Prematurity, NEC, and breastfeeding. 9
Recognising breastfeeding problems and how to help
What to consider in a history for a woman experiencing breastfeeding problems.8
•Previous breastfeeding experience, problems, pain.
•Any breast or nipple sensitivity before pregnancy.
•Milk supply issues (engorgement, low or oversupply).
•Pattern of breastfeeding (frequency, duration, night feeds, one or both breasts offered).
•Expressing of milk (frequency, hand or pump used).
•Maternal beliefs, ideas, concerns, and expectations about breastfeeding.
•Other fluids or foods given (when started, quantity, and frequency).
Maternal history + specific areas:
•Any complications during pregnancy, labour, or post-partum.
•Known medical conditions, such as thyroid disorders, Raynaud's, eczema or psoriasis, recent candida or bacterial infection, chronic pain syndromes, family history of ankyloglossia (tongue-tie).
•Previous breast surgery and indication.
•Medications and allergies.
•Alcohol and smoking history.
•Associated insomnia, stress, anxiety, or depression.
Breast and/or nipple pain history:
Always gain patient consent.
Ensure that a professional with appropriate training and expertise is present as a chaperone.
Woman's nipples: (FTDS)
- Flat or inverted nipples.
- Tenderness on palpation.
- Skin integrity, discolouration, lesions, or rashes.
Woman's breasts: (LTS)
- Lumps (?galactocele).
- Tenderness to light or deep palpation.
- Skin discoloration, lesions, or rashes.
- Signs of dehydration.
- Head and neck symmetry and facial features.
- Oral anatomy (ankyloglossia, palate, jaw, and lips) or oral pathology e.g. candida infection that may affect sucking and swallowing.
- Nasal congestion.
- Muscle tone, neurological maturity, behaviour.