A Guide to Supporting Breastfeeding for the Medical Profession / Amy Brown, Wendy Jones.

Format:

Book

Author/Creator:

Brown, Amy (College teacher)

Contributor:

Jones, Wendy, 1954-

Language:

English

Subjects (All):

Breastfeeding.

Breast Feeding.

Mothers.

Lactation.

Lactation Disorders.

Medical Subjects:

Breast Feeding.

Mothers.

Lactation.

Lactation Disorders.

Physical Description:

1 online resource (187 pages)

Edition:

1st ed.

Place of Publication:

Milton : Routledge, 2019.

Summary:

This book is a practical guide for medical practitioners as they navigate through breastfeeding problems that occur in day-to-day practice. If mothers have a breastfeeding complication they are often directed to their GP. In complex situations, medical staff will be making decisions around what treatment plan to follow and whether a mother can keep breastfeeding. In recent years there has been growing evidence that medical professionals often advise mothers to stop breastfeeding while undergoing treatment, when in reality this was not a necessary step. In a time when breastfeeding rates are decreasing, it is important that medical professionals give accurate advice and support a mother's choice to breastfeed if the situation allows it. A Guide to Supporting Breastfeeding for the Medical Profession includes contributions from a wide range of medical professionals and each chapter is written with the practitioner in mind. Contributors include GPs, paediatricians, neonatologists, lactation specialists and midwives. Doctors have a vital role to play in supporting and facilitating breastfeeding, and without the appropriate knowledge they can often inadvertently sabotage it. This book will be of interest to GPs and paediatricians as well as nurse prescribers, midwives and health visitors.

Contents:

Cover

Half Title

Title Page

Copyright Page

Table of contents

Figures

Tables

Foreword

Acknowledgements

1 The role of primary care and the GP in supporting breastfeeding

Discussions with patients about a perceived need to stop breastfeeding

Recognising and reassuring regarding normality

References

2 Why breastfeeding matters

Assumption 1

Assess the available data against the premises on which they are based - these are probably wrong

Assumption 2

Formula has been designed to be as close to human milk as possible

Assumption 3

Formula has fewer 'ingredients' than human milk

Health outcomes for babies

Maternal health

Note

3 Why are breastfeeding rates in the UK so low?

Understanding milk supply

Pain and difficulties with latch

Lack of professional support

Poor societal understanding of normal infant behaviour

Maternal mental health

Family attitudes

Partner attitudes

Negative public attitudes

Returning to work

Promotion of breastmilk substitutes

4 Contraindications to breastfeeding

Medical contraindications to breastfeeding

Phenylketonuria (PKU)

Galactosaemia

Maple syrup urine disease

Medical conditions where breastfeeding may be contraindicated but not identified by the blood spot test

Hepatitis C

Hepatitis B

Human immunodeficiency virus (HIV)

Herpes simplex virus (HSV)

Medication contraindicated during breastfeeding

Drugs which are absolutely contraindicated during breastfeeding

Drugs which should be prescribed with caution

Drugs which may be purchased by the mother which should be used with caution

When is a drug contraindicated in breastfeeding prescribed?

5 Breastfeeding and infant sleep - what medical practitioners need to know.

The evolved characteristics of human infants and maternal care

The sleep of breastfed babies and breastfeeding mums

Do sleeping arrangements affect breastfeeding?

Sudden infant death syndrome (SIDS) and safer sleep guidance

6 Birth experience and breastfeeding

Physiological birth experience

Pain relief used during labour and birth

Psychological impact

The benefits of skin-to-skin contact after the birth

Maternal pain medication after the birth

Postnatal environment

If an infant needs to go to neonatal intensive care

7 Breastfeeding complications

Positioning and attachment

Engorgement

Nipple pain

Breast pain

Blocked duct

Bleb/white spot

Mastitis

Abscess

Non-attachment/breast rejection

Low milk supply/perceptions of low milk supply

Oversupply

Summary

8 Pharmacokinetics of drug transfer into breastmilk

Passage of drugs into breastmilk

Passage in the immediate postnatal period

Transfer of drugs into breastmilk depends on pharmacokinetics

The oral bioavailability of the drug

The influence of the plasma protein binding of the drug

The influence of the milk-plasma ratio

The influence of the half-life of the drug

The importance of the relative infant dose (RID)

Licensed for children

Why are we concerned about prescribing during lactation?

The impact on a mother of being told to stop breastfeeding

Available data on newer medication

Summary of points to determine when a drug is likely to be compatible for use during breastfeeding

9 Compatibility of commonly used drugs in lactation

Gastrointestinal system

Inflammatory bowel disease (IBD)

Maintenance of remission

Monoclonal antibodies

Laxatives

Haemorrhoidal preparations

Treatment of anal fissures

Antispasmodics.

Cardiovascular system

Diuretics

Angiotensin-converting enzyme (ACE) inhibitors

Beta-blockers

Angiotensin II receptor antagonists (sartans)

Calcium channel blockers

Alpha-blockers

Anticoagulants

Antiplatelet agents

Lipid regulation

Respiratory system

Asthma

Antihistamines

Centrally acting drugs

Hypnotics

Anxiolytics

Epilepsy

Attention deficit disorder

Bipolar disorder

Depression

Selective serotonin re-uptake inhibitors (SSRIs)

Tricyclic antidepressants (caution with co-sleeping if they make the mother drowsy)

Serotonin and noradrenaline re-uptake inhibitors

Alpha2-adrenoreceptor antagonists

Drugs to treat obesity

Labyrinthitis/vertigo

Nausea and vomiting

Analgesics

Opiates

Muscle spasm

Local inflammation of joints

Migraine

Triptans

Over-the-counter remedies

Analgesics plus drugs to alter gastric motility

Ergotamine-containing drugs - avoid

Neuropathic pain

Smoking cessation

Vaping (electronic cigarettes)

Illicit substance withdrawal

Alcohol

Infection

Penicillins (all licensed for paediatric use)

Cephalosporins (all licensed for paediatric use)

Tetracyclines (not suitable for long courses, e.g. to treat acne, rosacea)

Aminoglycosides

Macrolides

Quinolones

Antifungals

Antivirals

Threadworm

Endocrine system

Diabetes

Insulin

Sulfonylureas

Biguanides

Dipeptidylpeptidase-4-inhibitors (gliptins)

Glucagon-like peptide1 receptor agonists (no data)

Meglitinides (no data)

Thioglitazones

Osteoporosis

Bisphosphonates

Thyroid

Contraception

Suppression of lactation

Enhancement of lactation

Termination of pregnancy or treatment of incomplete miscarriage

Treatment of ectopic pregnancy

Topical preparations

Eye drops

Ear drops

Nasal drops

Podiatry surgery.

Vaccinations

Anaesthetics

General anaesthetics

Local anaesthetics

Conscious sedation

10 Supporting breastfeeding women with mental health issues

What issues might be difficult for mothers with depression or anxiety?

Rumination

Less time and ability to engage with normal stress-relieving activities

Sleep

Uncertainty and worry

How can breastfeeding support mental wellbeing?

Mental health in the perinatal period and breastfeeding

How to support a breastfeeding mother with a mental health issue

Breastfeeding as a core belief value

Supporting mothers who wish to continue breastfeeding

Supporting mothers who decide to stop feeding

Talking therapies

Self-help resources

11 Tongue tie

Treatment of tongue tie

12 Colic and reflux in the breastfed baby

Infantile colic

Gastro-oesophageal reflux

Colic and reflux are sometimes symptoms of allergy

13 Why provide donor human milk?

Who are the donors?

What happens to the milk?

How should donor milk be used?

Room for improvement?

14 Breastfeeding a baby with health complications

Breastfeeding a baby with a cleft lip and palate

Breastfeeding and trisomy 21 (Down syndrome) Pippa Hodge, co-ordinator, T21 Brighton and Hove

Breastfeeding with a congenital heart defect

15 Breastfeeding sick babies

General principles for supporting breastfeeding families when the baby is unwell

Physiological, immunological and psychological importance of breastfeeding sick children

What health conditions cause babies and children to need support with breastfeeding?

Babies in the neonatal unit

Babies and older children in children's wards and hospitals

Acute conditions which may require support with breastfeeding.

Respiratory problems, especially croup, bronchiolitis and pneumonia

Gastroenteritis, including shock and dehydration

Jaundice and other liver problems

Severe infection of any origin, including sepsis and meningitis

Pain or dysfunction of the mouth and throat

Acute surgical issues affecting the gut

Anaesthesia

Acute illness or injury affecting the limbs or the nervous system

Long-term conditions which may require support with breastfeeding

Congenital heart disease (CHD)

Long-term respiratory conditions

Complex surgical conditions affecting the gut

Chronic kidney disease

Abnormal tone and movement

Cleft lip and/or palate and any other structural anomaly of the face or mouth

Insulin-dependent diabetes mellitus

Congenital adrenal hyperplasia

Oncological diagnoses and treatments

16 Infant feeding in emergencies - what doctors need to know

Preparation and planning

17 What GPs need to know about breastmilk substitutes

Introduction

'Closer to breastmilk?'

So what do you need to know about breastmilk substitutes?

What counts as a breastmilk substitute?

What products are available on the UK market?

Supporting families with normal, healthy infants and young children

Will hungry baby formula help a baby sleep better?

Is formula based on goats' milk less allergenic than formula made from cows' milk?

Is soya-based formula a good option if there are allergies in the family or if families are vegetarian?

Are ready-to-feed milks different to powdered milks?

What non-dairy alternatives to cows' milk are suitable from 1 year of age?

Is an infant milk for 'fussy eaters' useful?

18 Stopping breastfeeding

19 Where to find out more.

For further information and support you can contact any of the breastfeeding organisations as a professional.

Notes:

Description based upon print version of record.

Description based on print version record.

ISBN:

0-429-55329-3

0-429-26269-8

9780429262692

OCLC:

1130040961