Dear Wise ones,

I am currently in the process of trying to come up with "lactation care
plans" that we can give to our mothers who are having lactation issues. These
would be used for the common problems we see during the hospital stay:

"sleepy baby" who is probably not really sleepy but may be injured,
drugged, over-stimulated, jaundiced, immature, etc.

nipple damage like abrasions, cracks, fissures, blisters, reddened (we use
a ton of lanolin ointment!)

extreme breast fullness (not usually seen in 48 hour stays, but definitely
with cesareans)

challenging nipple anatomy like flat, retracting, inverted nipples

pumping protocols ( some mothers do not want to nurse, but are willing to
pump)

I need to use language that would be on a fifth grade reading  level, with
pictures.

All mothers go home with a "helpful hints" list that includes basic
lactation recommendations for feeding cues, frequency, finish the first breast
first, growth spurts to expect, signs that positioning and latch should be
improved, etc.

Now that we can see outpatients, I would use the same care plan when
mothers present with one of the above problems, but also need to develop one for
slow weight gain, and supplementation at the breast if the mom is willing.

I am thinking of calling these "lactation recommendations" rather than
plans, and wondered what you all think of that idea. What I am trying to avoid
is giving mothers, who are already struggling, the sense that these are
like the  "ten commandments of lactation", and must be rigidly adhered to,
rather than  simple, concise and doable baby steps that might help them overcome
these bumps  in the road. We all know mothers sometimes appear to want a
quick fix, and  they get very frustrated when staff present different ideas
(very often not  evidence based and outdated). And yes, we are working on
basic staff education  and competency, but that is always an ongoing process,
and does take up a  lot of time.


Thank you for any ideas or thoughts or suggestions that you have. I would
love see what other lactation programs have come up with, and if you don't
mind  sharing, I would be very grateful. My work email is [log in to unmask]
(mailto:[log in to unmask]) .


Mary-Jane Sackett, RN, IBCLC, RLC
Lactation Program Coordinator
Pittsfield, MA
(in the Berkshire Hills of Western Massachusetts, where we have very little
 snow)




             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome