By Marie Davis, RN, IBCLC
Topic Outline
Topic Outline
I. Time For Change: Evidence Based Practice
A. Features of the AAP Policy
B. Table 1: Breastfeeding Definitions
II. The Role Of The Medical Professional In Breastfeeding Support
A. Table 2: Surgeon General's Workshop
B. Language, Actions And Breastfeeding
Table 3: Watch your Language
C. Creating Acceptance
D. The Baby Friendly Hospital Initiative (BFHI)
Table 4: BFHI Baby Friendly Hospital Evaluation
III. Agents For Change
A. Breastfeeding Issues Inspire Emotions In Medical Providers
IV. Breastfeeding: The Lost Art
A. Human Bonding
B. Inability To Breastfeed Is Critical Emotionally For The Mother
V. The History Of Infant Feeding
A. Wet Nursing
B. The Legacy Of Scientific Motherhood
C. Decline And Fall Of Breastfeeding
D. Female Breasts: A Cultural Paradox
E. The "Right" To Breastfeed Becomes A Legal Issue
VI. Commercial Production Of Artificial Baby Milk (ABM)
A. What Artificial Baby Milk (ABM) Lacks
B. Restricting Sales Of ABM
C. Artificial Baby Milks: A Great Sales Campaign
D. That "Guilt" Thing
E. The Reasons Women Bottle Feed
VII. Human Milk Is Not Interchangeable With Other Nutrient Sources
Table 5: Comparison of Human Milk to ABM
A. Hazards Associated With The Use Of Artificial Baby Milks
B. Known Risks Associated With Artificial Baby Milk
C. What Breastfeeding Provides
D. A Detailed Look At Breastfeeding's Value
1. Sociological Value Of Breastfeeding
2. Breastfeeding Can Save Millions In Health Care Dollars
Table 6: The Cost of NOT Breastfeeding
3. Breastfeeding Is Economical For Individual Families
VIII. Relative Contraindications To Breastfeeding
IX. Anatomy Of The Breast
A. Breast Size
B. External Anatomy
1. Table 7: Internal Anatomy
2. Table 8: Microscopic Anatomy
3. Table 9: External Anatomy
C. Breast Growth In Pregnancy
D. Involution Of The Lactating Breast
X. Types Of Breastmilk
A. Colostrum
B. Transitional Milk
C. Mature Milk
XI. Milk Production
A. Lactogenesis
B. Neuroendocrine Pathways - Hormonal Controls Of Lactation
1. Prolactin
2. Oxytocin
a. MER
C. Supportive Hormones.
D. Cellular Manufacture Of Milk
The Process of Engorgement
XII. A Closer Look At The Components Of Human Milk
A. Protein
B. Lipids
C. Carbohydrates
D. Minerals
E. Vitamins
F. Immunological Components
XIII. Antepartum Educational Needs Of The Mother
A. Common Breastfeeding Myths
B. Breastfeeding Classes
Table 10: Breastfeeding Class Outline
XIV. Antepartum Lactation Assessment
A. Effects of Breast Surgery
1. Lumpectomy
2. Augmentation
3. Reduction
B. History Taking
C. Possible Effects Of Childhood Sexual Abuse On Breastfeeding
XV. Examination Of The Breast
A. Breast Lumps In Pregnant And Lactating Women
XVI. Preparation For Breastfeeding
A. Nursing Bras
XVII. Hospital Routines Should Support Lactation
A. Changing Hospital Routines To Support Lactation
1. Labor and Delivery Support
Table 11: Labor Outcomes Using a Doula
3. Labor Medications
a. Table 12: Perinatal Medications
b. The Concern Over Epidural Anesthesia
B. First Contact
C. Newborn Procedures
D. Nursery And Postpartum Routines
1. The Problem With Bottles
2. Routine Supplementation
3. Baby Needs Access to the Breast Around the Clock
4. Avoid Take Over Behavior
E. Assessment Of Feeding Components
F. Neonatal Weight Loss
G. Primary Failure Of Lactogenesis
XVIII. Continuity Of Information
1. Table 13: Keys for Nurses
A. Discharge Instructions
B. Critical Discharge Instructions
XIX. The Latch-On Process
1. Table 14: Latch On
2. Table 15: Madonna
A. Positioning
B. Breast Support
C. Rooting/Offering the Breast
D. Latching On
E. Is The Latch Correct?
F. Taking The Baby Off The Breast
G. Schedule Of Feedings : Newborn Feeding Patterns
H. Positions For Breastfeeding
1. Madonna or Cradle Hold
2. Side Lying
3. Football Hold
4. Positions for Twins
XX. Special Circumstances
A. Maternal Complications
1. Cesarean Section
2. Maternal Diabetes
3. Severe Illness In The Mother
B. Infant Complications
1. The Baby With Low Blood Sugar
Table 16: Comparison of Jaundice
a. Pathological Processes
b. Neonatal Jaundice Not A Pathological Process
c. Review Of Physiologic Jaundice
d. Review Of Jaundice While Breastfeeding
e. Review Of Breastmilk Jaundice
f. Reducing The Effects Of Newborn Jaundice
g. Phototherapy
C. The Premature Infant
1. Research Proves Mother's Milk Is Best For The Preterm
2. Early Pumping Paramount When Breastfeeding Is Delayed
Table 18: Pumping Instructions for the Mother with a Hospitalized Infant
3. Enhancing Human Milk For Enteral Feedings
4. Oral Feeding Options
5. Managing The First Breastfeedings For The Preterm Infant
a. Positions for Premature Infants
A. Breast Shells/Cups
B. Breast Pumps
C. Manual Pumps
D. Nipple & Breast Creams
1. Table 19: Breast Creams
E. Nipple Shields
1. Table 20: Nipple Shield Consent Form
F. Feeding Tube Devices
XXII. Medications And Breastfeeding
A. Medication Table 21
B. Herbs and Breastfeeding Table 22
XXIII. Breastfeeding: The Early Weeks
A. Postpartum Depression
XXIV. Weaning
XXV. Problem Solving, Lactation Clinic Advice Protocols
A. Standard Rationale In Lactation Practice
1. Table 23: Suggested Breastfeeding Frequency by Age
B. Latch-on Problems
1. Table 24: Rebirthing Help for Latch-On Problems
C. Sore Nipples
D. Sore Nipples: Thrush
E. Engorgement
1. Table 25: Engorgement: The Cabbage Cure
F. Plugged Duct(S)
G. Mastitis
1. Table 26: Comparison of Plugged Duct, Mastitis, Breast Abscess
H. Breast Abscess
I. Oversupply (Overactive Let-down) Syndrome
J. Slow Weight Gain/Dehydration
K. Failure To Thrive
XXVI. Help For The Breastfeeding Couple
A. La Leche League International
1. Table 27: IBCLE Requirements
XXVII. Case Presentations
A. Sore Nipples
B. Low Milk Supply
C. Fourteen Weeks to Latch-on
D. Breast Abscess
XXVIII. Part Two: Selections for Nurses from: Breastfeeding Basics
A. The First Four Weeks: Mother
C. Questions After the First Four Weeks
1. Table 28: Manual Expression of Breastmilk
H. Other Issues
XXIX. Resources
XXX. Lactation Terms: Glossary
XXXI. Works Cited
XXXII. Course Test
Copyright Marie Davis, RN, IBCLC 1999
Last reviewed: