Case 3: This primiparous mother had an uneventful birth in hospital, unmedicated

Question

Case 3: This primiparous mother had an uneventful birth in hospital, unmedicated. Her labor lasted 20 hours. She gave birth at a baby friendly hospital with a midwife. She had skin to skin contact and her baby did breast crawl and self-attachment. The baby, born at 8# is now 4 weeks, and has gained 1# 6 ounces. The mother feeds her baby on demand. You observe the feed. The mother is not using anything to prop up the baby, leans forward putting her nipple in front of the baby’s mouth by stretching her breast to the baby’s mouth. The baby is on her back and the mother tickles her cheek with her finger to get the baby to turn her head toward the breast. The baby opens her mouth about halfway and then grasps the nipple, biting down first, then starts to suck. The mother’s pain level is 7 of 10 (with 10 being the worst possible pain.) Her chief complaint: “My nipples are so sore I dread feeds. I have used APNO, lanolin, and ice on my nipples before feeds and tried a nipple shield. Nothing helps.” Differential lactation diagnosis statement: What is your care-plan for this situation?

Explanation / Answer

NURSING DIAGNOSIS :

EXPECTED OUTCOME :

NURSING INTERVENTION :

EVALUATE :

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