Keys to Successful Breastfeeding
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Transcript of Keys to Successful Breastfeeding
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Keys to Successful Breastfeeding:
Putting the 10 Steps into Practice
Elizabeth Flight, RN, CLE, IBCLC
Bethesda Naval Medical Center
Video Teletraining Program
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How can you help a newmother breastfeed?
• Build your knowledge base
• Build mother’s confidence
• Use “words that work”
• Follow up, follow up, follow up
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Mother’s Milk
• Ideal for feeding and nurturing infants
• Most complete and balanced form ofnutrition for human infants
• Uniquely immunoprotective• Improves maternal health
• Limited number of contraindications
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Anatomy and Physiology
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Nipple Structure
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Breast Massage for
Expression
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Breast Compression
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Hand Expression
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Milk Ejection Reflex
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Key Steps
• Early initiation of baby to breast
• Points for good position and latch
• Evidence of milk transfer
• Assess and document a breastfeedingsession.
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Newly-born Rooting
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Early breastfeeding
• Uterine involution
• Accelerate milk production
• Minimize engorgement
• Enhances attachment and bonding
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Early and Often
• Intense suck reflex
• Initiates gut peristalsis
• Increased immunological properties
(IgA)• Practice makes perfect
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Hunger Cues
• Rooting
• Sucking motions
• Motor activity/ hands to mouth
• Tense, clenched fist• Crying-LAST SIGN of HUNGER
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On Your Mark (Mother)
• Comfort with pillows or towels
• Support for heavy breasts
• Hand position based on breast size and
location
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Side-lying
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Get Set (Baby)
• Cradle
• Cross Cradle• Football or clutch
• Side-lying• Australian or prone (floating prone)
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Side-lying
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Go!
• Nose to nipple
• Tickle lips
• Be patient….
• Wait for baby to “Open WIDE”
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Cradle or Madonna Position
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Reverse Clutch or Cross Cradle
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Clutch or Football Hold
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Football Position
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The Gape
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The Approach
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Contact for Latch
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Good Latch
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You’re a Winner!
• Assess for:
– Wide open jaws, lips flanged out – Audible swallowing
– Long sustained burst suck pattern – Comes off breast satisfied
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Assessing over the first weeks
• Watching for urine output
• Watching stool patterns
• Watch weight loss/gain
– WHAT IS NORMAL???
• When is it necessary to supplement?
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Common Problems
• Sore Nipples• Engorgement
• Mastitis
• Yeast infections
• Medications
• Baby with a problem nursing
• Methods of supplementation
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Tandem Nursing Preemies
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Tandem Nursing (on the run)
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Preemie at the Breast
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What’s wrong with this?
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What’s wrong with this?
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What’s wrong with these?
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Can we change theMilitary Medical Model?
• SG/BUMED Instructions
• Deckplate support for AD mothers• Training in Residency Programs
• Staff ed & training focused on FCC• Build strong patient ed program
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Use Evidence Based Guidelines
• Data driven
• UNICEF “Ten Steps”• ILCA “First 14 Days”
• Social Marketing
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Provide Education and Training for ALL Staff who interact with Families
• Minimum 4-8 hours per year of
Annual Required Training
• Support Certification for Active Duty
– RNC or IBCLC
• Standardize training and “Guidelinesfor Practice” throughout the MTFs
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Provide opportunity for training
• Require IBCLC with EXPERIENCE
• Internship Program• Computer Based Training/ Distributive Ed
• Allow AD Nurses to function as LCs
• Allow AD Nurses to teach Family- CenteredChildbirth Classes
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Train our NMCRS Nurses
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Build Volunteer Programs
• Train experienced mothers in
counseling skills for peer support• Provide annual training programs
• Coordinate with Red Cross?• Coordinate with WIC or HMHB?
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Update the BUMED Instructions
• WHO Guidelines & Baby Friendly
– No freebies• Enforce language in the Instruction for
Formula Reps
• Look at purchasing formula for the units
– Dietary purchases from “general schedule”
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Yes, we can….
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And we have just begun…
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