hi libby,
there are forms in several bf/childbrith type catalogs. here is a site i
found on internet via google search
Breastfeeding Teaching Aids -> Breastfeeding Care Plans
... these forms provide a clear, time-saving method to record the
consultant's instructions to the client. The General Care Plans for
Breastfeeding are single ...
www.1cascade.com/display/Breastfeeding_Teaching_Aids/
Breastfeeding_Care_Plans/

what i find works well for me is to develop my own form. if you have word
processor program on computer you can make a simple instruction sheet for
differnet problems and you can change it as your use of it evolves. For
example, I have a big problem with routine use of formula by moms and
subsequent low supply. I have a handout which the front of it explains
'getting off to a good start' and supply/demand type info. it basically
urges the moms to do exclusive bf under normal circumstances. it talks some
about if you have a sick or premie baby and if you are pumping etc. the back
of it gives general strategies to get the milk supply back up. you could
have some/other of these strategies with a __ beside it to check it off if
it is what you want the mom to do. Here is the back of my form. It is not
perfect and I have changed it a few times, but it's working pretty well so
far.

"If your milk supply is low, building it up takes some time and effort. Work
with a lactation consultant using the following guidelines:

•       Keep in close touch with your pediatrician and a lactation consultant in
case supplementation and weight checks for the baby are needed while you are
building up your supply.
•       See a lactation consultant if less-than-ideal positioning and latching are
a likely cause of your low supply (jaundice, injured nipples, and a low
diaper count may go along with this). If caught early, this can often be
corrected quickly and easily.
•       Keep track of the baby’s wet and dirty diapers (numbers and amounts), as
this is a very good way to tell if the baby is getting enough breastmilk.
•       Breastfeed every 1 to 3 hours, or more if baby demands.
•       Avoid long periods without feeding or expressing.
•       Use the breast, instead of a pacifier, whenever the baby needs comforting.
•       Massage breasts before and after feeding or expressing to help with the
“letdown” or release of milk.
•       Use a top quality breastpump to express (sometimes expressing a little
extra after breastfeeding or in between breastfeedings works well). Talk
with a lactation consultant about a pump and to develop a plan for
expressing that is best for your situation.
•       Some medications can contribute to drying up your milk, such as
antihistamines, fluid pills, cold medicines, or some birth control pills.
Talk to your doctor and lactation consultant about this.
•       Sometimes herbs and some prescription medications are used to increase
milk supply. This is not the first thing to try but can work in some
situations. Talk to your physician and lactation consultant about this. It
used to be thought that drinking lots of fluids increased milk supply.
Research has shown this does not work. Mothers should drink when thirsty and
to keep their urine very light or clear.
•       Very rarely, a woman’s breasts don’t make enough milk to fully feed her
baby, even if she followed good breastfeeding practices right from the
beginning. I would encourage such a mother to try the above suggestions to
increase her supply to its top capacity and to continue breastfeeding, even
if she cannot provide 100% of the baby’s milk. In this situation, the baby
will need additional milk, so follow the pediatrician’s advice on what kind.

Laurie Wheeler is a board certified lactation consultant with Methodist
Women’s Center. She can be reached at (504) 244-5305.

Aug 2002"




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