1 / 32

Baby Friendly USA! & The ‘REAL’ World of Lactation

Baby Friendly USA! & The ‘REAL’ World of Lactation. Breast Feeding Conference 2010.

tory
Download Presentation

Baby Friendly USA! & The ‘REAL’ World of Lactation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Baby Friendly USA!&The ‘REAL’ World of Lactation

  2. Breast Feeding Conference 2010

  3. The Baby Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).BFHI promotes, protects and supports breastfeeding through ‘The Ten Steps to Successful Breastfeeding for Hospitals’.

  4. Working through the process… All 10 SIMPLE STEPS!

  5. EDUCATION • ALL DOCTORS AND NURSES IN MATERNAL/CHILD AREAS ARE REQUIRED TO TAKE A BREASTFEEDING COURSE • ALL CORPSMAN IN L&D ATTEND A BREASTFEEDING CLASS

  6. Breastfeeding Education Options • http://www.breastfeedingtraining.org • Excellent option for Providers – offered free and CME’s are included • “The Curriculum in Support of the Ten Steps to Successful Breastfeeding” - offered by Healthy Children’s Project, Inc. - MOST COST EFFICIENT OPTION FOR RN STAFF • www.healthychildren.cc • “Ten Steps to Successful Breastfeeding” – available through Jones and Bartlett Publishing • $$ COSTLY BUT EXCELLENT CURRICULUM

  7. BREASTFEEDING POLICY FOLLOWING THE 10 STEPS FOR SUCCESSFUL BREASTFEEDING Many Sample policies that meet the Baby-Friendly requirements are available online

  8. PATIENT EDUCATION • BEGIN BREASTFEEDING EDUCATION EARLY IN PREGNANCY • PUT BABY TO BREAST AS SOON AS POSSIBLE AFTER DELIVERY • KEEP BABY SKIN-TO-SKIN FOR FIRST HOUR OF LIFE • PROVIDE POST-PARTUM SUPPORT

  9. BABY FRIENDLY ON-SITE SURVEY • The Baby Friendly USA team visited our hospital for two full days focusing on: • Interviewing staff and patients • Reviewing policies and statistics • Auditing charts • Reviewing educational literature

  10. Obstacles Encountered • Staff education: constant staff turn-over makes education a continuous process; now included in initial orientation to the unit. • Patient Education: There is a big difference between education offered and pt’s perception of education related to breastfeeding. • Supplementation: Only when medically indicated, education of staff, providers and patients is essential.

  11. Benefits of MTF’s • Early follow-up appointments by RN/Lactation consultant. • Orders can be given and must be carried out. • Younger mind-set of providers • Constantly in learning mode • Most cost effective way to achieve healthier population • Networking – why reinvent the wheel!

  12. Support System • Many mom’s are away from family, husband’s deployed, feel alone, breastfeeding is not her family’s norm. • MOM CONNECTION: weekly breastfeeding support group *** so important to long term success with breastfeeding.*** • Access to Lactation Consultant • Establish an environment where breastfeeding is seen as the norm, prenatally, ante-partum, and post-partum, and in the clinics

  13. Robert E. Bush Naval Hospital • Recognized the long term health benefits of promoting breastfeeding • Invested in an optimal level of care to encourage breastfeeding • Strive to provide the best possible care to our smallest patients

  14. Robert E Bush Naval Hospital The first and only Naval Hospital worldwide that has achieved accreditation as a Baby-Friendly Facility

  15. New Changes For Baby-Friendly Re-Certification All Baby-Friendly Facilities are now required to do two Performance Improvement projects every year to maintain certification.

  16. Joint Comission and Orxy ‘Exclusive Breast Milk Feeding’ Only maternal medical conditions are acceptable: HIV,substance abuse,TB, Chemo or radiation, active vericella, HSV with breast lesions. Must be documented clearly in the chart.

  17. PER JOINT COMMISSION QUALITY CORE MEASURES • The ‘ONLY’ acceptable reason for a baby to NOT be exclusively breastfed, per Joint Commission and Oryx, are maternal medical indications.... a mother’s choice not to breastfeed is NOT an acceptable reason for the baby to get anything other than breastmilk

  18. WHAT CAN WE DO?? • STRESS IMPORTANCE OF EXCLUSIVE BREASTFEEDING TO PARENTS • DOCUMENT EDUCATION IN CHART • DOCUMENT REASONS FOR SUPPLEMENTATION IF NEEDED

  19. NATIONAL AVERAGE • BASED ON THE NEW STRINGENT GUIDELINES- THE NATIONAL AVERAGE IS NOW CONSIDERED 30% EXCLUSIVE BREASTFEEDING RATE

  20. Lactation Consults • Perceived vs actual low milk supply. • Usually it is a perceived problem, education and thorough assessment are key. • Many mom’s returning to the workplace that rely on pumping to maintain their supply may encounter a decreased milk volume. Reglan works quite well in most cases to increase production. • Reglan 10mg: 1 tab on day one; 1 tab BID day two; days 3-10, 1 tab TID; days 11 & 12, 1 tab BID, days 13 & 14, 1 tab daily. Total: 33 tabs • Some working mom stay on 1 tab per day throughout duration of breastfeeding

  21. Cont…. • Necessary to have access to hospital grade pump and allowed time and space to pump at work. • There are OPNAV, BUMED, MCO/ instructions protecting active duty breastfeeding mothers • Tri-care does cover hospital grade pumps for mothers of premature infants (code E0604) • Some hospitals have electric pump loaner programs or can refer pt to rental station

  22. Thrush • La Leche League International quotes research stating the increased use of antibiotics in the OB setting has increased the cases of ductal yeast. • Tx of GBS+ moms • Routine antibiotic use with C-sections

  23. Symptoms and Tx • If mom is symptomatic • burning • itching • deep radiating pain in nipples or breast • traces of white fungus in the folds of nipple • shiny, blistery, cracked, red appearing nipples • mom has vaginal yeast infection • R/O OTHER POSSIBILITIES, ie: latch/positioning

  24. Tx cont… • Treat mom with Diflucan • “Medications and Mothers’ Milk” Thomas Hale, PhD. Recommended therapy: • Diflucan 200-400mg loading dose then 100-200mg per day times 14 days • Encourage natural treatment in conjunction with medication; acidophilus bifidus and grapefruit seed extract

  25. Tx cont… • Jack Newman’s All Purpose Nipple Cream: • Mupirocin 2% (15g) • Betamethasone 0.1% (15g) • Miconazole powder (brining the final concentration to 2% miconazole) • Apply sparingly to nipples/areolae after each feeding, do not wash or wipe it off before feeding.

  26. BREASTFEEDING COUPLET – BOTH PARTNERS, MOM AND BABY, HAVE TO BE TREATED • Many times the baby is asymptomatic. • Symptoms include: • White patches in the mouth • Diaper rash • Whitish sheen to inside of lips/saliva • Baby not nursing well because mouth is sore.

  27. Thrush Tx cont… • Nystatin: • Most effective Tx is to treat after every feeding • One dropper full, half in each cheek • Treat for 2 weeks • Instruct mom to sterilize pacifier, bottle nipples, anything that baby puts in the mouth

  28. Nipple Shields • Nipple shields are an awesome tool when used appropriately • Rarely should they be introduced during the first 24 hours of life • Lactation Consultant should be notified if use of a shield is initiated • This “quick fix” can create weeks/months of issues for the nursing couplet

  29. Indications for Nipple Shields • Premature baby that is not fully effective at the breast • Latch problems after 24 hours of life • Neurologic problems, weak suck, tongue thrusting or retracting • Mother with truly inverted nipples

  30. Inappropriate use of Nipple Shield • Sore nipples; rather than mask the issue, identify the problem and correct the latch. • Sleepy baby in the first 24 hours; allow baby time to adjust to extra-uterine like • Poor latch; contact lactation consultant to assess couplet

  31. Questions?

More Related