Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students Objective13: Difficulties Objective14: Nursing diag

1. Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students • Objective13: Difficulties • Objective14: Nursing diagnoses case studies • Objective 15:Finding information on the internet • Objective16: Role playing scenarios Property of MN Department of Health/DeJong

2. Objective 13 Recommend solutions for breastfeeding difficulties Property of MN Department of Health/DeJong

3. “My Baby is so Sleepy” Sleepy Baby Property of MN Department of Health/DeJong

4. “My Baby Can’t Latch Well” • Difficulty with latch (assess the baby’s frenulum. Do you see a heart-shaped tongue?) • Baby refuses to latch on one side vs. the other Property of MN Department of Health/DeJong

5. Tools to Support Breastfeeding • The Nipple Shield is primarily used when the infant will not latch to the mother’s bare breast. • Fit to infant’s mouth. Property of MN Department of Health/DeJong

6. Tools to Support Breastfeeding • Breast Pump • May be needed by Mom for: • Infant born premature or sick • Nipple soreness • Being away from infant • Returning to work Property of MN Department of Health/DeJong

7. Supplemental Nursing System (SNS) • Useful for infants able to latch but who need supplementation • Need photo Property of MN Department of Health/DeJong

8. “But, I’ve Got Twins!” • Multiples: Twins Property of MN Department of Health/DeJong

9. “I Don’t Make Enough Milk” • Managing Low Milk Supply • Managing Perception of Insufficient Milk Supply Property of MN Department of Health/DeJong

10. In McCann et al.’s (2007) study of breastfeeding attitudes and reported problems in a national sample of WIC participants, breastfeeding mothers were asked about their own problems with breastfeeding at the one-month interview; 70% said that they had experienced at least one of the specific problems listed. • Thirty-four percent of mothers said they thought they did not have enough milk for the infant, and 10% thought there was something wrong with their milk. Property of MN Department of Health/DeJong

11. Apprehension about Breastmilk Sufficiency • Although 71% of mothers agreed that “breast milk alone gives a new baby all he/she needs to eat” and 80% agreed that “any woman who wants to can breastfeed,” fewer (55%) agreed that they had enough breast milk. • In this study, concern about insufficient breast milk was the second-most frequently reported problem at the one month interview and the most common problem at three and five months. Apprehension about breast milk sufficiency was strongly related to breastfeeding cessation and formula supplementation. Property of MN Department of Health/DeJong

12. “I’m Too Engorged” • Causes: • Treatment: Property of MN Department of Health/DeJong

13. “I Have Sore Nipples” Causes: Treatment: Property of MN Department of Health/DeJong

14. “I Think I Have Mastitis” • Causes: • Treatment: Property of MN Department of Health/DeJong

15. “I Think I’m Sick” • KEEP NURSING! Continuing to breastfeed while sick is providing baby with _______________ against illness. • Cessation should only occur if directed by a Lactation Consultant or Provider. Property of MN Department of Health/DeJong

16. Avoid Supplementation Unless: Compelling medical need Benefits outweigh the risks Informed decision-making by parents A plan is in place to minimize harm and continue to support breastfeeding

17. If Supplementation is Needed Use small feeds Protect maternal milk supply and maternal confidence (Pessl, 2011) Use smallest amount needed for the shortest possible time

18. Objective 14 Write appropriate nursing diagnoses for a Breastfeeding-related Case Study Property of MN Department of Health/DeJong

19. Case Study • A 27-year-old mother presents to the clinic for her child’s 2 month check-up, stating, “I wish I knew more about preparing and storing milk for when I go back to work. I just really don’t know what I’m doing. I’m afraid I’m going to do it wrong, and that I’m not going to find the time to do it.” • She asks you to instruct her about preparing and storing expressed breast milk. She is planning to return to work as a 4th-grade teacher in 3 weeks. Property of MN Department of Health/DeJong

20. What are the priority nursing diagnoses for the case? Property of MN Department of Health/DeJong

21. Objective 15 Appraise lactation-related information available on the internet Property of MN Department of Health/DeJong

22. Website #1 • www.cdc.gov/breastfeeding/data/reportcard.htm Property of MN Department of Health/DeJong

23. Website #2 • http://www.cdc.gov/vitalsigns/BreastFeeding/?s_cid=vitalsigns_081 Property of MN Department of Health/DeJong

24. Website #3 • http://www.babyfriendlyusa.org/eng/index.html Property of MN Department of Health/DeJong

25. Website #4 • http://www.lalecheleague.org/ Property of MN Department of Health/DeJong

26. Website #5 • http://kellymom.com/ Property of MN Department of Health/DeJong

27. Website #6 • http://www.breastfeedinginc.ca/content.php?pagename=videos Property of MN Department of Health/DeJong

28. Website #7 • http://www.drjacknewman.com/ Property of MN Department of Health/DeJong

29. Website #8 • http://www.goldenstart.info/ Property of MN Department of Health/DeJong

30. Website #9 • http://www.motherlove.com/mm5/merchant.mvc?Screen=CTGY&Store_Code=MHC&Category_Code=resources-faq-low-breast-milk Property of MN Department of Health/DeJong

31. Website #10 • http://womenshealth.gov/breastfeeding/ • http://womenshealth.gov/breastfeeding/government-in-action/national-breastfeeding-campaign/index.cfm Property of MN Department of Health/DeJong

32. Objective 16 Role-play selected scenarios with one another Image used with permission from William Burleson, Office of Statewide Health Improvement Initiatives, MN Department of Health, on 2/10/2012. Property of MN Department of Health/DeJong

33. Case Study #1 • A 25-year-old mother has just delivered her first child. She says she is too tired to nurse and wants you to feed the baby formula until her milk “comes in.” States, “It’ll be good for the baby to get used to a bottle anyway since I have to go back to work in 2 weeks.” What is your response? Property of MN Department of Health/DeJong

34. Case Study #2 • A 27-year-old mother presents to the clinic for her child’s 2 month check-up, stating, “I wish I knew more about storing milk for when I go back to work. I’m afraid I’m going to do it wrong.” • She asks you to instruct her about preparing and storing expressed breast milk. She is planning to return to work as a 4th-grade teacher in 3 weeks. Property of MN Department of Health/DeJong

35. Storage Duration of Human Milk for Healthy Full-Term Infants Property of MN Department of Health/DeJong

36. Case Study #3 • A new mom calls into the Ask-A-Nurse stating that she is worried that she can’t eat her usual diet because she is nursing. What is your response? Property of MN Department of Health/DeJong

37. End of: • Objective13: Difficulties • Objective14: Nursing diagnoses case studies • Objective 15:Finding information on the internet • Objective16: Role playing scenarios Next: • Objectives 17: Providing support in a variety of settings • Objectives 18: Impact of public health • Objectives 19: Evaluation of own community – discuss ways to support breastfeeding where student works and lives Property of MN Department of Health/DeJong