Sender: |
|
Date: |
Wed, 27 Jan 2010 23:21:09 +0200 |
Reply-To: |
|
Message-ID: |
<09F4FA9FDF3446AE887E025F419BAE9A@kasunen> |
Subject: |
|
MIME-Version: |
1.0 |
Content-Transfer-Encoding: |
quoted-printable |
Content-Type: |
text/plain; format=flowed; charset="UTF-8"; reply-type=original |
From: |
|
Comments: |
RFC822 error: <W> Incorrect or incomplete address field found and
ignored. |
Parts/Attachments: |
|
|
Hello Merete!
I have been working with a couple of mothers with the breast trauma (one
accident and a couple of moms after abscesses). One mother had been in a car
accident and was stuck under a car on one side of her body at the end of her
pregnancy. Several ribs were broken and needed surgical treatment and she
needed treatment in the ICU for a couple of days. The baby was at our ward
and needed special care also after the cesarean was done when the mother was
stable enough for it. The baby recovered well after baby´s system managed
the pain medicines the mother had needed prior the cesarean.
The ICU staff started wondering about mother´s milk starting to flow around
4 days postpartum and the father got advice from us pediatric RNs what to
do. Our ward loaned the pump and he delivered the pump to the mom. I met the
mother about 6-7 days after the baby had been born when she came back from
the ICU (another hospital) to the surgical ward with pleural tube etc. I
took the baby to the mother and helped her to breastfeed the baby and then
later that same day to help and teach her to pump her breasts. I am glad I
took the time when I saw the breasts better (luckily our ward was not full
that time). The ICU RNs had helped her to pump only a couple of times and
the breasts where becoming engorged. The traumatized breast was more
swelled, tight and darker and had hematomas. The trauma pain was managed
with post-op. "epidural pain pump" so that side was a kind of dumb and the
mother did not feel the pain and she got other pain medicines also. I gently
helped her to pump both breasts, she could not do it by herself since it was
too painful to adjust position or move hands. Then I looked for the surgical
nurses and told them that mothers breasts needed imediate care and told the
basic treatment for engorgement (cold and frequent enough pumping). I
suggested that the IBCLC of our hospital should be contacted in the morning.
They did what was needed, not the quite the frequency that is suggested but
well enough. The IBCLC visited the mom the next day.
We were in time, the breasts got better and she did not develope mastitis on
the trauma side (which I was worried when I saw the breast). The baby nursed
at first twice a day (the mother was so much in pain that she could not
tolerate more) and mom pumped. When the mother recovered the milk came more
plentiful. The mother was incredible brave and started to come to the baby´s
ward to breastfeed. (The surgical ward could not arrange a single room for
the mom and was worried for the baby´s health after they had to take another
patients to mothers room.) They needed nurses help to move and position the
baby to the breast and to transport the mother between the wards.
To cut this short: the mother got about half of the milk when the baby went
home. After a week at home with the mom, she breastfeed 6-7 times a day and
needed supplementation only a 2-3 times a day. The trauma side breast made
less milk during the hospital stay but the amount was increasing also on
that side and the hematomas dissolved. It is so cool to see how the mother´s
bodies do they best to recover and the milk start to flow after even this
kind of situation.
I have been talked with the two IBCLCs of our organization that we
obviously need to educate the staff of our ICUs and surgical wards about the
breast management also in the future.
Warmly,
Pia Ruohotie, RN and breastfeeding counsellor
from Helsinki, Finland
***********************************************
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
|
|
|