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Property of MN Department of Health/DeJong 1 Baileys Golden Start Breastfeeding Curriculum for Nursing Students Objective 8: Nurses role Objective 9: Positions Objective10: History and trends Slide 2 Discuss the role of the nurse in assessing and encouraging the breastfeeding dyad. Property of MN Department of Health/DeJong2 Slide 3 When supporting normal breastfeeding, suggest the mother focus on getting comfortable and give encouragement rather than instructions (Mohrbacher, 2010, p. 29). Property of MN Department of Health/DeJong3 Slide 4 U.S. Pediatrician Christina Smillie (2008) emphasizes to mothers that there is no one right way to do this and focuses instead on: Displaying confidence that breastfeeding will work. Encouraging the mother to talk to her baby. Reassuring the mother that her babys actions are normal (Mohrbacher, 2010, p. 39). Property of MN Department of Health/DeJong4 Slide 5 Important to know what questions to ask. Breast surgery history Past breastfeeding experience History of sexual abuse History of hypothyroidism? History of Polycystic Ovarian Syndome? Nipple concerns (inversion, flat) Production concerns All mothers should be assessed for potential lactation issues prior to discharge. Property of MN Department of Health/DeJong5 Slide 6 Infant Feeding Cues Hand to Mouth Property of MN Department of Health/DeJong6 Slide 7 May even root on inanimate objects anything that brushes against their check or lips. Property of MN Department of Health/DeJong7 Slide 8 8 Slide 9 Would have been best to feed this baby in the Quiet Alert State, noted in picture 2. Property of MN Department of Health/DeJong9 Slide 10 Baby must be ready to feed Dont latch baby when crying Tickle lips Undress baby (skin-to-skin) Proper alignment with mom (belly to mom; chin to breast, nose to nipple) Be patient Quickly pull baby to breast when mouth is wide open Property of MN Department of Health/DeJong10 Slide 11 Nipple disappears Nose and chin close to breast Property of MN Department of Health/DeJong11 Slide 12 What is your assessment of this babys alignment? What is your assessment of this babys latch? Property of MN Department of Health/DeJong12 Slide 13 Ask mother how it feels: should be a deep firm pull with out extreme pain Many women are surprised by the strong tugging and may not experience it as pleasant at first Property of MN Department of Health/DeJong13 Slide 14 Replace vague terms as BF well, fair, poor IBFAT ( Infant Breastfeeding Assessment Tool, Matthews) MBA (Mother Baby Assessment Score, Mulford) SAIB ( Systematic Assessment of the Infant at the Breast, Shrago & Bocar) LATCH tool ( Jensen, Wallace & Kelsey) Property of MN Department of Health/DeJong14 Slide 15 Property of MN Department of Health/DeJong15 Slide 16 Which of the following may indicate a poor latch? A. Maternal pain B. Trauma to the breast or nipple tissue C. Dimpling of the infants cheeks D. All of the above Property of MN Department of Health/DeJong16 Slide 17 Keep the baby next to mother Feed the baby breastmilk Keep the baby in love with the mothers breast (Pessl, 2011). Property of MN Department of Health/DeJong17 Slide 18 Breaking the latch Burping the baby Property of MN Department of Health/DeJong18 Slide 19 Compare and contrast various breastfeeding positions Property of MN Department of Health/DeJong19 Slide 20 Cradle Hold Baby needs to be appropriate size to fit in the crook of Moms arm without head falling back too far. Property of MN Department of Health/DeJong20 Slide 21 Cross Cradle Provides mom more control over latching due to one hand free to support breast. Useful for large breasted or engorged women due to supporting breast. Property of MN Department of Health/DeJong21 Slide 22 Tee Ball Practice for babies to help hold it! (DeJong, 2012) or like Training wheels for a baby learning to breastfeed (Wiessinger) Helpful with preterm, late preterm infants, Downs syndrome, anytime needing more support Property of MN Department of Health/DeJong22 Slide 23 Under-arm/ Football Property of MN Department of Health/DeJong23 Slide 24 Side Lying Property of MN Department of Health/DeJong24 Slide 25 Laid Back Position Mom uses her body to support her baby. Mother leans back in any chair or in bed and positions baby prone on her abdomen. Property of MN Department of Health/DeJong25 Slide 26 Tips for any position Belly to belly Nose to nipple Hips aligned Use support/Boppie Pillow if needed Property of MN Department of Health/DeJong26 Slide 27 Tips for any position Provide support for mom and baby so mother does not support the babys weight the entire feeding. Emphasize to bring baby to mom, and do not let mom lean over to baby. Property of MN Department of Health/DeJong27 Slide 28 http://www.youtube.com/user/Gerber?v=Q5a W7xoOOlw&feature=pyv&ad=7361692495&kw =breastfeeding%20more%3Alabel_breastfeedin g%20more%3Apregnancy Property of MN Department of Health/DeJong28 Slide 29 Discuss the history and current trends of breastfeeding and lactation education in the United States and internationally Stanisaw Wyspiaski, "Motherhood", pastel, 1902, National Museum, Warsaw. Breastfeeding Is Beautiful by Caitlin Smith Property of MN Department of Health/DeJong29 Slide 30 Historically, when Didnt we Feed Babies Breastmilk? When mothers died in childbirth When mothers were ill When mothers did not produce enough milk When the medicalization of infant feeding became normal When formula companies wanted to make a profit Slide 31 They Turned Out Okay But, survival does not equal optimal health (Pessl, 2011). Remember, formula: Has no living human cells May cause GI irritation with possible bleeding (anemia) Has excessive protein and sodium Slide 32 We must re-evaluate our care and look at our practices We must consistently question what we are doing Are the things we are doing in the best interest of the mother/infant dyad? Property of MN Department of Health/DeJong32 Slide 33 End of: Objective 8: Nurses role Objective 9: Positions Objective10: History and trends Next: Objective 11: Best practices Objective 12: Breastfeeding Report Card, Healthy People, Surgeon Generals Call to Action Property of MN Department of Health/DeJong33