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Date: | Thu, 28 Jul 2005 01:37:01 +0000 |
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I do a brief assessment on all my inpatient postpartum moms. (an office
consult for low supply would be a more in-depth assessment of course.) I
ask: have you ever had any breast surgery, breast biopsy, or significant
injury to the breast? what medications are you on and do you take any meds
fairly regularly? any hormone problems like thyroid, female problems, ovary
problems, or infertility issues? do you smoke? do you have any concerns
about your breasts or your nipples? this is a general screening and takes
about a minute but you do pick up risk factors and should follow that dyad
more closely. of course i do a breast assessment too.
one of the handouts i developed talks about developing a good milk supply
and why exclusive bf is best. it addresses the risks of *unnecessary*
(replacement) feeds. it says "during your hospital stay, make sure you are
taught how to position the baby well and how to latch the baby on. You
should also know how to tell if the baby is breastfeeding effectively and
signs that s/he is getting enough milk. it addresses the baby who is not
latching or is bf very poorly and having mother express for him (and he
*may* need supplementation - ebm is our first choice) and the last part goes
something like this " although possible, it is uncommon for a mother to have
a low supply due to a physical reason on her part. Work with your lactation
consultant if there are any signs of low milk production or signs that the
baby is not getting enough. Begin working with her right away!"
I feel this is important to include for the few who will have the problem.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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