CLC Section 3A & 3B
... - ANS-
Australian Posture - ANS--parent lies "down under" the toddler
-toddler is supported at the chest, tummy to tummy
-this role is specially beneficial whilst the milk supply is greater or there may be a effective let
down because on this position the infant has increases potential to maneuver his/her head to
better manipulate large or rapid milk go with the flow
Babies Use Their Senses to Reach Breast - ANS--the better temperature of areola enables
manual babies to breast
-smell is also an vital early evolved experience for maximum newborns to draw the infant to
the breast
-exposure to mom's scent might also facilitate infant's edition to the early postnatal
surroundings
-mom's areola & milk odor seem like sufficient to draw & manual neonates to the smell
supply, esp after toddler has been uncovered to the contractions of hard work; maternal
breast milk scent calms newborns at some point of painful tactics
-women are rewarded once they smell infants; frame odors of unexpected 2 day old infants
elicits activation in reward-related cerebral areas of women regardless of their maternal
reputation
Baby Position At Breast For Maximal Milk Transfer - ANS--child is near breast
-infant's shoulders are supported at base of the neck
-no strain on returned of child's head, child should be able to tilt head
-child's body rotated towards determine's chest (tummy to mummy)
-toddler moved closer to breast, lining up nose at nipple
-breast isn't moved to toddler; breast ought to lie in natural role & baby be delivered to breast
-start feed w/ nose contrary nipple assists child to orient to breast thru properly-developed
sense of scent & aligns mouth at breast whilst child's head tilts returned
-as toddler chin comes in the direction of breast, he'll gape, opening mouth very extensive as
head tilts again (if child fails to gape, repeat this maneuver)
-consider additional S2S to improve toddler's motor state organisation for child who fails to
gape or nurse
-do no longer push nipple into baby's mouth, doing this may result in most effective
positioning of nipple or appropriate compression & launch of breast & nipple tissue (can
purpose ache, harm, & sluggish drift of milk)
-head tilt permits lower lip to seal to breast first observed with the aid of upper lip
-toddler's mouth will appear off-center whilst compared w/ areola, baby's decrease lip can be
in opposition to breast a whole lot father from nipple than upper lip (asymmetric latch)
-infant seals to breast & starts offevolved to suck unexpectedly (might be 8 or extra sucks to
at least one swallow), then shifts into pattern of 2 sucks to one swallow or 1 suck to at least
one swallow
,-2:1 or 1:1 suck to swallow is a time of more milk transfer; those are interspersed w/ greater
rapid sucking sequences & occasional rest periods
-after colostral stage, child can switch numerous ozof milk in very few minutes while
appropriately latched & hungry
-there may be no proper length of feed to ensure adequate milk transfer, however toddlers
with constantly short (<5 min) or long (>20 min) feeds must be assessed to make sure good
enough milk switch
Best Practice w/ Robson's Criteria - ANS--if dyad experiences immediately, non-stop,
uninterrupted S2S contact for first hour or so after start & stepped forward via Widstrom's
Stages & suckled they have got performed the usual of pleasant exercise
-this algorithm combines Robson's standards fro obstetric classification, parameters of
satisfactory exercise of S2S contact (immediately, non-stop, & uninterrupted) along w/
Widstrom's nine degrees with a view to examine the enjoy of moms and toddlers inside the
first hour after delivery
-this simple set of rules for hospitals to comply with could have a ways attaining impact on
making exercise seen, auditing, & reporting practices enabling the success of first-class
practice, as well as offering a consistent measure for future studies
BF Counseling Goals - ANS--own family worries are heard and valued (listen to what is
happening and concentrate to what is being stated; just because the priority is the identical
that 10 other sufferers have had doesn't suggest the reasons for having the priority are the
equal)
-child feels heard & valued (if you need to feed/care for child for the duration of this meeting,
please do)
-counselor elicits "the complete story" before supplying remarks or intervention (do not just
get concerns from chart or referral, get into it with them)
-adults, baby & counselor are absolutely worried in trouble fixing
-safety is continually the primary attention (even over BF) (if someone may be very
depressed that is first priority - "good day shall we find you a counselor to help you with xy&z
and we can deal with feeding day after today")
-generation & devices are used very carefully (don't simply use gear and devices to clear up
the issues
Breastfeeding Positions - ANS--cradle or madonna posture
-pass cradle posture
-football or clutch posture
-semi-reclining (laid again) posture
-aspect lying posture
-australian posture
Calculating Baby's Approx Daily Needs - ANS--get pre-feed wt take a look at
-have a look at a feed
-behavior publish feeding wt & calculate milk transfer; calculate baby's approx each day
wishes & divide that determine by way of the range of said feeds in 24 hours; how does the
quantity arrived at evaluate w/ the amount of milk transferred at some point of this feed
--if milk switch estimate is much decrease than predicted need, follow protocol for bad milk
supply & milk switch
,--if switch estimate is higher than expected need, observe protocol for oversupply
--if switch estimate is kind of the same as envisioned want, agenda observe up touch to
make certain that the problem is resolving
--any single feed does no longer necessarily suggest normal milk intake; it's helpful to look at
numerous feeds over a time frame to get better estimate of common transfer
Cesarean Birth is Barrier to BF - ANS--unplanned, non-compulsory, & repeat c segment
have terrible effect on BF
-first hours after birth you've got short window; one the progesterone is going out w/ delivery
of placenta, then we want to have prolactin to be had in bloodstream to pop into those
receptor websites in an effort to begin making milk; so that you can alternate the ones cells
over to exploit making cells from colostrum making cells; if progesterone is going out & there
may be no prolactin to fill them, those cells are going to involute & are not going to be
available to make milk until the subsequent pregnancy
-perhaps because of later initiation of BF or greater separation or extra supplementation or
extra wt loss
-better submit-op ache manipulate improves BF consequences
-child's intestine microbiome is stricken by antibiotic use, mode & vicinity of birth
-babies who're born thru c segment can cross S2S throughout final
-S2S after c segment may also increase BF initiation, lessen components supplementation
in medical institution & preserve infant temperature
-if mother is separated from baby, associate can do S2S
-in have a look at of fathers, "babies in the S2S organization have been comforted, they
stopped crying, have become calmer, & reached a drowsy state earlier than the babies in the
cot organization"
-now not inside the first 2 hours, however maybe whilst mother goes to take a bath, S2S w/
dad is crucial too; if mom is hemorrhaging or has an emergency than dad need to do S2S
inside that first hour time frame
Colic - ANS--circumstance of infancy defined by classic rule of 3: bouts of high-pitches
crying lasting greater than 3 hours an afternoon, for extra than three days a week, & greater
more than 3 weeks in a properly-nourished, in any other case wholesome infant
-typically started after 2 weeks of age & resolves through 4 months
Collaborative BF - ANS--as the infant seeks the breast the parent gently assists
Concern: Baby Has A Birth Defect: Cardiac Problem - ANS--infant is identified w/ cardiac
hassle
*Ask yourself: -what's the extent of the impact of the child's condition on BF?; watch the child
on the breast to evaluate child's potential to are seeking for the breast, latch, & transfer milk
*Watch out for: -babies w/ cardiac defects may also fatigue without difficulty at breast, so
they will need to be fed often
-observe for signs and symptoms of cardiac troubles, such as circumoral cyanosis (blue,
gray, or white coloration across the lips) for the duration of feeds
*What to do about it: -determine feeding hx; how infant has been fed, how infant is
responding to feeding & so on
-have a look at a feed
-if possible, acquire pre and publish feeding wt take a look at to quantify milk transfer
, *Expected resolution: -cardiac defects have distinction levels of impact on the ability to feed
properly in each infant affected; many infants w/ cardiac troubles can BF well, but they
should be observed intently to ensure appropriate increase
*What else to take into account: -for those nursing infants w/ recognized cardiac issues, milk
expression after feeding is often had to enhance milk removal (& milk deliver)
-if toddler does no longer switch milk properly in the course of feeds, don't forget use of
change rubdown &/or at breast supplementation w/ expressed milk
Concern: Baby Has A Birth Defect: Cardiac Problem OVERALL - ANS--cardiac defects are a
number of the most common delivery defects going on in 1 in one hundred births
-BF or feeding expressed BM inside the event that feeding on the breast isn't always
possible may be a super contribution to the fitness of the child dealing w/ a heart problem
Concern: Baby Has A Birth Defect: Craniofacial Anomalies (Cleft Lip/Palate, Pierre Robin
Sequence, and many others.) - ANS--child diagnosed w/ craniofacial anomaly
*Ask your self: -what is the quantity of the effect of infant's situation on BF?; watch toddler at
breast, to assess baby's potential to make a seal on breast, keep breast in mouth, make &
preserve a vacuum, & switch milk
*Watch out for: -problems coordinating treating & feeding
-signs and symptoms of breathing misery, stridor (excessive pitched noise when child
inhales)
-circumoral cyanosis at some point of feeds
*What to do approximately it: -determine feeding hx, how the child has been fed, how toddler
is responding to feeding, & so on
-look at a feed
-if feasible get pre and put up feeding wt assessments to quantify milk transfer
-w/ cleft lip, angling the breast so that the smooth tissue fills the void inside the lip may be a
very good answer; alternatively the lip location may be held closed w/ fingers throughout the
feed
-when dealing w/ unilateral cleft palate, advise angling the breast in the infant's mouth in any
such way that gentle tissue of breast fills the customer location & nipple extends into the
intact side of the mouth
-w/ Pierre Robin sequence, upright feeding posture might also assist child in accomplishing
deep latch
*Expected resolution: -infants w/ clefts & Pierre Robin series have various levels of fulfillment
in feeding on the breast
*What else to take into account: -many that nurse infants w/ those demanding situations will
want to specific milk after the feed to maintain & growth their milk deliver
-if baby does not transfer milk nicely at some point of feeds, recollect use of alternate
rubdown &/or at breast supplementation w/ expressed BM
-unique feeding devices that rely handiest on advantageous stress to create milk drift have
been used to feed infants who cannot transfer milk at the breast even if using an at-breast
supplemental tool
Concern: Baby Has A Birth Defect: Craniofacial Anomalies (Cleft Lip/Palate, Pierre Robin
Sequence, etc.) OVERALL - ANS--in the event that a infant affected infant any such
challenges is unable to feed at the breast, verify if the determine wishes to explicit milk to be
fed to the toddler & provide guide as wanted
... - ANS-
Australian Posture - ANS--parent lies "down under" the toddler
-toddler is supported at the chest, tummy to tummy
-this role is specially beneficial whilst the milk supply is greater or there may be a effective let
down because on this position the infant has increases potential to maneuver his/her head to
better manipulate large or rapid milk go with the flow
Babies Use Their Senses to Reach Breast - ANS--the better temperature of areola enables
manual babies to breast
-smell is also an vital early evolved experience for maximum newborns to draw the infant to
the breast
-exposure to mom's scent might also facilitate infant's edition to the early postnatal
surroundings
-mom's areola & milk odor seem like sufficient to draw & manual neonates to the smell
supply, esp after toddler has been uncovered to the contractions of hard work; maternal
breast milk scent calms newborns at some point of painful tactics
-women are rewarded once they smell infants; frame odors of unexpected 2 day old infants
elicits activation in reward-related cerebral areas of women regardless of their maternal
reputation
Baby Position At Breast For Maximal Milk Transfer - ANS--child is near breast
-infant's shoulders are supported at base of the neck
-no strain on returned of child's head, child should be able to tilt head
-child's body rotated towards determine's chest (tummy to mummy)
-toddler moved closer to breast, lining up nose at nipple
-breast isn't moved to toddler; breast ought to lie in natural role & baby be delivered to breast
-start feed w/ nose contrary nipple assists child to orient to breast thru properly-developed
sense of scent & aligns mouth at breast whilst child's head tilts returned
-as toddler chin comes in the direction of breast, he'll gape, opening mouth very extensive as
head tilts again (if child fails to gape, repeat this maneuver)
-consider additional S2S to improve toddler's motor state organisation for child who fails to
gape or nurse
-do no longer push nipple into baby's mouth, doing this may result in most effective
positioning of nipple or appropriate compression & launch of breast & nipple tissue (can
purpose ache, harm, & sluggish drift of milk)
-head tilt permits lower lip to seal to breast first observed with the aid of upper lip
-toddler's mouth will appear off-center whilst compared w/ areola, baby's decrease lip can be
in opposition to breast a whole lot father from nipple than upper lip (asymmetric latch)
-infant seals to breast & starts offevolved to suck unexpectedly (might be 8 or extra sucks to
at least one swallow), then shifts into pattern of 2 sucks to one swallow or 1 suck to at least
one swallow
,-2:1 or 1:1 suck to swallow is a time of more milk transfer; those are interspersed w/ greater
rapid sucking sequences & occasional rest periods
-after colostral stage, child can switch numerous ozof milk in very few minutes while
appropriately latched & hungry
-there may be no proper length of feed to ensure adequate milk transfer, however toddlers
with constantly short (<5 min) or long (>20 min) feeds must be assessed to make sure good
enough milk switch
Best Practice w/ Robson's Criteria - ANS--if dyad experiences immediately, non-stop,
uninterrupted S2S contact for first hour or so after start & stepped forward via Widstrom's
Stages & suckled they have got performed the usual of pleasant exercise
-this algorithm combines Robson's standards fro obstetric classification, parameters of
satisfactory exercise of S2S contact (immediately, non-stop, & uninterrupted) along w/
Widstrom's nine degrees with a view to examine the enjoy of moms and toddlers inside the
first hour after delivery
-this simple set of rules for hospitals to comply with could have a ways attaining impact on
making exercise seen, auditing, & reporting practices enabling the success of first-class
practice, as well as offering a consistent measure for future studies
BF Counseling Goals - ANS--own family worries are heard and valued (listen to what is
happening and concentrate to what is being stated; just because the priority is the identical
that 10 other sufferers have had doesn't suggest the reasons for having the priority are the
equal)
-child feels heard & valued (if you need to feed/care for child for the duration of this meeting,
please do)
-counselor elicits "the complete story" before supplying remarks or intervention (do not just
get concerns from chart or referral, get into it with them)
-adults, baby & counselor are absolutely worried in trouble fixing
-safety is continually the primary attention (even over BF) (if someone may be very
depressed that is first priority - "good day shall we find you a counselor to help you with xy&z
and we can deal with feeding day after today")
-generation & devices are used very carefully (don't simply use gear and devices to clear up
the issues
Breastfeeding Positions - ANS--cradle or madonna posture
-pass cradle posture
-football or clutch posture
-semi-reclining (laid again) posture
-aspect lying posture
-australian posture
Calculating Baby's Approx Daily Needs - ANS--get pre-feed wt take a look at
-have a look at a feed
-behavior publish feeding wt & calculate milk transfer; calculate baby's approx each day
wishes & divide that determine by way of the range of said feeds in 24 hours; how does the
quantity arrived at evaluate w/ the amount of milk transferred at some point of this feed
--if milk switch estimate is much decrease than predicted need, follow protocol for bad milk
supply & milk switch
,--if switch estimate is higher than expected need, observe protocol for oversupply
--if switch estimate is kind of the same as envisioned want, agenda observe up touch to
make certain that the problem is resolving
--any single feed does no longer necessarily suggest normal milk intake; it's helpful to look at
numerous feeds over a time frame to get better estimate of common transfer
Cesarean Birth is Barrier to BF - ANS--unplanned, non-compulsory, & repeat c segment
have terrible effect on BF
-first hours after birth you've got short window; one the progesterone is going out w/ delivery
of placenta, then we want to have prolactin to be had in bloodstream to pop into those
receptor websites in an effort to begin making milk; so that you can alternate the ones cells
over to exploit making cells from colostrum making cells; if progesterone is going out & there
may be no prolactin to fill them, those cells are going to involute & are not going to be
available to make milk until the subsequent pregnancy
-perhaps because of later initiation of BF or greater separation or extra supplementation or
extra wt loss
-better submit-op ache manipulate improves BF consequences
-child's intestine microbiome is stricken by antibiotic use, mode & vicinity of birth
-babies who're born thru c segment can cross S2S throughout final
-S2S after c segment may also increase BF initiation, lessen components supplementation
in medical institution & preserve infant temperature
-if mother is separated from baby, associate can do S2S
-in have a look at of fathers, "babies in the S2S organization have been comforted, they
stopped crying, have become calmer, & reached a drowsy state earlier than the babies in the
cot organization"
-now not inside the first 2 hours, however maybe whilst mother goes to take a bath, S2S w/
dad is crucial too; if mom is hemorrhaging or has an emergency than dad need to do S2S
inside that first hour time frame
Colic - ANS--circumstance of infancy defined by classic rule of 3: bouts of high-pitches
crying lasting greater than 3 hours an afternoon, for extra than three days a week, & greater
more than 3 weeks in a properly-nourished, in any other case wholesome infant
-typically started after 2 weeks of age & resolves through 4 months
Collaborative BF - ANS--as the infant seeks the breast the parent gently assists
Concern: Baby Has A Birth Defect: Cardiac Problem - ANS--infant is identified w/ cardiac
hassle
*Ask yourself: -what's the extent of the impact of the child's condition on BF?; watch the child
on the breast to evaluate child's potential to are seeking for the breast, latch, & transfer milk
*Watch out for: -babies w/ cardiac defects may also fatigue without difficulty at breast, so
they will need to be fed often
-observe for signs and symptoms of cardiac troubles, such as circumoral cyanosis (blue,
gray, or white coloration across the lips) for the duration of feeds
*What to do about it: -determine feeding hx; how infant has been fed, how infant is
responding to feeding & so on
-have a look at a feed
-if possible, acquire pre and publish feeding wt take a look at to quantify milk transfer
, *Expected resolution: -cardiac defects have distinction levels of impact on the ability to feed
properly in each infant affected; many infants w/ cardiac troubles can BF well, but they
should be observed intently to ensure appropriate increase
*What else to take into account: -for those nursing infants w/ recognized cardiac issues, milk
expression after feeding is often had to enhance milk removal (& milk deliver)
-if toddler does no longer switch milk properly in the course of feeds, don't forget use of
change rubdown &/or at breast supplementation w/ expressed milk
Concern: Baby Has A Birth Defect: Cardiac Problem OVERALL - ANS--cardiac defects are a
number of the most common delivery defects going on in 1 in one hundred births
-BF or feeding expressed BM inside the event that feeding on the breast isn't always
possible may be a super contribution to the fitness of the child dealing w/ a heart problem
Concern: Baby Has A Birth Defect: Craniofacial Anomalies (Cleft Lip/Palate, Pierre Robin
Sequence, and many others.) - ANS--child diagnosed w/ craniofacial anomaly
*Ask your self: -what is the quantity of the effect of infant's situation on BF?; watch toddler at
breast, to assess baby's potential to make a seal on breast, keep breast in mouth, make &
preserve a vacuum, & switch milk
*Watch out for: -problems coordinating treating & feeding
-signs and symptoms of breathing misery, stridor (excessive pitched noise when child
inhales)
-circumoral cyanosis at some point of feeds
*What to do approximately it: -determine feeding hx, how the child has been fed, how toddler
is responding to feeding, & so on
-look at a feed
-if feasible get pre and put up feeding wt assessments to quantify milk transfer
-w/ cleft lip, angling the breast so that the smooth tissue fills the void inside the lip may be a
very good answer; alternatively the lip location may be held closed w/ fingers throughout the
feed
-when dealing w/ unilateral cleft palate, advise angling the breast in the infant's mouth in any
such way that gentle tissue of breast fills the customer location & nipple extends into the
intact side of the mouth
-w/ Pierre Robin sequence, upright feeding posture might also assist child in accomplishing
deep latch
*Expected resolution: -infants w/ clefts & Pierre Robin series have various levels of fulfillment
in feeding on the breast
*What else to take into account: -many that nurse infants w/ those demanding situations will
want to specific milk after the feed to maintain & growth their milk deliver
-if baby does not transfer milk nicely at some point of feeds, recollect use of alternate
rubdown &/or at breast supplementation w/ expressed BM
-unique feeding devices that rely handiest on advantageous stress to create milk drift have
been used to feed infants who cannot transfer milk at the breast even if using an at-breast
supplemental tool
Concern: Baby Has A Birth Defect: Craniofacial Anomalies (Cleft Lip/Palate, Pierre Robin
Sequence, etc.) OVERALL - ANS--in the event that a infant affected infant any such
challenges is unable to feed at the breast, verify if the determine wishes to explicit milk to be
fed to the toddler & provide guide as wanted
