PP Healing
s/s of perineal hematoma
New onset perineal pain, blood loss
3 Qualities of a Good Latch
Chin to breast, audible swallow, 8-12 diapers, no pain, flanged lips
Name 2 risk factors for development of mastitis
poor latch, injured nipples, uncoordinated suck
What options are ideal for the first 21 days? Why?
IUD, Nexplanon, BTL, POP, DMPA bc does not increase risk blood clot
What vitamins are absent in Breastmilk
K, vitamin D (b12 if mother is deficient)
When should the uterus be involuted to the pre pregnant location?
10 days-2 weeks
DROP in which hormone triggers onset of milk? Which stage of Lactogenesis is this
Lactogenesis 2
Best treatment for a plugged duct
Hot shower, massage, warm compress, BF, assess latch
Name 2 contraindications to a postplacental IUD?
Chorioamnionitis, sepsis, ongoing PPH
What is the dose, timing & indication for RhoGAM administration postpartum?
How long does it take for granulation tissue grow in healing
starts at 5-7 days
Which hormone stimulates milk PROduction in lactogenesis 3?
PROlactin
Name 3 contraindications to BF
Neonatal galactosemia, maternal infection HIV, untreated TB, recent varicella or HSV lesion on breast
What is the relative percentage risk of expulsion for a postplacental IUD?
10-30%
When does the hyperpigmentation resolve postpartum?
6 months postpartum
What happens to maternal cardiac output postpartum
Increases by 80% in the first 48h, returns to normal by 6w
Which hormone stimulates milk ejection (let down reflex)?
Oxytocin
Name 5 risk factors for inadequate milk supply
Nipple anomaly, Breast implants or surgery, gland hypoplasia, hypothyroid, GDM, HTN, retained placenta, poor latch, PCOS, pacifier/supplement
What is the ideal timing of postplacental IUD insertion?
Within 10 minutes of birth
Why is there hair loss postpartum
Decrease in estrogen to normal, hair growth slows and starts shedding phase.
When do coagulation factors normalize postpartum
4-6 weeks
When does lactogenesis 1 begin?
2nd trimester and continues days/weeks after birth
Medical Rx for Mastitis ?
Dicloxacillin 500 QID x 14, Keflex 500 QID x 14
Name 3 factors needed for lactation amenorrhea method
breastfeeding exclusively, infant <6m old, no menses
Name 2 other factors that may have similar symptoms to postpartum Depression
Sleep deprivation, thyroiditis, anemia, infection