Again: I'm a hospital-based L.C. I've decided to gather data on babies who
are ineffective suckers beyond the first 24 hours post birth. I reviewed
the literature and developed the following data collection tool. Of course
I'd like to demonstrate a relationship between epidurals and ineffective
breastfeeding, but I also wanted to look at other factors which may impact
early breastfeeding. I'm posting the list I have come up with. Perhaps the
wise women and men of Lactnet can suggest others or maybe other hospitals
could collect data so we could study a larger sample.

The babies we are studying are those who are not demonstrating sustained,
consistent effective breastfeeding by 24 hours of age.

SEX: Male  Female
GESTATION:  <37 wks  37-41 wks  >41wks
SIZE FOR DATE:  AGA  IUGR  SGA  LGA
MOTHER HAD PIH?  Yes  No
DELIVERY: Vaginal  Cesarean  (Scheduled)  (Emergent)
PROLONGED FIRST STAGE?
SECOND STAGE > 2 HOURS?
PRECIPITOUS DELIVERY?
PRESENTATION: OA   Posterior   Ascynclytic
FORCEP?
VACUUM EXTRACTION?
MECONIUM STAINED AMNIOTIC FLUID?
MATERNAL FEVER?
INDUCTION: AROM  Gel  Pitocin (length of admin)
TOTAL IV FLUIDS PRIOR TO DELIVERY:
ANALGESIA: none  Stadol  Nubain   Spinal Morphine  Epidural(list med+dose)
CIRCUMCISION/ AGE: _____hours
ARTIFICIAL NIPPLE?   PACIFIER?   NIPPLE SHIELD?
SUPPLEMENTS GIVEN BY:  dropper   cup   bottle   __________
AGE AT FIRST BREASTFEEDING ATTEMPT:___________
EVENTS PRIOR TO FIRST BREASTFEEDING ATTEMPT: skin to skin   Bulb suction
intubation   Resuscitation   Chemstrip   Weight   Eye prophylaxis
Physical separation from mother
INFANT PHYSICAL CHARACTERISTICS: Excessive molding/ caput  bruising
forcep marks  receeding chin  short tongue   tight frenulum  abnormal
palate
MOTHER'S NIPPLES: soft   flat   inverted   inelastic


To date, we have reviewed 14 babies and 10 of them are boys! Circumcision
was delayed on three of them because of ineffective feeding. I am not a
researcher (obviously). I know lots of you are, so any comments or
suggestions that will help make this more meaningful will be welcome. I
know we would all like to work ourselves out of jobs by helping to prevent
these sad situations.

Does anyone know of a "Research for Dummies" book?  :-)
Amy Mueller



Amy Mueller, BSN, RN, IBCLC
Traverse City
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