Women's health & pregnancy 3
Track 22
| Saturday, October 28, 2023 |
| 2:00 PM - 3:15 PM |
| Meeting Room E3.4 |
Speaker
Dr Syeda Sadia Farzana
Family Medicine and Breast Feeding Medicine Specialist
Bangladesh Society of General Physicians, IBLCE, NZLCA, Future Skills Academy collaborated with Otago Polytechnic AIC
Breastfeeding challenges and the role of family physicians.
2:00 PM - 3:15 PMSummary
In her 30s, G1P1, Niva delivered a full-term baby girl 4weeks back by normal vaginal delivery in an established hospital setting without any complications. Baby Cloe weighed 3.5 kg at birth and the Apgar score was 9/10. She was on formula-feeding 8 times/day since day 03. There were 5-6 wet nappies/per day. Niva managed to hand express from both breasts occasionally to maintain the supply but could express out only 20-25ml/sitting/breast to feed Cloe. Niva had been struggling to sleep at night since Cloe was born and Cloe did not seem to be a happy baby.
She was concerned to consult her family physician to assist her in re-lactation.
History:
Niva`s family physician ordered lab tests and scans antenatally but not much discussion about breastfeeding, and no breast examinations were done. She only had the knowledge that breast milk was the best for babies. Niva had never been to any prenatal classes. She had minimum skin-to-skin contact throughout the day and no breastfeeding at night. Niva tried to latch Cloe on the left breast sometimes but never on the right breast from day 01.
On examination:
Niva: BMI was 36, normotensive, no other abnormality detected.
Baby: Normal findings, active reflexes.
Observing the dyad: Niva failed to attach and latch Cloe. The baby was uncomfortable while her mom tried to cradle hold. Cloe was unsettled on mom`s large boobs and was crying out of frustration.
Breast findings:
Right nipple: inverted
Breasts: large, pendular, soft, not engorged, non-tender.
Goal: “Keep the flow, keep the baby fed, keep the baby closer”
Plan:
Reassurance
Demonstration of different feeding positions, attachment, latching
Breast support
Use of an electric pump to draw out the right nipple and frequent pumping to establish the supply
On-demand feeding including night feeding
Counseling about myths
Follow up after 7 days
She was concerned to consult her family physician to assist her in re-lactation.
History:
Niva`s family physician ordered lab tests and scans antenatally but not much discussion about breastfeeding, and no breast examinations were done. She only had the knowledge that breast milk was the best for babies. Niva had never been to any prenatal classes. She had minimum skin-to-skin contact throughout the day and no breastfeeding at night. Niva tried to latch Cloe on the left breast sometimes but never on the right breast from day 01.
On examination:
Niva: BMI was 36, normotensive, no other abnormality detected.
Baby: Normal findings, active reflexes.
Observing the dyad: Niva failed to attach and latch Cloe. The baby was uncomfortable while her mom tried to cradle hold. Cloe was unsettled on mom`s large boobs and was crying out of frustration.
Breast findings:
Right nipple: inverted
Breasts: large, pendular, soft, not engorged, non-tender.
Goal: “Keep the flow, keep the baby fed, keep the baby closer”
Plan:
Reassurance
Demonstration of different feeding positions, attachment, latching
Breast support
Use of an electric pump to draw out the right nipple and frequent pumping to establish the supply
On-demand feeding including night feeding
Counseling about myths
Follow up after 7 days
Takeaways
At the conclusion of my presentation attendees will take away
1. Family physicians can play a key role to ease breastfeeding challenges by applying their role-specific knowledge and skills about breastfeeding and lactation management.
2. Educating lactating mothers about latching techniques, especially with simulated demonstrations is important for successful early feeding and re-lactation.
3. Re-lactation is possible with time, patience, determination, and a cooperative baby.
Biography
Sadia Farzana is an academic, primary care researcher, International Board-Certified Lactation Consultant, and Clinician having publications. Sadia is a member of the Academy of breastfeeding medicine and the New Zealand Lactation Consultant Association. Sadia has been practicing as a family physician for the last 15 years at icddr,b, Dhaka Bangladesh. She is currently on her Doctoral journey researching on how to improve the quality of care for patients with complex needs by providing effective training to the caregivers. Sadia is also teaching the GPs in Bangladesh to acquire and practice evidence-based knowledge on Lactation management. She is also practicing as a Lactation Consultant and playing an important role in the diverse community in New Zealand and Bangladesh.
