What are green/shiny stools a sign of? ✔✔ -sign of overproduction leading to less fat in milk, faster digestion causing not enough time for lactase
... [Show More] to digest the lactose in milk. An improved latch could allow for more fat flow
Signs of oversupply ✔✔ Rapid weight gain in infant, unsettled baby after feeding, recurrent plugged ducts and mastitis, painful feedings, voluminous (huge volumes of) stools- often green & shiny
What causes nipple pain? ✔✔ Improper latch--> need lactation support to help with proper latch on, good seal
True/false: baby should be pulled into breast. ✔✔ False! Do not pull baby into breast, let baby tilt head back for optimal latch. Hand on back of baby's head can interfere baby's interoral function by restricting the movement of the cranio-cervical spine--> causes nipple trauma. Make sure crook of arm in cradle position does not block baby from being able to fully tilt back.
Should a latch be symmetric or asymmetric? ✔✔ Asymmetric! A baby should form a teat with breast tissue underneath the nipple as part of a latch
What is a symmetric latch ✔✔ Not a good latch, causes nipple damage
Asymmetric latch ✔✔ Optimal attachment to the breast, where the baby's lips are not centered in relationship to the areolar, but rather vertically off-centered with the baby's chin and lower lip closer to the edge of the areola than the baby's upper lip. A baby should form a teat with breast tissue underneath the nipple as part of a latch
Do nipple creams work? ✔✔ Continued questions of effectiveness, fear of ingestion by baby
Should a frenotomy be suggested for tongue tie? ✔✔ No study was able to report that frenotomy led to better long term breastfeeding
Tongue tied breastfeeder ✔✔ -complete feeding assessment and suggest ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
What is a fissure straight down the nipple evidence of? ✔✔ A symmetric latch. Top lip needs to have good seal, moist part of lip should be touching nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? ✔✔ If nipple not stretched deeply into mouth, less oxytocin flows, less fat is in mix. With less fat, milk digested quicker = not enough time for baby to make enough lactase to digest lactose in milk.
What to do for oversupply? ✔✔ Decrease additional stimulation/milk removal if possible
Consider block feeding (only nursing on one side only per feeding)
Watch for mastitis
Try australian posture (mother down under, baby on top)
Consider donating to milk bank
Consult with HCP for medical dx
How many mL considered oversupply? ✔✔ normal milk production = 750-1000 mL/day
Thrush during BF ✔✔ painful for mother & baby.
may be visible or may not (whiteness that can't be wiped off) [Show Less]