<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" lang="en" xml:lang="en">
<!--Generated at Mon, 20 Aug 2012 17:49:29 +1000 HEXML processor version: 2642-->
  <head>
    <meta name="author" content="Denise Fisher" />
    <meta name="course" content="ES01" />
    <meta name="topic" content="8.0" />
    <meta http-equiv="content-type" content="text/html; charset=utf-8" />
    <meta name="copyright" content="2012 Health e-Learning" />
    <meta name="robots" content="NONE,NOARCHIVE" />
    <meta name="cache-control" content="NO-CACHE" />
    <link rel="stylesheet" href="design/hexml.pack.css?v=1345448969" type="text/css" />
    <script type="text/javascript" src="design/hexml.pack.js?v=1345448969"></script>
    <title>Maternal Challenges</title>
  </head>
  <body>
    <div id="access">
      <a href="#access" accesskey="a">Access Keys</a>
      <a href="#menu" accesskey="m">Skip to Menu</a>
      <a href="#content" accesskey="c">Skip to Content</a>
      <a href="#footer" accesskey="f">Skip to Footer</a>
    </div>
    <div id="content">
      <h1 id="top">8.0 Maternal Challenges</h1>
      <div><p> A knowledge of the conditions or events which are linked with decreased initiation or duration of breastfeeding will help you to focus your breastfeeding assistance and education activities to those in most need. </p><p class="listTitle"> Maternal Risk Factors <br /> </p><ul><li> acute or chronic disease </li><li> maternal obesity </li><li> hypertension during pregnancy </li><li> intrapartum analgesics or anaesthetics </li><li> assisted or surgical delivery of baby </li><li> breast or nipple abnormality </li><li> history of breast surgery or trauma </li><li> previous breastfeeding difficulty </li><li> persistent breast pain </li><li> severe engorgement </li><li> cracked/bleeding nipples </li></ul> Risk factors such as intrapartum sedation and assisted birthing use the same management techniques as for the baby affected by these factors. <p> Mothers with persistent breast pain, acute or chronic disease and previous breast surgery will require ongoing management and should receive an early referral to a lactation consultant who can continue care in the community. <br /> </p></div>
      <table class="callout">
        <thead>
          <tr class="decoRow">
            <td class="topleft" style="width: 10px">
              <img src="design/callout_01.png" width="10" height="10" alt="" />
            </td>
            <td class="topcenter" style="background: repeat-x url(design/callout_02.png);">
              <img src="design/callout_02.png" width="59" height="10" alt="" />
            </td>
            <td class="topright" style="width: 10px">
              <img src="design/callout_03.png" width="10" height="10" alt="" />
            </td>
          </tr>
        </thead>
        <tfoot>
          <tr class="decoRow">
            <td class="topleft" style="width: 10px">
              <img src="design/callout_07.png" width="10" height="10" alt="" />
            </td>
            <td class="topcenter" style="background-image: url(design/callout_08.png);">
              <img src="design/callout_08.png" width="59" height="10" alt="" />
            </td>
            <td class="topright" style="width: 10px">
              <img src="design/callout_09.png" width="10" height="10" alt="" />
            </td>
          </tr>
        </tfoot>
        <tbody>
          <tr>
            <td class="middleleft" style="background: repeat-y url(design/callout_04.png);">
              <img src="design/callout_04.png" width="10" height="80" alt="" />
            </td>
            <td class="body"><img src="design/warning.png" class="icon" alt="" /><h3></h3>
    <div>Don't endanger breastfeeding by delaying referral.<br /></div>
  </td>
            <td class="middleright" style="background: repeat-y url(design/callout_06.png);">
              <img src="design/callout_06.png" width="10" height="80" alt="" />
            </td>
          </tr>
        </tbody>
      </table>
      <div>This module will only cover the more common occurring problems.<br /></div>
      <div id="footer"><a href="topic_7-5-4.html" rel="prev" class="prev">&laquo; Previous</a><a href="topic_8-1.html" rel="next" class="next">Next &raquo;</a><br style="clear: both" /><a href="#top" id="topLink">Back to top</a><a href="javascript: window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2012 Health e-Learning<p class="printOnly">COPYRIGHT: You are permitted to print ONE (1) copy for your personal use only. No graphics, tables, quizzes, videos, etc, may be used in any form without express written consent. Author: Denise Fisher</p></div>
    </div>
    <div id="menu">
      <h1>Breastfeeding Essentials</h1>
      <ol>
        <li>1.0 <a href="topic_1-0.html">Why Breastfeeding is Important</a><ol><li>1.1 <a href="topic_1-1.html">Biochemistry</a></li><li>1.2 <a href="topic_1-2.html">Immunology</a></li><li>1.3 <a href="topic_1-3.html">Relative risks</a></li></ol></li>
        <li>2.0 <a href="topic_2-0.html">Communication Skills</a><ol><li>2.1 <a href="topic_2-1.html">Non-verbal</a></li><li>2.2 <a href="topic_2-2.html">Listening skills</a></li><li>2.3 <a href="topic_2-3.html">Building confidence</a></li><li>2.4 <a href="topic_2-4.html">An example</a></li></ol></li>
        <li>3.0 <a href="topic_3-0.html">Pregnancy Care</a><ol><li>3.1 <a href="topic_3-1.html">The feeding decision</a></li><li>3.2 <a href="topic_3-2.html">The barriers</a></li><li>3.3 <a href="topic_3-3.html">Physical preparation</a></li></ol></li>
        <li>4.0 <a href="topic_4-0.html">The Birth Experience</a><ol><li>4.1 <a href="topic_4-1.html">The first hours</a></li><li>4.2 <a href="topic_4-2.html">Labor interventions</a></li><li>4.3 <a href="topic_4-3.html">Postnatal interventions</a></li></ol></li>
        <li>5.0 <a href="topic_5-0.html">Breastfeeding the Baby</a><ol><li>5.1 <a href="topic_5-1.html">Positioning Principles</a></li><li>5.2 <a href="topic_5-2.html">Breastmilk transfer</a></li><li>5.3 <a href="topic_5-3.html">Assessing breastfeeding</a></li></ol></li>
        <li>6.0 <a href="topic_6-0.html">A time to learn</a><ol><li>6.1 <a href="topic_6-1.html">Practical skills</a></li><li>6.2 <a href="topic_6-2.html">Breastfeeding messages</a></li><li>6.3 <a href="topic_6-3.html">Normal growth</a></li><li>6.4 <a href="topic_6-4.html">Sleep</a></li><li>6.5 <a href="topic_6-5.html">Psychological support</a></li><li>6.6 <a href="topic_6-6.html">Discharge planning</a></li></ol></li>
        <li>7.0 <a href="topic_7-0.html">Infant Challenges</a><ol><li>7.1 <a href="topic_7-1.html">Late preterm infant; Non-latching</a></li><li>7.2 <a href="topic_7-2.html">Hypoglycemia; Jaundice</a></li><li>7.3 <a href="topic_7-3.html">Supplementation</a></li><li>7.4 <a href="topic_7-4.html">Crying baby</a></li><li>7.5 <a href="topic_7-5.html">Inadequate weight gain</a><ol><li>7.5.1 <a href="topic_7-5-1.html">Feeding-line device at the breast</a></li><li>7.5.2 <a href="topic_7-5-2.html">Cup feeding</a></li><li>7.5.3 <a href="topic_7-5-3.html">Finger Feeding</a></li><li>7.5.4 <a href="topic_7-5-4.html">Bottle feeding</a></li></ol></li></ol></li>
        <li class="current">8.0 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><a href="topic_8-0.html">Maternal Challenges</a><ol><li>8.1 <a href="topic_8-1.html">Engorgement</a></li><li>8.2 <a href="topic_8-2.html">Nipple Pain</a></li><li>8.3 <a href="topic_8-3.html">Breast Problems</a></li><li>8.4 <a href="topic_8-4.html">Insufficient breastmilk</a></li><li>8.5 <a href="topic_8-5.html">Medical, Surgical Issues</a></li></ol></li>
        <li>9.0 <a href="topic_9-0.html">Promotion, Protection and Support</a><ol><li>9.1 <a href="topic_9-1.html">The International Code of Marketing of Breastmilk Substitutes</a></li><li>9.2 <a href="topic_9-2.html">The Baby Friendly Initiative</a></li><li>9.3 <a href="topic_9-3.html">Young Child Feeding</a></li><li>9.4 <a href="topic_9-4.html">Local initiatives</a></li><li>9.5 <a href="topic_9-5.html">Infant feeding in emergencies</a></li></ol></li>
        <li>10.0 <a href="topic_10-0.html">Closing session</a><hr /></li>
        <li class="appendix"> <a href="references.html">List of references</a></li>
        <li class="appendix"> <a href="contents.html">Course contents</a></li>
        <li class="appendix"> <a href="full.html">Print version</a></li>
      </ol>
    </div>
  </body>
</html>
    </ol>
    </div>
  </body>
</html>
