Course contents

Introduction

  1. 1 Introduction

Case Study A (Joanne)

  1. 1 Case Study A (Joanne)

Discussing breastfeeding

  1. 1 Discussing breastfeeding

What information to give

  1. 1 Disadvantages of Breast Milk Substitutes

Effects of Breastfeeding alternatives

  1. 1 Effects of Breastfeeding alternatives

Common breastfeeding concerns

  1. 1 Topics to discuss
    1. 1.1 Encourage acquiring knowledge and support networks
    2. 1.2 Discuss the most appropriate outcome depending on individual circumstances
    3. 1.3 Encourage both parents to develop their own unique roles
    4. 1.4 Support breastfeeding with confidence, anywhere the mother and baby may be
    5. 1.5 Assist women to quit smoking and limit alcohol intake while breastfeeding, but it's better to be breastfed than formula fed even if the mother smokes.
    6. 1.6 Discuss healthy eating for maternal well-being

Breast examination

  1. 1 Normal appearance
  2. 2 What anatomical variations would give rise to concerns?

Contraindications to breastfeeding

  1. 1 Contraindications
    1. 1.1 Active tuberculosis
    2. 1.2 HIV
    3. 1.3 Human T-cell Leukaemia Virus Type 1
    4. 1.4 Medications
    5. 1.5 Illicit drug use
    6. 1.6 Classic galactosaemia and some inborn errors of metabolism in the infant
  2. 2 Conditions that are NOT a contraindication to breastfeeding.
    1. 2.1 Hepatitis B
    2. 2.2 Hepatitis C
    3. 2.3 Pregnancy

Conditions related to lactation outcomes

  1. 1 Conditions related to lactation outcomes

Medications

  1. 1 Medications

Case Study B (Joanne)

  1. 1 Case Study B (Joanne)

Preparation Before Birth

  1. 1 Preparation Before Birth

Birthing Factors that Affect Breastfeeding

  1. 1 Labour Analgesia
  2. 2 Late Preterm Birth

Management After Birth

  1. 1 Step 4 - Immediate skin-to-skin contact
  2. 2 Step 5 - Show mothers how to breastfeed and how to maintain lactation if separated
  3. 3 Step 6 - Give newborns no food or drink other than breastmilk, unless medically indicated
  4. 4 Step 7 - Practice rooming-in 24 hours a day
  5. 5 Step 8 - Encourage breastfeeding on demand
  6. 6 Step 9 - Give no artificial teats

Poor Attachment

  1. 1 Poor Attachment

Hypoglycaemia

  1. 1 Which infants are at risk and should be monitored?
  2. 2 Definition of hypoglycemia
    1. 2.1 Operational thresholds for plasma glucose levels
  3. 3 Treatment

Jaundice and Breastfeeding

  1. 1 Jaundice and the newborn
  2. 2 Feeding and jaundice
  3. 3 Breastmilk Jaundice

Case Study C (Joanne)

  1. 1 Case Study C (Joanne)

Early problems

  1. 1 Secretory activation
  2. 2 Predisposing factors
  3. 3 Management

Risk of SIDS

  1. 1 Normal sleep behavior
  2. 2 SIDS and sleep location
  3. 3 When parents choose to bed-share

Contraception

  1. 1 Contraception

Milk composition

  1. 1 Breastmilk Composition
    1. 1.1 Carbohydrates
    2. 1.2 Protein and non-protein nitrogen
    3. 1.3 Fat
    4. 1.4 Vitamins
    5. 1.5 Minerals
    6. 1.6 Changes in milk composition
    7. 1.7 Milk yield

Slowing of growth

  1. 1 Slowing of growth

Introducing solids

  1. 1 Introducing solids

Weaning

  1. 1 Weaning

Case Study D (Sally)

  1. 1 Case Study D (Sally)

Initial assessment

  1. 1 Adequacy of breastmilk intake?
  2. 2 Breast or nipple problems? Maternal confidence?
  3. 3 Infant examination

Milk production

  1. 1 What initiates and controls milk production?
  2. 2 Risk factors for a delay in Secretory Activation

Causes of inadequate infant growth

  1. 1 Causes of inadequate infant growth

Increasing milk supply

  1. 1 Increase breast drainage
  2. 2 Food and rest
  3. 3 Galactagogues
  4. 4 Supplementation

Case Study E (Anna)

  1. 1 Case Study E (Anna)

Sore nipples

  1. 1 What is good attachment?
  2. 2 What to look for when assessing positioning and attachment

Factors causing nipple damage

  1. 1 Engorgement
  2. 2 Anatomical variations of mother
  3. 3 Anatomical variations of the infant
  4. 4 Neurological issues with the infant
  5. 5 Inappropriate use of lactation aids
  6. 6 High intra-oral pressure

General treatment for sore nipples

  1. 1 Assess positioning and attachment
  2. 2 Advice about breastfeeds
  3. 3 Advice about nipple treatment
  4. 4 Lactation aids
  5. 5 Rest nipples

Further causes of nipple pain

  1. 1 Infection
  2. 2 Vasospasm
  3. 3 Other dermatological conditions

Mastitis – diagnosis

  1. 1 What may predispose Anna to developing mastitis?

Mastitis – treatment and complications

  1. 1 Effective milk removal/breast drainage
  2. 2 Occasionally, a woman with mastitis develops a breast abscess. What would predispose Anna to a breast abscess?
  3. 3 What symptoms or signs would make you suspect a breast abscess?

In conclusion

  1. 1 In conclusion