W - Care of lactating woman Flashcards
Understand what are normal
–breasts – full/engorged breasts,
nipples–sore/ crackednipples,
lochia flow
- Management
–health teaching for lactating woman(methods/techniques to
prevent complications, –charts)
*Include overall care e.g.psychological care(adaptation to mother hood)
Whats the LATCH Breastfeeding Charting System?
Latch
0: Too sleepy/reluctant -> No latch
1: Repeated attempts: must hold nipple in mouth, stimulate to suck
2: Grasps breast, tongue down, lips flanged, rhythmic sucking
Audible swallowing
0: None
1: A few swallows with stimulation
2: Spontaneous & intermittent <24 hrs old;
Spontaneous & frequent >24hrs old
Type of nipple
0: inverted
1: flat
2: everted after stimulation
Comfort of breast/nipple
0: Engorged, cracked, bleeding, bruises, severe discomfort
1: Filling, reddened small blisters/bruises, mild/moderate discomfort
2: Soft, non-tender
Hold/Positioning
0: Full assist - nurses holds infant at breast
1: Minimal assist - staff places pillows down for support, elevates head of bed, teach one side, mother does the other -> mother takes over the feeding
2: No assistance from staff, mother can hold baby herself
Total score: 10 = mother is ready to independently breastfeed
What are signs of good/proper latch on & effective suckling?
Good latch = CALM
C: Chin & cheek close to breast
A: Areola covered as much as possible
L: upper & lower lips flanged out
M: mouth is wide open
Effective suckling:
- rhythmic, deep sucks
- mother not in pain
- swallowing heard
What are the positions during breast feeding and the 4 key points on breastfeeding positions?
Positions:
Cradle, side lying, cross-cradle, football
Four key points on Breastfeeding Positions
1. The baby’s head and body should be in a straight line. A baby cannot suckle or swallow easily if his head is twisted or bent.
2. His mouth should face the breast, with his top lip opposite the nipple. The baby’s whole body should almost face his mother’s body.
3. mother should hold body close to hers.
4. If her baby is newborn, she should support his whole body, not just his head and shoulders.
How often should you breastfeed and what should your baby’s tummy size & weight be from 1 day - 3 weeks?
Day 1 - 3 wks:
- At least 8 feeds / day
- baby is sucking strongly, steadily, slowly, swallowing often
Tummy size:
- Day 1-2: cherry size
- Day 3-4: walnut
- Day 5 -6: apricot size
- Day 7 - 3 wks: size of a large egg
Weight:
day 1-3: lose an average of 7% of birth weight
day 4 - 3 wks: gain 20-35g per day & regain birth weight by 10-14 days
How many wet & soiled diapers should your baby have?
WET
Day 1- 4: At least 1,2,3,4 respectively
Day 5 - 3 wks: at least 6 heavy wet with pale yellow / clear urine
SOILED
Day 1-2: At least 1-2 black or dark green meconium
Day 3-4: At least 3 Transitional stools - brown, green or yellow
Day 5-3wks: At least 3 large, soft, seedy yellow
What growth spurts should your baby experience & what other signs should you look out for?
At around 2 wks, 6 wks & 3 mths - babies often experience growth spurts
- may want to nurse more than usual
Other signs:
- strong cry, move actively, wake easily
- breasts feel softer & less full after breastfeeding
What are the causes of breast engorgement?
Solutions? How to prevent it?
Causes:
* physiological (3rd - 4th postpartum)
* ineffective / inadequate removal of milk
Solutions:
- Before feeds: cold compress, express milk to relieve tension in breasts
- During feeds: Ensure correct positioning
- After feeds: express breastmilk to prevent engorgement, cold compress, supportive bra
Preventions:
- Frequent, unrestricted feeding
- Proper attachment
Whats the cause of sore nipples?
Solutions? How to prevent it?
Cause: Incorrect positioning
Solutions:
1. Rest affected nipple if necessary (express)
2. Feed from the unaffected side first
3. Review technique of latching on & removal from nipple
4. Emphasise importance of “correct positioning”
5. Massage nipples with breast milk after feeds & expose them
