What are green/shiny stools a sign of?
ANSWER: -sign of overproduction leading to less fat in milk, faster digestion
causing not enough time for lactase to digest the lactose in milk. An improved latch
could allow for more fat flow
Signs of oversupply
ANSWER: Rapid weight gain in infant, u...
ANSWER: Improper latch--> need lactation support to help with proper latch on,
good seal
True/false: baby should be pulled into breast.
ANSWER: False! Do not pull baby into breast, let baby tilt head back for optimal
latch. Hand on back of baby's head can interfere baby's interoral function by restricting
, Deeagles - Stuvia US
the movement of the cranio-cervical spine--> causes nipple trauma. Make sure crook of
arm in cradle position does not block baby from being able to fully tilt back.
Should a latch be symmetric or asymmetric?
ANSWER: Asymmetric! A baby should form a teat with breast tissue underneath
the nipple as part of a latch
What is a symmetric latch
ANSWER: Not a good latch, causes nipple damage
Asymmetric latch
ANSWER: Optimal attachment to the breast, where the baby's lips are not
centered in relationship to the areolar, but rather vertically off-centered with the baby's
chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby
should form a teat with breast tissue underneath the nipple as part of a latch
Do nipple creams work?
ANSWER: Continued questions of effectiveness, fear of ingestion by baby
Should a frenotomy be suggested for tongue tie?
ANSWER: No study was able to report that frenotomy led to better long term
breastfeeding
, Deeagles - Stuvia US
Tongue tied breastfeeder
ANSWER: -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?
ANSWER: 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?
ANSWER: 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.
What to do for oversupply?
ANSWER: 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?
, Deeagles - Stuvia US
ANSWER: normal milk production = 750-1000 mL/day
Thrush during BF
ANSWER: 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
ANSWER: -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?
ANSWER: Not candida infection!
Reynaud's Phenomenon
ANSWER: -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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