Lactation Final Questions and Answers.

Lactation Final Questions and Answers. The HSCI 434: Lactation Education prenatal and Perinatal Period course Canvas page is organized by modules. Each week, students are responsible for complete a certain number of modules. Information regarding which modules the student should complete each week can be found in the course syllabus. During week #2 of this course the student is responsible for completing module ___ - Module ___ a. 5, 11 b. 6, 11 c. 7, 10 d. 4, 7 b. 6, 11 This course meets asynchronously online. This means students may complete each module a any time during the week that they wish. Course written assignments, quizzes are due a. Anytime during the week as long as you complete them by the last day of the course. b. On a set date which will always be a Sunday at 11:59pm b. On a set date which will always be a Sunday at 11:59pm True or false: Course assignment and quizzes can be turned in late a. true b. false b. false True or false the online final exam in this course can be completed any time during the last week of the course. a. True b. False b. False To be successful in the course it is important to: a. View all online lectures and documentaries b. Complete all weekly quizzes Read pre-module reading assignments c. Complete all written assignments d. All of the tasks listed are important to complete to be successful in this course. d. All of the tasks listed are important to complete to be successful in this course. True or False: Many professional health organizations recommend that mothers breastfeed their babies exclusively for the first year of their baby's life. a. True b. False b. False Research findings suggest that there are many positive health outcomes associated with breastfeeding for the breastfeeding mother including all of the following EXCEPT: Reduction in the risk of developing type 2 diabetes. a. Reduction in the risk of developing ovarian cancer. b. Reduction in the risk of developing type 2 diabetes. c. Reduction in the risk of developing cardiovascular disease. d. Reduction in the risk of developing breast cancer. e. Reduction in the risk of developing ear infections. e. Reduction in the risk of developing ear infections. Which of the two scenarios described below would make a research study's findings stronger? a. A research study that measured breastfeeding by asking women in their 60s about the frequency and duration of breastfeeding with their now adult child. b. A research study that followed women over a 6-month period and measured breastfeeding by asking participants once a week about the frequency and amount of breastfeeding they were doing. b. A research study that followed women over a 6-month period and measured breastfeeding by asking participants once a week about the frequency and amount of breastfeeding they were doing. Prior to the 1800s, the most common alternative to maternal breastfeeding (i.e., if a mother was not available to breastfeed her infant) was: a. None of the responses were the most common alternative to maternal breastfeeding b. Hand-fed foods c. Use of a wet nurse d. Artificial baby milk e. Rice cereal c. Use of a wet nurse During the 1900s all of the following EXCEPT _______ led to the decline in breastfeeding prevalence rates. a. The public's faith in science and technology. b. Creation of easy to clean infant feeding devices. c. Marketing of artificial baby milk. d. Women's interest in impacting society outside of their home. e. The natural childbirth movement. e. The natural childbirth movement. The "Baby Killer" report you read for this course highlights some reasons that the marketing of formula in developing countries can be inappropriate and detrimental to an infant's health. Those reasons include all of the following EXCEPT: a. Many families cannot afford formula and use substitutes that are not appropriate. b. All of the possible answers are reasons that the marketing of formula in developing countries can be inappropriate and detrimental to an infant's health c. Many families are illiterate and cannot read instructions on how to properly prepare formula. d. Lack of access to clean water. e. Many families cannot afford formula and therefore dilute it. b. All of the possible answers are reasons that the marketing of formula in developing countries can be inappropriate and detrimental to an infant's health The international code of marketing of breastmilk substitutes recommends all of the following EXCEPT: a. Health care facilities should not promote infant formula b. Mothers should receive free infant formula samples. c. Infant formula should not be advertised publicly. d. All infant formula should be labeled with an explanation of the benefits of breastfeeding and the costs and hazards associated with artificial feeding. b. Mothers should receive free infant formula samples. Currently under the Women Infant and Children (WIC) program,_______________ receive more benefits (e.g., food coupons). a. Breastfeeding mothers b. Formula feeding mothers c. Both formula feeding and breastfeeding mothers receive the same benefits c. Both formula feeding and breastfeeding mothers receive the same benefits Imagine that you were recently hired as a lactation educator. Your primary responsibility is to answer calls on a breastfeeding warmline. Read the scenarios below and decide whether the concern reported by the hypothetical mother calling the breastfeeding warmline is within your scope of practice. A pregnant mother calls the breastfeeding warmline. She tells you that she has a rare medical condition for which she takes a variety of medications. She asks you if it would be fine for her to breastfeed her baby. a. The concern raised in the scenario is WITHIN the lactation educator's scope of practice b. The concern raised in the scenario is NOT WITHIN the lactation educator's scope of practice b. The concern raised in the scenario is NOT WITHIN the lactation educator's scope of practice During pregnancy, all of the following changes occur in the mammary glands EXCEPT: a. All of the listed changes occur during pregnancy. b. The breasts begin to produce colostrum. c. The areola may enlarge and darken. d. The montgomery glands become more visible. e. The mother's breasts may grow about 1-2 cup sizes. a. All of the listed changes occur during pregnancy. After the placenta is delivered which of the following changes in hormone levels occur? a. Progesterone levels rise and prolactin levels drop. b. Progesterone and prolactin levels drop. c. Progesterone levels drop and prolactin levels rise. d. Progesterone levels and prolactin levels stay the same. c. Progesterone levels drop and prolactin levels rise. The nipple shown in the picture above is: a. Everted b. Inverted c. Flat d. Folded b. Inverted In the United States during the 1950s _____________ played a significant role in women's renewed interest in breastfeeding. a. Faith in science b. Advance in science and technology c. None of the options played a significant role in women's renewed interest in breastfeeding. d. The creation of infant formula e. The natural childbirth movement e. The natural childbirth movement Please identify the health enhancing behavior listed below that is associated with a reduction in the risk of an infant developing sudden infant death syndrome a. Proper use of condoms when engaging in sexual activity b. Smoking cessation c. Breastfeeding d. Engaging in risky sexual activity e. Formula Feeding c. Breastfeeding The follow question relates to a scenario involving a pregnant mother and a lactation educator. Lactation Educator: Have you thought about how you are going to feed your baby once she is born? Pregnant Woman: Yes. I plan to formula feed. Lactation Educator: Can you tell me a little bit about why you have chosen to formula feed. Pregnant Woman: No one I know was able to breastfeed. Lactation Educator: Can you tell me a little bit about why they were not able to breastfeed? Pregnant Woman: They had trouble making milk. My mom says that women in our family don't make a lot of milk. The most likely concern this mother is expressing with regards to breastfeeding is _________________. Education you might share with this mother to help address her concerns could include _____________________. a. Fear that breastfeeding will hurt/ the key to building milk supply is frequent and effective feedings. b. Concern that breastfee e. Lack of confidence in ability to produce enough milk to nourish the baby/ the key to building milk supply is frequent and effective feedings Which of the following statements is most accurate regarding the following hypothetical situation. Yarely gave birth to 6.5-pound baby girl who she is breastfeeding. How will her small breastmilk storage capacity impact her ability to breastfeed her infant. a. Yarely will be able to meet her infant's needs by feeding her when she exhibits early feeding cues, which will likely be very frequent b. Yarely will need to supplement her baby with about one ounce of formula after each feeding. c. The only way Yarely will be able to provide sufficient amounts of breastmilk for her baby is by pumping at least three times a day d. She will need to express milk either after a feeding or between feedings in order to meet her baby's needs. e. Yarely's milk supply will meet her baby's needs for the first few weeks of life. However, once her baby is about 2 weeks old it will not be sufficient and she will need to supplement. a. Yarely will be able to meet her infant's needs by feeding her when she exhibits early feeding cues, which will likely be very frequent All of the following are reasons why a pregnant woman may be encouraged to stop breastfeeding EXCEPT: a. Experiencing uterine pain or bleeding. b. Signs of preterm labor. c. Difficulty gaining weight during pregnancy. d. Asthma. e. History of preterm labor. d. Asthma. True or False: A woman who has had a breast reduction surgery, which involved having her nipple removed and re-positioned, is more likely to produce enough milk to exclusively breastfeed her baby for six months than a woman who has had liposuction to reduce the size of her breasts. a. True b. False b. False True or false: The consumption of folate during early pregnancy is associated with the reduction of risk of an infant developing neural tube defects. a. True b. False a. True All of the following are nutrients that may be lacking in the diet of a vegetarian EXCEPT: a. Protein b. All of the choices are nutrients that may be lacking in the diet of a vegetarian c. Vitamin B12 d. Iron e. Calcium b. All of the choices are nutrients that may be lacking in the diet of a vegetarian True or false: Undetected and untreated vitamin B deficiency in infants can result in severe and permanent neurological damage. a. True b. False a. True You are a lactation educator who answers phone calls made to a breastfeeding warmline. Julie, a pregnant vegetarian, has contacted you. She tells you she would like to breastfeed her baby and wants to know if her diet will have any impact on her baby's health. Which of the following is the most appropriate way to respond to Julie? a. None of the responses would be an appropriate way to respond b. It is great that you are interested in breastfeeding. However, it is not recommended that moms who are vegetarian breastfeed. Are you open to consuming some animal products? c. It is great that you want to breastfeed! You don't have to worry about your diet because even if your diet is not perfect your breastmilk will always be perfect. d. It is great that you want to breastfeed! For the most part, regardless of what the mother eats, her breastmilk is perfect for her baby. However, if a mother's diet is lacking in some vita d. It is great that you want to breastfeed! For the most part, regardless of what the mother eats, her breastmilk is perfect for her baby. However, if a mother's diet is lacking in some vitamins, her breastmilk will be lacking in those vitamins. This is the case with Vitamin B12, which can often be low in a vegetarian woman's diet and is particularly important for a baby's development. You may consider meeting with a registered dietitian to find out if you need to consume more foods with vitamin B12 and/or take a B12 supplement. Sheila, the healthy mother of exclusively breastfed 2-month old Taylor decides to go vegan (i.e., consume a diet that does not include animal proteins, eggs, or milk). To ensure that baby Taylor gets adequate amounts of _____ via breastmilk, Sheila will need to supplement her diet with ____. a. Vitamin B12, Vitamin B12. b. Vitamin D, Vitamin C c. Calcium, Calcium d. Iron, Calcium e. Vitamin B12, Vitamin D a. Vitamin B12, Vitamin B12. You are a lactation educator who answers calls on a breastfeeding warmline. Jeni, a breastfeeding mother calls and tells you she is trying to lose weight and wants to know what is the recommended amount of weight loss per week. Which of the below answers is the best: a. 3-5 pounds b. It is not recommended that breastfeeding women lose weight c. 0.5-2 pounds d. 1-3 pounds e. 2-4 pounds c. 0.5-2 pounds True or False: The following hospital practice has a positive impact on breastfeeding: "feeding baby every 5 hours." a. True b. False b. False Suctioning after delivery can negatively impact breastfeeding in the following way: a. Breast aversion b. Edema in the extremities including the breast and nipple tissue c. Impaired sucking d. Baby who is uncomfortable breastfeeding in many positions e. Delays first feeding a. Breast aversion The following is a close-ended question: a. How many times a day does your baby breastfeed? b. What are your plans after your baby is born? c. Can you tell me a little bit about how your breastfeeding experience is going? d. What are the baby's dad's feelings about breastfeeding? e. What have you heard about breastfeeding? a. How many times a day does your baby breastfeed? All of the following are signs of an ineffective latch EXCEPT: a. Infant's lips are touching the breast. b. Nipple abrasions and/or cracking. c. Infant's lower lip is pulled-in. d. Nipple may be flattened after a feeding. e. Mother feels pain. a. Infant's lips are touching the breast. The breastfeeding position shown in the picture above is a. Cradle b. Side-lying c. Laid-back d. Football e. Cross-cradle a. Cradle After successfully completing HSCI 434: Lactation Education Prenatal Perinatal Period, students may call themselves: a. Certificated Lactation educator b. International Board Certified Lactation Consultant c. Certified lactation educator. a. Certificated Lactation educator True or false: After completing the Minor in Human Lactation, I will be a Lactation Consultant. a. True b. False b. False, The minor in human lactation prepares students to become lactation educators. To become an International Board-Certified Lactation Consultant, individuals must pass the International Board of Lactation Consultant Examiners (IBLCE) Exam. True or false: At this time, CSUN does not provide students with the opportunity to complete the clinical hours to be eligible to sit for the IBLCE exam a. True b. False a. True, At this time CSUN only allows students to complete the coursework required to be eligible to sit for the IBLCE exam Please list the key talking points that you would share with pregnant mothers who contact you with the following common concern: embarrassment of public breastfeeding You are definitely not alone. Many nursing mothers feel embarrassed or shameful for breastfeeding in public but feeding your baby when he/she is hungry is your right as a mother. All 50 states permit women to breastfeed in public. While it is legal to nurse without covering up if you feel like you are drawing attention to yourself or just don't want others to see you feeding your baby, maybe you would feel more comfortable carrying around some sort of blanket or cover to keep the breastfeeding process intimate between you and your baby. Breastfeeding is a natural process and you shouldn't feel embarrassed for doing it in public especially since you have a high risk of soaking your shirt with milk from hearing your baby cry which is an even bigger mess. Please list the key talking points that you would share with pregnant mothers who contact you with the following common concern: fear that breastfeeding will be painful. Breastfeeding will generally cause sore nipples during the first couple of weeks of your feeding journey. Lots of women are scared of pain related to cracks, blisters, and bleeding. For the women who are experiencing pain after weeks 1 and 2 of breastfeeding should reconsider the placement of the nipple during feeding. When the nipple is latched well, it is deep in the baby's mouth allowing the baby's tongue to get the milk out easily. If the nipple is not far enough back, the tongue will rub or press on the nipple causing pain. You should not feel pain after two weeks of breastfeeding but to reduce the soreness in the beginning you can ice your breasts, or apply a warm compress and/or freshly expressed breast milk for cracked nipples. Please list the key talking points that you would share with pregnant mothers who contact you with the following common concern: concern that breastfeeding will result in significant time and social constraints When you are able to be with your baby, breastfeed every 2-3 hours. But understand that busy moms breastfeed too! Lots of busy moms take advantage of breast pumps to allow someone else to feed the baby a bottle of your breastmilk. When you are away from your baby, express your milk every 2-3 hours if you have a baby 0-6 months, and every 3-4 hours if your baby is 6 months or older. This will maintain your milk supply. It is also a good idea to only have someone else bottle-feed your baby as one of your baby's favorite things about breastfeeding is that it happens while the baby is with you, so they may be more reluctant to take a bottle from you but should be fine while you are away. Please list the key talking points that you would share with pregnant mothers who contact you with the following common concern: lack of social support for breastfeeding. I am sorry you are feeling alone right now. Having a lack of social support makes any task a difficult one. But know that even if you do not have support from the people you know around you, there are always other individuals you can talk to and get to know. Start looking for experienced lactation coaches and consultants in your area. If you find it is hard to get out of the house, usually you can find coaches or consultants that actually make house calls. Otherwise, you can go to several facilities that help educate and ease the minds of breastfeeding mothers, or look for various support groups online or in person. No matter how true you might think it is you are never alone in your struggles and there will always be people out there who want to help and support you. Review the concerns and describe how you would respond to each. My breasts are very small, so I am afraid I will not be able to produce enough milk to feed my baby (hint for finding information on this topic: look up "storage capacity"). o The short answer is no. You can breastfeed regardless of your breast size. o Breast size does not have any correlation to the amount of milk a woman will produce. Your breasts will also likely grow while you are breast feeding but again, that has no affect o The storage capacity of a woman's breast differs in the amount of milk ducts they have. Woman can have anywhere from 3-15 ducts or lobules that carry milk. Review the concerns and describe how you would respond to each. My work is very stressful, so I am afraid that my milk would be bad for my baby. o While you are stressed, your milk that you produce is absolutely fine to give your baby. o However, stress is the number 1 killer of breastmilk meaning it might cause a decrease in your milk supply. High levels of stress can come from work, lack of sleep, hormones, etc. So, it's important to try to lower your stress as much as possible to keep a strong milk supply going. o Try to regularly exercise, eat well, and sleep as best as you can. But you don't have to worry if the milk is bad for your baby. Still breastfeed when you can, and pump regularly when you can't. Review the concerns and describe how you would respond to each. I don't have the perfect diet, so I am worried that my breastmilk will be poor in nutritional quality. o You do not have to worry about maintaining an absolutely perfect diet in order to produce adequately nutritious breastmilk. o Studies have actually shown that the quality of a mother's diet has little influence on her milk. You are more likely to affect your breastmilk with a poor diet. But you do have a higher need for calories while breastfeeding so it's important to eat various healthy and nutritious foods to ensure your health and the health of your baby. Review the concerns and describe how you would respond to each. I tend to get frequent colds, so I don't think it will be a good idea for me to breastfeed my baby. o Even though you get frequent cold it is still okay for you to breastfeed. o When you are sick it is still ok to breastfeed but a few tips to keep in mind are to wash your hands often, try not to cough/sneeze directly on the baby, get lots of rest, drink plenty of fluids, watch your milk supply, and talk to a doctor before taking medication. o Common illness actually cannot be passed to the baby through breastfeeding. If you are sick, antibodies can be passed to your baby to protect them from getting your cold or other sickness. Review the concerns and describe how you would respond to each. I had prior breast surgery, so I am afraid that I will not be able to produce enough milk to feed my baby. o Most women who had breast augmentation surgery are still able to breastfeed with a few expectations. Whether you're able to breastfeed depends on the original state of your breasts before surgery and possibly the type of incision used. o Implants are usually placed behind the milk glands or under the chest muscles, which doesn't affect milk supply. However, the location and depth of the incision used for your surgery may affect your ability to breastfeed. o You may also worry about the effect breastfeeding will have on your implants. It's normal for your breasts to change in shape and size during pregnancy and after breastfeeding. Breastfeeding won't affect your implants, but the size and shape of your breasts overall may be different. Review the concerns and describe how you would respond to each. I am pregnant with twins and am concerned that my body will not make enough milk to feed both of my babies. o Most women are able to produce enough milk to feed twins. o You should usually spend about 10 min. Breastfeeding on each side for one baby so when you are nursing twins, you are spending 20 minutes at a time nursing each baby. o Breastfeed as much as you can and pump when you can't. Make sure you are nursing or pumping at least 8 times a day to maintain a good milk supply Review the concerns and describe how you would respond to each. I am currently breastfeeding my six-month-old baby and just found out that I am pregnant. I heard that if I continue breastfeeding my older baby, I will harm my developing baby. o While nipple stimulation can bring on labor in a woman who is full term, there is no evidence that breastfeeding while can cause early miscarriages in women who continue to nurse through pregnancy or harm for your developing baby. o Oxytocin is what would induce preterm labor but such small amounts are released during a nursing session so there is not enough to induce labor usually. o Generally, breastfeeding while pregnant is safe. However, trace amounts of hormones can be present in your milk but these are not harmful to your breastfeeding child. Review the concerns and describe how you would respond to each. I heard that mothers who drink alcohol can't breastfeed. o I will advise you that not drinking alcohol is the safest option for breastfeeding mothers, but it is okay for mothers who drink to breastfeed. o Generally, a moderate amount of alcohol consumption (up to 1 standard drink per day) is not known to harm the infant. o It is recommended that you wait at least 2 hours after drinking to breastfeed. You do not necessarily need to pump and dump unless it gives you some comfort but alcohol leaves the milk supply as it leaves the bloodstream. Review the concerns and describe how you would respond to each. I have tuberculosis and heard that mothers with tuberculosis can't breastfeed. o Mothers with TB are okay to breastfeed as long as they are currently taking medication. If you have untreated tuberculosis you should not breastfeed or have direct contact with your newborn until you have started the appropriate drug treatments until you are no longer contagious. Review the concerns and describe how you would respond to each. I was just diagnosed with breast cancer and am scheduled to begin chemotherapy after the birth of my baby. I heard that I can't breastfeed. o For the safety of your baby it is not recommended to breastfeed during chemotherapy. o High levels of chemotherapy drugs appear in breast milk and could potentially harm your nursing baby. o You will most likely be able to breastfeed once you completed your treatment Review the concerns and describe how you would respond to each. I have a nipple ring and heard that I can't breastfeed. o Although you should wait until your piercing fully heals to nurse, you are okay to breastfeed and shouldn't worry about the piercing affecting your ability to breastfeed. o But while having a nipple piercing doesn't stop the production of milk, having a piercing could slightly interfere with your milk flow. This doesn't happen to everyone. But it might happen if a piercing blocks or causes damage to ducts in the nipple and, as a result, milk doesn't flow as easily. o Along with a piercing possibly blocking the tiny ducts that carry milk from the nipple, some women experience scarring inside of the nipple after a piercing. Scarring might not be visible to the eye, but its presence can block milk ducts and stop or inhibit the flow of milk from the breast. The likelihood of scarring is higher when there are multiple piercings in a single nipple. Review the concerns and describe how you would respond to each. I was just diagnosed with HIV. I heard that I can't breastfeed once my baby is born. o HIV is a virus that attacks the body's immune system and is spread through certain body fluids, including breast milk. Mother-to-child transmission can occur during pregnancy, birth, or breastfeeding. Treatment for HIV (antiretroviral therapy, or ART) reduces the risk of transmission from a mother to her infant. o In 2009, The World Health Organization is recommended that HIV-positive mothers or their infants take antiretroviral drugs throughout the period of breastfeeding and until the infant is 12 months old. This means that the child can benefit from breastfeeding with very little risk of becoming infected with HIV. o For mothers not taking antiretroviral pills, it is urged to not breastfeed. The best way to prevent transmission of HIV to an infant through breast milk is to not breastfeed. In the United States, where mothers have access to clean water and affordable replacement feeding (infant formula), CDC and the American Academy of Pediatrics recommend that HIV-infected mothers completely avoid breastfeeding their infants, regardless of ART and maternal viral load. After viewing the Biological; Nurturing video found on canvas module "Biological Breastfeeding" please describe the main differences between mother led breastfeeding and baby led breastfeeding ( i.e., Biological Nurturing/Laid-Back Breastfeeding)? baby-led breastfeeding is an approach to feeding that focuses on a baby's innate abilities to latch when placed on skin-to-skin contact with mom. Mother led breastfeeding however is when the mother takes a stronger lead and physically places her baby directly on her breast, skipping a lot of the initial steps in baby led breastfeeding. There are some circumstances when a mother will need to watch the clock, rather than rely on her baby to tell her that he or she is hungry. The exceptions to baby-led feedings include when baby is a reluctant/ sleepy nurser or when baby is fussy at the breast. Under those circumstances the mother will need to be proactive and led the feedings ( i.e., mother-led feedings. The objective of the questions below are to enable students to provide mothers with a baby that is a reluctant/sleepy nurser with a breastfeeding care plan that promotes effective breastfeeding. After reading, "Counseling the Nursing Mother: A Lactation Consultants Guide: Chapter 15: Getting Breastfeeding Started pp 342- 343," please answer the questions below: 1. Please list the factors that can contribute to an infant being a reluctant/sleepy nurser. 2. Please describe the strategies you would recommend to a breastfeeding mother whose infant is a 1. Sleepiness in newborns can be caused from labor medications or simply because of the immaturity of the baby's system. A reluctant feeder might be anxious or frightened by their moving arms and legs or might be sensitive to being handled. 2. If your baby is sleeping a lot in the earlier days, they will feed more at night. It is advantageous for you both to wake the baby up several times a day to breastfeed in order to maintain your milk supply. If your baby is fussy when at the breast, it may help to swaddle the baby to keep them calm. If you have a sleepy/reluctant feeder, with a lactation consultant, you can create a care plan that works best for your baby. 3. ways you can wake a sleeping baby to feed are by talking to the baby and trying to make eye contact, loosening or removing their blankets, holding the baby upright, undressing the baby fully or partially, change baby's diaper, and something you can also try is increasing skin-to-skin contact by rubbing the baby's arms/legs/head etc. There are some circumstances when a mother will need to watch the clock, rather than rely on her baby to tell her that he or she is hungry. The exceptions to baby-led feedings include when baby is a reluctant/ sleepy nurser or when baby is fussy at the breast. Under those circumstances the mother will need to be proactive and led the feedings ( i.e., mother-led feedings. The objective of the questions below are to enable students to provide mothers with a baby that is fussy at the breast with a breastfeeding care plan that promotes effective breastfeeding. After reading, "Counseling the Nursing Mother: A Lactation Consultants Guide: Chapter 15: Getting Breastfeeding Started pp 342- 343," please answer the questions below: 1. Please list the factors that can contribute to an infant being fussy at the breast. 2. Please describe the strategies you would recommend to a breastfeeding mother whose infant is fussy at the b 1. Reasons an infant may be fussy at the breast can include discomfort or pain from forceps or vacuum or other mechanical birthing tools, the baby is irritable, the baby needs to be swaddled, or even from medications passed from mother to baby during labor. 2. If your baby is fussy at the breast, I encourage you to hold your baby calmly in skin-to-skin contact at the breast, limit number of latching attempts, if the baby cries when you try to latch them try again in 10-15 min., avoid putting pressure on the baby while feeding. 3. Five ways to calm a fussy baby include limiting invasive procedures to minimize crying, provide skin-to-skin contact, cuddle without pushing the baby to feed, be sensitive and respectful to your baby's cues, use slow, calm, and deliberate movements in caring for the baby, and talk or sing to the baby in a soft voice. During pregnancy, educate pregnant women and their families about the importance and management of breastfeeding. Breastfeeding has numerous benefits for both mother and baby. It is recommended by the World, Health Organization as well as the United Nations Children's Fund that mothers strictly feed their babies only breastmilk for at least the first 6 months of life (WHO & UNICEF, 2017). Breastfeeding is your human right and states are legally responsible for providing the support and protection necessary for women to make informed decisions about the nutrition of their children. Right after birth, uninterrupted skin to skin contact (explain) Uninterrupted skin-to-skin contact is so important immediately following the birth of your baby. This is when a baby is placed on the mother's chest less than 10 minutes after birth. The mother and baby are to have this skin-to-skin contact for at least 60 continuous minutes (WHO & UNICEF, 2017). Right after birth early initiation of breastfeeding. (explain) o Another important thing to remember for a newborn is early initiation of breastfeeding. You want to start breastfeeding within an hour after giving birth. Newborns who are placed skin-to-skin with their mothers after birth usually find their own way to the breast/nipple and attach spontaneously. (WHO & UNICEF, 2017). o infants who initiated breastfeeding 24 hours or more after birth had an increased risk of neonatal mortality compared to when initiation was started under 24 hours after birth, it is recommended that all mothers should be supported to initiate breastfeeding as soon as possible after birth, within the first hour after delivery (WHO & UNICEF 2017). During the hospital stay, provide mothers with practical support to enable them to initiate and establish breastfeeding and manage common breastfeeding difficulties. o Teaching mothers how to breastfeed is not just about teaching a mother to latch her baby on, but is a mix of practical, emotional, motivational, and informational interventions that teach a mother how to successfully breastfeed (WHO & UNICEF, 2017). o Giving mothers breastfeeding support in the hospital increases the likelihood that the mother will continue to breastfeed once at home. During the hospital stay, mothers should be coached on how to express breastmilk as a means of maintain lactation in the event of their being separated temporarily from their infants. While a mother should always breastfeed with the baby when possible, it is important that mothers know how to express their own breastmilk in order to maintain lactating at a high enough volume and in case the mother plans on being separated from her baby at any point in time. This will allow the baby to have access to breastmilk without necessarily needing mom around (WHO & UNICEF, 2017). During the hospital stay, maternity facilities should enable mothers and their infants to remain together throughout the day and night ( i.e., rooming in) During the hospital stay, maternity facilities should allow mothers and their infants to stay together throughout the day and night. This is referred to as a process called "Rooming-in". Rooming-in involves keeping mothers and infants together in the same room, immediately after leaving the labor/delivery room, until discharged. The infant stays with the mother every minute of the day except instances like the mother needing to use the bathroom (WHO & UNICEF, 2017). When combined with other postpartum practices, rooming-in is considered one of the most effective methods for increasing the duration of breastfeeding. Mom also has a higher likelihood of learning her baby's feeding cues and establishing feeding patterns before going home (Usainov, 2020). During the hospital stay, mothers should be counseled and supported to practice "responsive feeding/demand feeding (explain) During your hospital stay, you should be counseled and supported to practice something called responsive, or demand feeding. This basically just means there is no limit or cap on the amount your newborn is breastfed. Instead, mothers are encouraged to breastfeed whenever the infant shows signs of hunger, or as often as the infant wants rather than being on a regular feeding schedule (WHO & UNICEF, 2017). Mothers should be discouraged from giving any food or fluids other than breastmilk unless medically indicated. (explain) Unless you are medically indicated to do so, you should refrain from giving any food or fluids other than breastmilk to your baby for at least the first 6 months of the infant's life (WHO & UNICEF, 2017). Breastfeeding lowers your baby's risk of having asthma or allergies, fewer ear infections, respiratory illnesses, bouts of diarrhea, and fewer trips to the hospital. List two infant conditions that are an acceptable medical reason to use breastmilk substitutes o Infants with classic galactosemia: a special galactose-free formula is needed. o Infants with maple syrup urine disease: a special formula free of leucine, isoleucine, and valine is needed. List two maternal condition that are an acceptable medical reason to use breastmilk substitutes. o HIV Infection: if replacement feeding is acceptable, feasible, affordable, sustainable, and safe. o Sepsis: a severe illness that prevents a mother from caring for her infant. Analgesia Rationale: Influence on Breastfeeding: o RATIONALE: Analgesia are drugs that relieve pain without a total loss of feeling, muscle movement, and consciousness and are used to lessen pain. o INFLUENCE: Pain relief medications diminish early sucking. Consequently, mothers who receive such medications during labor are more likely to leave the hospital without having established breastfeeding Mechanical devices used to deliver babies (forceps and vacuum) Rationale: Influence on Breastfeeding: o RATIONALE: Complications with delivery can result in the use of forceps or vacuum extraction to help remove the baby from the womb o INFLUENCE: Both of these procedures increase the risk of bruising, injury, sensitivity to the infant's head, and discomfort for the newborn when nursing. Bruising increases the risk of jaundice, which can cause sleepiness and a lack of interest in feeding. Clinicians have also noted increased chomping and inability to suck in babies who have been subjected to forceps and vacuum extractions (Lauwers & Swisher 2014). Anesthesia (epidural and spinal) Rationale: Influence on Breastfeeding: o RATIONALE: Epidural analgesia causes some loss of feeling in the body from the uterus down. Epidural anesthesia is used for cesareans and provides complete loss of physical sensation o INFLUENCE: Epidurals can affect breastfeeding ability, either directly through the medication or through the chain of events triggered by anesthesia use. Neonatal fever and sepsis rates are higher in epidural births compared with no analgesia, although maternal fever is a factor in sepsis. Epidurals are also associated with impaired sucking, supplementation, and breastfeeding cessation (Lauwers & Swisher 2014). Episiotomy Rationale: Influence on Breastfeeding: o RATIONALE: An episiotomy is a surgical incision through the perineum to enlarge the vaginal opening during delivery. o INFLUENCE: Women who have had an episiotomy often find it difficult to get comfortable, particularly when they sit upright. If the mother has pain when sitting, it is difficult for her to relax enough to position her baby comfortably at the breast.