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# 

# HANDOUT #6E -- HOW TO HELP MOTHERS WITH BREASTFEEDING CONCERNS

+-----------+------------------+-----------------------+-------------+
| **Mom's   | **Common         | **Simple Comfort      | **When to   |
| Concern** | Causes**         | Measures**            | YIELD**     |
+-----------+------------------+-----------------------+-------------+
| **FUSSY   | \--Change in     | \--Give baby          | \--Calming  |
| BABY**    | baby's           | continual access to   | techniques  |
|           | environment from | the breast            | do not      |
|           |                  |                       |             |
|           | hospital to home | \--Calm baby          | help        |
|           |                  |                       |             |
|           | \--Other changes | -   Hold baby close,  | \--Mother   |
|           | in baby's        |     skin to skin      | is          |
|           | routine          |                       | concerned   |
|           |                  | -   Rock or walk with | about       |
|           | \--Baby wants to |     baby              |             |
|           | be close to mom  |                       | excessive   |
|           |                  | -   Use a baby sling  | crying of   |
|           | \--Baby is ill   |     to keep baby      | her baby    |
|           |                  |     close             |             |
|           | \--Teething      |                       |             |
|           |                  | -   Play calming      |             |
|           |                  |     music             |             |
|           |                  |                       |             |
|           |                  | -   Have someone      |             |
|           |                  |     other than mom    |             |
|           |                  |     hold\             |             |
|           |                  |     the baby          |             |
+-----------+------------------+-----------------------+-------------+
| **SORE    | \--Baby is not   | **Beginning the       | \--Common   |
| NIPPLES** | positioned or    | Feed:**               | comfort     |
|           | latched          |                       | measures    |
|           |                  | \--Start feedings on  |             |
|           | properly         | side that is least    | do not      |
|           |                  | sore                  | resolve     |
|           | \--Baby had      |                       | sore        |
|           | other nipples in | \--Try different      | nipples     |
|           | his mouth        | positions             |             |
|           |                  |                       | within 24   |
|           | \--Wet nursing   | \--Apply bag of       | hours       |
|           | pads             | frozen peas with a    |             |
|           |                  | wet washcloth         | \--Mom      |
|           | \--Lotions or    |                       | reports     |
|           | perfumes         | over the breast to    | severely    |
|           |                  | take edge off pain    |             |
|           | \--Thrush in     |                       | damaged     |
|           | baby or mother   | \--Massage breasts to | nipples or  |
|           |                  | get milk to flow      | pain        |
|           |                  |                       |             |
|           |                  | **During the Feed:**  | with        |
|           |                  |                       | br          |
|           |                  | \--Do not limit how   | eastfeeding |
|           |                  | long baby breastfeeds |             |
|           |                  |                       | \--Baby has |
|           |                  | **After the Feed:**   | white       |
|           |                  |                       | patches     |
|           |                  | \--Air dry the        |             |
|           |                  | breasts               | inside his  |
|           |                  |                       | mouth       |
|           |                  | \--Apply a little     |             |
|           |                  | breast milk or        |             |
|           |                  | lanolin               |             |
|           |                  |                       |             |
|           |                  | \--Avoid creams that  |             |
|           |                  | have to be removed    |             |
|           |                  | before                |             |
|           |                  |                       |             |
|           |                  | baby can breastfeed   |             |
|           |                  | again                 |             |
|           |                  |                       |             |
|           |                  | \--Use breast shells  |             |
|           |                  | to keep clothing away |             |
|           |                  | from her              |             |
|           |                  |                       |             |
|           |                  | breasts               |             |
+-----------+------------------+-----------------------+-------------+
| **Mom's   | **Common         | **Simple Comfort      | **When to   |
| Concern** | Causes**         | Measures**            | YIELD**     |
+-----------+------------------+-----------------------+-------------+
| **ENGO    | \--Delaying or   | **Before the Feed:**  | \--Comfort  |
| RGEMENT** | missing feedings |                       | measures do |
|           |                  | \--Apply warm (not    | not         |
|           | \--Baby is not   | hot) compresses       |             |
|           | positioned or    |                       | relieve the |
|           | latched well     | \--Express a little   | engorgement |
|           |                  | milk to soften the    |             |
|           |                  | areola                | after 24    |
|           |                  |                       | hours       |
|           |                  | **After the Feed:**   |             |
|           |                  |                       | \--Mother   |
|           |                  | \--Express enough     | reports     |
|           |                  | milk to relieve       | fever or    |
|           |                  | fullness if she       | flu-        |
|           |                  |                       |             |
|           |                  | still feels very full | like        |
|           |                  |                       | symptoms    |
|           |                  | \--Ice packs          |             |
|           |                  |                       |             |
|           |                  | \--Talk with          |             |
|           |                  | physician about       |             |
|           |                  | ibuprofen             |             |
+-----------+------------------+-----------------------+-------------+
| **PLUGGED | \--Engorgement   | **Before the Feed:**  | \--Plugged  |
| DUCT**    | is not relieved  |                       | area is not |
|           |                  | \--Place warm         | relieved    |
|           | \--Baby is not   | compress on plugged   |             |
|           | positioned or    | area before           | within 24   |
|           | latched well     |                       | hours       |
|           |                  | feeding               |             |
|           | \--Baby is       |                       | \--Mother   |
|           | always breastfed | **During the Feed:**  | reports     |
|           | in the same      |                       | fever or    |
|           |                  | \--Begin feeding on   | flu-        |
|           | position         | the side with the     |             |
|           |                  | plug                  | like        |
|           | \--Tight or      |                       | symptoms    |
|           | binding bra      | \--Gently massage the |             |
|           |                  | plugged area while    |             |
|           | \--Delayed or    | baby                  |             |
|           | missed feedings  |                       |             |
|           |                  | is feeding            |             |
|           |                  |                       |             |
|           |                  | **After the Feed:**   |             |
|           |                  |                       |             |
|           |                  | \--Hand express or    |             |
|           |                  | pump to remove enough |             |
|           |                  | milk to               |             |
|           |                  |                       |             |
|           |                  | relieve fullness and  |             |
|           |                  | to remove the plug    |             |
+-----------+------------------+-----------------------+-------------+
| **LOW     | \--Replacing     | \--Correct baby's     | \--Mother   |
| MILK      | breast feedings  | positioning and       | is still    |
| SUPPLY**  | with formula     | latch, if needed      | concerned   |
|           |                  |                       |             |
|           | \--Baby is not   | \--Increase number of | about milk  |
|           | positioned or    | feedings or milk      | supply      |
|           | latched well     | expressions           | after       |
|           |                  |                       |             |
|           | \--Delaying      | \--Make sure mom is   | comfort     |
|           | feedings         | not limiting baby's   | measures    |
|           |                  | time at the           | are tried   |
|           | \--Limiting the  |                       |             |
|           | baby's time at   | breast                |             |
|           | the breast       |                       |             |
|           |                  | \--Use breast         |             |
|           | \--Birth control | compression           |             |
|           | pills containing |                       |             |
|           | estrogen         | \--Relax before       |             |
|           |                  | feeding to help milk  |             |
|           | \--Mother is     | flow                  |             |
|           | separated from   |                       |             |
|           | baby and not     | \--Spend lots of time |             |
|           |                  | with baby             |             |
|           | expressing milk  |                       |             |
|           | often enough     |                       |             |
|           |                  |                       |             |
|           | \--Illness in    |                       |             |
|           | the baby or      |                       |             |
|           | mother           |                       |             |
|           |                  |                       |             |
|           | \--Smoking       |                       |             |
|           |                  |                       |             |
|           | \--Previous      |                       |             |
|           | breast surgery   |                       |             |
|           |                  |                       |             |
|           | \--Mother is     |                       |             |
|           | pregnant again   |                       |             |
+-----------+------------------+-----------------------+-------------+
| **NURSING | \--Illness in    | \--Minimize           | \--Nursing  |
| STRIKE**  | the baby         | distractions and      | strike      |
|           |                  | noises during         | continues   |
|           | \--Teething      | feedings              | past        |
|           |                  |                       |             |
|           | \--Any number of | \--Try other          | 24 hours    |
|           | reasons that     | positions             |             |
|           | mother may       |                       |             |
|           |                  | \--Offer the breast   |             |
|           | never figure out | before baby is fully  |             |
|           |                  | awake or              |             |
|           |                  |                       |             |
|           |                  | when he first shows   |             |
|           |                  | signs of being hungry |             |
|           |                  |                       |             |
|           |                  | \--Offer breast milk  |             |
|           |                  | in a cup, dropper, or |             |
|           |                  | spoon until           |             |
|           |                  |                       |             |
|           |                  | breastfeeding resumes |             |
+-----------+------------------+-----------------------+-------------+