Continuity of Care for Breastfeeding Families Birth & Beyond California: Breastfeeding Training & QI Project With funding from the federal Title V Block Grant 1

Objectives Identify three pre-discharge infant breastfeeding issues requiring follow up care Identify three pre-discharge maternal breastfeeding issues requiring follow up care Identify two follow-up resources available for breastfeeding families 2

Pre-Discharge Breastfeeding Assessment – Baby Issues Excessive weight loss Lack of output Difficulty with latch Difficulty with suckling Lethargy 3

Pre-Discharge Breastfeeding Assessment – Baby Issues Jaundice Preterm/late preterm Anatomical concerns Health concerns 4

Pre-Discharge Breastfeeding Assessment – Mother Issues Sore nipples Unusual nipple size/shape Engorgement Questionable milk supply History of breastfeeding problems History of breast surgery History of infertility Health concerns 5

Pre-Discharge Breastfeeding Assessment – Mother Issues Lack of social support Maternal-infant attachment concerns Potential for postpartum depression Lack of confidence Inability to breastfeed without help 6

Follow Up Care Avoid “Zone of No Professional Contact” Infants and mothers with identified pre- discharge breastfeeding issues need a documented plan of care and discharge follow up All breastfeeding women and infants should receive contact within the first week 7

Pediatric Appointment “ All breastfeeding newborn infants should be seen by a pediatrician, or other knowledgeable and experienced health care professional, at 3 to 5 days of age.” AAP, Breastfeeding and the Use of Human Milk,

Breastfeeding Resources Activity Create a list of resources in your community –WIC Agency –Public Health Department –Home Visitation Nurses –Pediatric Clinics/Pediatricians –OB Clinics/CPSP/OBs –Mothers’ Support Groups –Lactation Clinics/Lactation Consultants –OT/PT/RD –Sweet Success –Urgent/Emergency Care –Others 9

Online Resources La Leche League – International Lactation Consultants Association – California Department of Public Health – Office on Women’s Health – Breastfeeding Task Force of Greater Los Angeles – 10

Breastfeeding Support Groups “Foster the establishment of breastfeeding support groups and refer mothers to them on discharge” 11 Model Hospital Policy Recommendations,

Safe Discharge for Breastfeeding Mothers and Babie s Prevent a cascade of breastfeeding complications Pre-discharge assessment Appropriate referr als 12