Breastfeeding
Ensuring adequate intake of these 2 things helps milk to come in.
What are hydration and adequate calories?
Galactagogues are substances that increase milk production or flow. While it is fun to think that cookies may actually be good for our health pospartum, remind patients that the best way to enhance their supply is feeding on demand, lots of skin to skin, breast stimulation and getting rest.
This is the most common cause of postpartum readmission at Evanston Hospital.
What is Pre-eclampsia?
These are the ABCs of safe sleep.
What are Alone, on their Back, in a Crib?
These two hormones are primarily responsible for milk production and let down.
What are Prolactin and Oxytocin?
Prolactin is responsible for milk synthesis and levels are typically highest at night. Oxytocin is responsible for contracting the lactocytes and causing the milk to "let down". There is another hormone, FIL (feedback inhibitor of lactation) which suppresses milk production when the breasts are at full storage capacity.
The time frame within which patients with blood pressure issues should follow up.
What is 7 days if they are not on medication, 72 hours if they are discharged on BP medication?
Approximately four infants every month.
What is the number of infants who die of SUID in Cook County each month?
Wait and see is the preferred treatment of this breastfeeding complication.
What is ankyloglossia (tongue tie)?
Typically feeding needs to be established first before it is clear if ankyloglossia is going to inhibit breastfeeding. Try conservative measures while in the hospital (nipple shield, vary positions, pumping). If a tongue tie is causing latching or transferring difficulties a pediatrician or ENT may suggest a frenotomy.
20mg PO, daily for 5 days.
What is the doseage and durarion of our standard lasix order?
This racial demographic group is most likely to experience SUID in Cook County and nationally.
The SUID rate by racial/ethnic group, varies nationally and in Cook County.
African American infants are 14x more likely, Hispanic infants 2.5x more likely. While it is difficult to establish an exact causal link, the racial disparities are thought to be linked to social determinants of health.
Hemorrhage, T2DM/T1DM, cesarian section, anemia, retained placenta, breast surgery, obesity, PCOS and hypothyroidism.
What are maternal conditions which can cause a delay in milk production?
The best way to assist your patients experiencing any of these conditions is to encourage on-demand feeding and regular breast stimulation.
The top three types of infection which cause postpartum readmission.
What are Endometritis, wound infection and mastitis?
This is one of the main risk factors for SUID.
What is prematurity?
27% of the infants dying of SUID in Cook County were born prematurely.
These infants require an automatic referral to lactation.
What are late preterm infants, multiples, and ISCU admissions?
For all other families assist with a feeding and make an assessment before referring. It is common that patients with a history of difficulty breastfeeding or with a history of breast surgeries may need to be referred.
These labs are followed in a patient with pre-eclampsia or eclampsia (3).
What are P/C ratio, liver enzymes, platelets?
SUID is most likely to occur before what age (months)?
What is before the age of 6 months?
SUID can happen anytime birth to 1 year, 82% of the deaths in Cook County were before 6 months, the peak is between 1 and 2 months.