context
- micro, meso, macro
knowing the profession
- knowledge of standards or practice, competencies, skills, and roles of nurses
knowing the self
individual strengths, limitations, skills, experience, preconceptions, others needs
knowing the case
- pathology
- patterns that exist
- predicted trajectory
- patient responses
knowing the person
- patients past experince, patterns in personal responses, supports, resources
knowing the patient
knowing patients data, patterns in labs
what are the 3 rules to breastfeeding
- feed the infant
- move the milk
- help the dyad learn to breastfeed
what strategies would help the parents take care of ‘feed the infant’ and ‘move the milk’
- increase frequency/duration
- improve latch/position
- SSC
- feeding cues
- offer both breasts
supplemental options to recommend are:
- expressed milk
- pasteurized donor milk
- artificial milk
what strategies would be helpful for establishing a breastfeeding relationship
- try different latches/positions
- SSC
- understand cues
- gentle and responsive
what are some positional safety for infant feeding
- tuck infant in close to moms body
- support infants touch the breast with hands
reasons for a difficult latch at birth to 2 months of age
- poor mechanics
- flat/inverted nipple
- pain
- oral aversion
- tongue tied
- sleepy
what are some reasons an infant may refuse to breast feed at 2months to a year of age
- pain (teething)
- illness
- mothers stress
- distracted
- abundant of milk supply
what is the most common issue for poor latch
- sore/cracked nipples
early signs of mastitis
- breast pain, swelling, redness, flu-like symptoms
what are some guidelines for mastitis
- early diagnosis
- continue to breastfeed
- educate
- support the person: warm showers, cold compress, positioning
- antibiotic therapy
- pain management - massage
what are the categories for low milk supply
- perceived
- temporary
- primary
perceived low milk supply is due to
- parents thinking their infants behaviour says they don’t have enough
- cluster feeds
- freq feeds
need to do a feeding assessment for perceived low milk supply such as:
- feeding effectiveness (latch)
- adequate intake
- intake and output
- SSC - responsive feeding
temporary low milk supply is when:
- factors delay lactogenesis II beyond 72 hours from birth
common causes for temporary low milk supply
- inadequate stimulation
- infreq. feeds
- ineffective fees
- cesarean delivery
- high stress
causes of primary low milk supply for the mom:
- primary insufficiency (growth of breast)
- hormonal issues (PCOS, thyroid)
- breast surgery
- obesity
causes of primary low milk supply for the infant
- tongue tied
- jaundice, thyroid, illness
- neurological disorder
- preterm/SGA
infant behaviours seen with a generous milk supply
- gulps, gags, fussing, pulling off, clicking sound when swallowing
- explosive green stools
- gassy
- colicky/crying lots
- large weight gain
