On our charting we have checkoff items that give us a picture, such as:
__Latch: __Nipple Only __Shallow __Deeply onto areola
__Lips flared: __Upper __Lower
__Nipple after feed: __No shape change __Creased
__Nipple pain _____ at latch
__Nipple pain _____ mid-feed
__Nipple pain _____ end of feed

For the nipple pain items, we ask her to rate her pain using the same 0-10
scale everyone else in the hospital uses. By the time we see her, she has
made this evaluation about her pain elsewhere in her body, so she is
familiar with it. 0 means no pain at all. 10 means make it stop or I'll
quit BFing right now! We don't always check everything, but we have lots of
options for physical observations & questions. I also judge pain by her
facial expression, body language, sucking air between her teeth (or not),
etc. We also have several checkoff items describing the appearance of
nipples & breasts.

Several people on L'net graciously sent us samples of their own charting
when we started at my hospital 3 years ago. We combined them & reworked the
result. We still rework it on occasion. It also has many teaching topics,
types of suckling, duration of feed, # suckles per bout, feed ended by mom
or by baby, baby's behavior/appearance at end of feed...



--- Phyllis Adamson, IBCLC, RLC
--- Glendale, AZ, USA
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