhage?)
-incision that is not healing (? Infection)
, -red or swollen leg that is painful or warm to touch (blood clot?)
-temperature of 100.4 or higher (infection)
-headache that does not get better after medicine, or headache with vision
changes (post birth pre-e?)
What to do for oversupply? - ANS✔✔-Decrease additional stimulation/milk
removal if possible
Consider block feeding (only nursing on one side only per feeding)
Watch for mastitis
Try australian posture (mother down under, baby on top)
Consider donating to milk bank
Consult with HCP for medical dx
How many mL considered oversupply? - ANS✔✔-normal milk production = 750-
1000 mL/day
Thrush during BF - ANS✔✔-painful for mother & baby.
may be visible or may not (whiteness that can't be wiped off)
-mother will have itchy, flaky, shiny skin
-candida not found inside the ducts or milk
Treatment of candida on breast - ANS✔✔--nystatin first line
-flucanizole second line
-throw out all yeast vectors (pacifiers sterilize breast pumps)
-flucanazole oral capsules may be used to clean yeast vectors due to the biofilm
created on pacifiers by candida
What to do if antifungal treatment for yeast doesn't work? - ANS✔✔-Not candida
infection!
Reynaud's Phenomenon - ANS✔✔--vasospasm of nipple, recognized by triple
color sign: from white--> blue--> raspberry or bicolor sign white --> raspberry.
pain is extreme and spasmodic (not continuous)
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