Latching
This type of latch is when more of the top of the areola is visible than the bottom of the areola
assymetrical latch
during bad latch, nipple might appear...
lipstick shaped or flat, bruised, blistered
Where should nipple point prior to latching baby
under baby's nose above top lip
One of the best positions for early breastfeeding
cross cradle
Where should the nipple point once inside baby's mouth? Towards the palate or towards the tongue
the palate/roof of the mouth
At what birth weight loss should we re assess latch and milk transfer - possibly refer to lactation consultant
over 7-8% loss
True of False: The baby's gape (corners of baby's mouth) should be about as wide as 140 angle
True
Mom requests baby be supplemented since baby won't latch. What is the first thing option for "supplementing"?
hand expressed/pumped colostrum followed by the second choice of donor milk
What should be in line with the baby's nose while breastfeeding
The top of the areola
What sounds should NOT be heard
clicking or smacking
what mouth movements should you see with a good latch
jaw/ear movement or swallowing movement
Mom has flat or inverted nipples. BAby unable to latch. Name 3 things to try
wear breast shells in between feeds, use hand expression and hand pump 1-3 minutes prior to attempting to latch, Attempt to latch immediately after pumping while nipple everted.
True or False: Baby's nose should tilt away from breast while chin is tucked into the breast
True
should you experience pain during breastfeeding
no!
how much weight should the baby gain
about 1oz per day
PPD #3 Baby is jaundice, tbili 11, had 1 meconium stool on day 2, only 1 wet so far today, weight loss 9% Mom says baby nursing all the time and cries whenever she takes him off. What is the main concern with this breastfeeding dyad and what is one thing you could suggest?
Baby isn't latching well or transferring milk well. Assess latch for effectiveness, if good latch, have mom pump - feed expressed colostrum. If unable to pump colostrum may offer donor milk after feeds per mother's consent.
4 signs of a good latch
Comfortable and pain free, baby tummy to tummy, baby's chin touches mom's breast, nose tilts away from breast, baby's mouth opens wide around the breast, not just the nipple, and baby's lips turn out, wide angle at corner of mouth
PPD #2 Mom reports Baby won't latch but you haven't seen baby attempt yet. So what is the first thing you as the nurse do?
observe a feeding, help with position and latch. Check for signs of a good latch and maternal comfort during feed
what angle should corner of baby's mouth with a good latch?
140 degrees
Describe 4 signs of adequate transfer of milk in the first few days of life
- Appropriate output per day of life (voids/stools)
- correct latch with Visible/Audible swallows - not just flutter sucks
- Content/Satiated between feeding sessions
- Feeds at least 8-12 times a day (on demand)
- less than 8% weight loss
- bilirubin within normal limits for day of life