Continuity of Care for Breastfeeding Families

Birth & Beyond California: Breastfeeding Training & QI ProjectWith funding from the federal Title V Block Grant

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Objectives

• Identify three pre-discharge infant breastfeeding issues requiring follow up care

• Identify three pre-discharge maternal breastfeeding issues requiring follow up care

• Identify two follow-up resources available for breastfeeding families

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Pre-Discharge Breastfeeding Assessment – Baby Issues

• Excessive weight loss

• Lack of output

• Difficulty with latch

• Difficulty with suckling

• Lethargy

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Pre-Discharge Breastfeeding Assessment – Baby Issues

• Jaundice

• Preterm/late preterm

• Anatomical concerns

• Health concerns

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Pre-Discharge Breastfeeding Assessment – Mother Issues

• Sore nipples• Unusual nipple size/shape• Engorgement• Questionable milk supply• History of breastfeeding problems• History of breast surgery• History of infertility• Health concerns

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Pre-Discharge Breastfeeding Assessment – Mother Issues

• Lack of social support

• Maternal-infant attachment concerns

• Potential for postpartum depression

• Lack of confidence

• Inability to breastfeed without help

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Follow Up Care

• Avoid “Zone of No Professional Contact”• Infants and mothers with identified pre-

discharge breastfeeding issues need a documented plan of care and discharge follow up

• All breastfeeding women and infants should receive contact within the first week

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Pediatric Appointment

“All breastfeeding newborn infants should be seen by a pediatrician, or other knowledgeable and experienced health care professional, at 3 to 5 days of age.”

AAP, Breastfeeding and the Use of Human Milk, 2005

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Breastfeeding Resources Activity

• Create a list of resources in your community– WIC Agency– Public Health Department– Home Visitation Nurses– Pediatric Clinics/Pediatricians– OB Clinics/CPSP/OBs– Mothers’ Support Groups– Lactation Clinics/Lactation Consultants– OT/PT/RD– Sweet Success– Urgent/Emergency Care– Others

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Online Resources• La Leche League

– www.lalecheleague.org

• International Lactation Consultants Association – www.ilca.org

• California Department of Public Health– www.cdph.ca.gov/programs/breastfeeding

• Office on Women’s Health– www.womenshealth.gov

• Breastfeeding Task Force of Greater Los Angeles– www.breastfeedla.org

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Breastfeeding Support Groups

“Foster the establishment ofbreastfeeding support groups and refer

mothers to them on discharge”

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Model Hospital Policy Recommendations, 2005

http://cdph.ca.gov/Breastfeeding

Safe Discharge for Breastfeeding Mothers and Babies

• Prevent a cascade of breastfeeding complications

• Pre-discharge assessment• Appropriate referrals

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