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PED Breastfeeding
| Question | Answer |
|---|---|
| Recommended first feeding time | Baby to breast within 1-2 hours post birth |
| Encourage feeding | 8-12 times/24 hours |
| deep sleep state | may last 24 hours |
| in the first 24 hours, look for | one feeding, one pee, one poop |
| colostrum is a | laxative, helps them get rid of meconium. |
| Don't worry if the baby isn't eating in the first day b/c | they are born overhydrated and with brown fat. God designed it this way b/c it is timely with when the milk comes into the mom's breast |
| shallow latching | can be painful for the mom. Want deep latching/listen for swallows (soft k sound) |
| Colostrum | precurose to milk, protein and antibody rich, 5-10ml/feeding. |
| Milk Supply | transitions in between 2-4 days post partum, volume increases quickly, 750ml-1000ml/24 hours by 10-14 days pp. First two weeks are key; need to get up and pump or breast feed during the night to make sure prolactin inhibtor levels do not increase |
| Support and Education | Feeding cues, positioning and Latch (up at breast height), Audible swallows when feeding, frequency and duration of feeds, awake/sleep states, expectations |
| Most feedings last | 20-40 min. If you count the latching and burping, it may take another 10 minutes. |
| Best position for breast feeding to start with | football |
| top reasons women quit breastfeeding | engorgement, sore nipples |
| Late pre-term infant | 34-37 weeks: full term nursery of ICN. Effective breastfeeding may not occur or is inconsistent. Supplementation at breast or with alternative feeding method. Feedings improve as infant matures developmentally |
| Mom's with premature infant and special needs infant | pre-term breast milk uniquely suited for preterm baby. Iniate pumping within 6-8 hours after delivery. Pump every 3 hours around the clock while establishing supply. |
| Milk supply is established in the first | two weeks |
| Ineffective/non nutritive breastfeeding | mom does not feel strong tug on nipple, immature suck pattern, no audible swallows when feeding, baby falls asleep at breast after 5-10min. |
| Engorgement | onset may be gradula, immediately (3-4 days) post-partum. Bilateral, generalized heat and swelling, generalized pain, maternal temp<101, Tx: heat prior to feeding, breastfeed, or pump, ice post feeding, cabbage leaves |
| Persistent nipple soreness and pain | not normal, if it persists, may precede post partum depression. Begin feed on least sore side. Hydrogel dressings/breast shells |
| Mastitis | Onset: sudden or gradual (after 10 days), unilateral, localized edema, heat, erythema. Pain intense but localized. Maternal temp>101, flu-like sx, Tx: breastfeed/pump/rest/fluids/abx |
| ABX for mastitis | dicloxicillin (10-14 day course), oxacillin, first-generation cephalosporin, erythromycin |
| Offending organism in Mastitis | Staph aureus |
| Plugged Ducts | onset gradual, unilateral, may be little or no heat, swelling may shift. pain mild but localized. Temp<38.4. Tx: heat/massage/nurse - infant's chin pointed toward plugged duct. |
| "Plug" in plugged duct | curdled milk |
| Fungal Infxn: Yeast | Nipples persistently sore, unresponsive to position changes, sucking corrections, or nipple creams. Pinkish-red appearance with shiny nipples/areola: White plaques on nipples. Tx: both mom and baby must be treated. Antifungals. |
| Breast Reduction and Breast Augmentation | can both affect production. Breast reduction moreso than augmentation |
Created by:
ltm12