Minggu, 22 Mei 2016

Mastitis and Blocked Ducts

Mastitis is a bacterial infection of the breast that usually occurs in breastfeeding mothers, needs to be differentiated from a plugged duct because a plugged duct does not need treatment with antibiotics, whereas mastitis often, but not always, requires treatment with antibiotics. A blocked duct presents as a painful, swollen, firm mass in the breast. Mastitis is usually associated with fever and more intense pain as well. However, it is not always easy to distinguish between a mild mastitis and a severe blocked duct. Both are associated with a painful lump in the breast. Without a lump in the breast, one cannot make a diagnosis of mastitis. A blocked duct can, apparently, go on to become mastitis.

Blocked ducts will almost always resolve spontaneously within 24 to 48 hours after onset, even without any treatment at all, can be made to resolve more quickly by:
1.      Continuing breastfeeding on the affected side.
2.      Draining the affected area better.

If the blocked duct is associated with a small blister on the end of the nipple, you can open it with a sterile needle. Opening the blister has the added benefit of decreasing nipple pain, even if the blocked duct does not immediately resolve. If a blocked duct has not settled within 48 hours, therapeutic ultrasound often works. Get the blocked duct re-evaluated at the clinic. Ultrasound also seems to prevent recurrent blocked ducts that always occur in the same part of the breast.

Here is my approach to dealing with mastitis.

1.      If the mother has symptoms consistent with mastitis for more than 24 hours, she should start antibiotics. If, over the next 24 hours, the mother has not worsened, but not improved, she should start the antibiotics. However, if symptoms are starting to decrease, there is no need to start the antibiotics. If the course of your mastitis does not follow this pattern, contact the clinic.

2.      Amoxicillin, plain penicillin, and some other antibiotics often prescribed for mastitis are usually useless for mastitis. If you need an antibiotic, it must be effective against Staphylococcus aureus. 

Continuing breastfeeding helps mastitis to resolve more quickly. There is no danger for the baby. Heat applied to the affected area helps healing. Fever helps fight off infection. 

An abscess occasionally complicates mastitis. You don’t have to stop breastfeeding to get a breast lump investigated. A breastfeeding friendly surgeon will not tell you that you must stop breastfeeding before she can do tests for a breast lump.

Breastfeeding Pain

Unfortunately, many breastfeeding moms experience some sort of pain as they begin to nourish their baby. Most of the time, a poor latch is the cause of nipple pain. Aaaaaah! Your baby will suck extra-hard on your breast if the milk flow is pinched off due to a poor latch, if milk supply is low.

Sore nipples in later months may be related to sucking pattern changes in a teething baby. The pain gets a little better once she’s feeding but is still pretty bad for the whole time. Experiencing pain when using a breastpump? If your breastshields are too small, pumping can cause unneeded friction on your nipples. Soothe sore nipples with Medela’s Tender Care Lanolin and Hydrogel pads, which are both safe for mom and baby.

Keep bra pads and bras dry and allow air to circulate around your breasts whenever possible. Multiple-hole breast shells like SoftShells can help protect from further irritation by holding fabric off of sore nipples and allowing for better air circulation.

Injured nipples may also become infected with bacteria, which can slow healing and cause pain even when positioning and latch are corrected. A common yeast infection known as thrush can cause redness, irritation in your nipples. If you suspect you have a thrush infection, contact your healthcare provider. Your doctor can help identify and treat tongue-tie, determine if an allergic reaction is the cause of your pain. 

Have you experienced pain while breastfeeding? Supplement with formula: I’m not going to do this since the baby is actually getting plenty to eat, and since I’m prone to low milk supply issues I think that skipping feedings could cause more problems than it solves.

Job Description for Lactation Consultant

Lactation consultants provide information and advice to parents and others on breastfeeding and lactation, often work in hospitals, although they may also provide home visits to clients as well. Requirements for lactation consultant position may vary depending on the employer. Often, lactation consultants are registered nurses who have received additional education to become a lactation consultant. 

Lactation consultant tasks:
1.      Assist patients having breastfeeding problems.
2.      Select and oversee breastfeeding supplies and accessories for sale and rental.
3.      Design, instruct and assess classes for staff, pregnant and new breastfeeding mothers.

Sabtu, 21 Mei 2016

Tips for Nursing Mothers

It is a myth that a mother needs to drink milk to make milk, according to the Los Angeles Children’s Hospital. Mothers should drink 6 to 8 glasses of fluids a day to produce enough milk and to stay hydrated. 

Eating a balanced diet and continuing to take prenatal vitamins will keep both mother and child healthy during the breastfeeding process. Mothers should wash fruits and vegetables to remove possible pesticides. Before taking any medications a mother should consult her medical professional. Smoking should always be avoided while breastfeeding. The baby is exposed to nicotine through the breast milk when the mother smokes. Mothers should never breastfeed while alcohol is still in their system because it can harm the baby.

Many mothers worry if they’re babies are getting enough to eat. How often a child needs fed depends on age and individual needs. The mother should wake the baby to eat if 3 to 4 hours have passed since the last feeding. If the baby doesn’t wake up to eat on a regular basis, the mother should consult with her pediatrician.

Mothers can continue to breastfed after one year as long as it is comfortable for the mother and child. “Weaning is an individual process and a decision between mother and baby,” said Sharon McDuffie, a lactation specialist at MedStar Washington Hospital Center, in Washington, D.C. "Mothers please don’t take it personal if your baby makes the decision before you do."

Positioning the baby is key to breastfeeding success. Debbie Pierce, a registered nurse and board-certified lactation consultant at Kaiser Permanente in Colorado, recommends varying breastfeeding positions to prevent plugged milk ducts.  

The mother should hold the baby so that the head is level with the breast, nose to nipple. Then, the baby should be turned so the mother and baby are tummy-to-tummy. Many experts recommend tickling the baby's lower lip with the nipple and waiting for the baby's mouth to open wide before offering the breast. Then, pull the baby in to latch on. Mothers shouldn’t worry about suffocation. The baby will pull off if unable to breathe. 

If the infant is not able to breastfeed directly, the pump acts as mom’s mechanical baby. If an infant is not breastfeeding well, the mother should pump after a few feedings per day, preferably after feedings when the infant didn’t nurse as well. 

“For instance, if the baby is 6 weeks old the mom will need to pump more often when away from her infant, versus if the baby is 3 months or older,” said Hurst.

Pumping at work can create some challenges, but mothers should know their legal rights. 

How to tell whether your baby's getting enough breast milk

While most moms are able to provide their babies with all the milk they need, there are times when babies don't get enough. Signs that your breastfeeding baby is getting enough nourishment:
1.      After a feeding, your baby seems relaxed and satisfied.
2.      After gaining back her initial weight loss after birth, your baby continues to gain weight.
3.      After your milk comes in, though, your baby will wet six to eight cloth diapers a day.