challenges faced by breastfeeding mothers Flashcards
nipple pain in breastfeeding mother - differentials (7)
poor attachment of baby when feeding
nipple thrush
nipple bacterial infection
nipple vasospasm
nipple eczema / dermatitis
blocked breast ducts
mastitis
nipple bacterial infection - management
mupirocin ointment 2% TDS
nipple vasospasm
- expected presentation
- mechanism causing it
- management (2)
- nipple pain, especially when cold
- raynaud’s phenomenon of nipples
- keep area warm
- nifedipine 20mg PO OD if bad
nipple eczema
- expected presentation
- expected examination
- management (1)
nipple pain in an older infant >6mo
red, itchy, rash thats kinda spreading but has clear edge on nipple
mometasone furoate 0.1% OD TOP after feeds, for 10 days
difference between blocked ducts vs mastitis
the latter has inflammation/infection symptoms, the former is just the blocked duct
management of low milk supply (4)
- aim for 8 or more feeds per day
- delay use of pacifiers, nipple shields, formula
- express milk with breast pump when infant not feeding
- use a galactagogue (domperidone 10mg PO TDS)
infants with feeding challenges - ddx (5)
delivery related
- preterm infant < 35/40
- trauma from delivery - cephalhaematoma
oropharynx anatomy defects
- cleft palate
- tongue tie
- laryngomalacia
functional lactose overload - management (3)
refer to lactation consultant
change feeding pattern to block feeding
educate mother on underlying mechanism for functional lactose overload
breastfeeding - what is block feeding
feeding with one breast over 2-3 hour period, rather than switching breasts between feeds
management of breast and nipple thrush
baby - miconazole oral gel QID TOP 1/52
mum - fluconazole 150mg alternate days, 3 doses then
nystatin 2x500,000 TDS + miconazole gel QID, complete after 1/52
nonmedical
- wash hands frequently
- sterilise dummy, replace weekly
