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<html lang="en" class="hexml-course s2e"><!--[if lt IE 8]> <html class="oldie"> <![endif]--><!--Generated at Wed, 12 Oct 2022 23:23:13 +0000--><head><meta name="author" content='["Carole Dobrich"]'><meta name="course" content="MA03"><meta name="topic" content="5.0"><meta http-equiv="content-type" content="text/html; charset=utf-8"><meta name="copyright" content="2022 Health e-Learning"><meta name="robots" content="NONE,NOARCHIVE"><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0"><link rel="stylesheet" href="//static.health-e-learning.com/jigsaw/design/hexml.pack.css?v=1665616993" type="text/css"><script type="text/javascript" charset="utf-8" src="//static.health-e-learning.com/jigsaw/design/hexml.pack.js?v=1665616993"></script><title>MA03: Special needs and infant challenges [Domain 6]</title></head><body class="loading"><div class="ajax-modal Fixed"></div><div class="watermark"><span>Health e-Learning</span></div><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="nav"><span class="nav-menu">Maintaining BFHI Education for Nurses and Midwives - Series 2</span><a id="hamburger" href="#"><span class="hamburger hamburger--collapse"><span class="hamburger-box"><span class="hamburger-inner"></span></span></span></a><div class="progress-container"><div id="myBar" class="progress-bar"></div></div></div><nav id="menu"><ol><li><a href="topic_1-0.html"><span class="menu-item-icon">1.0 </span><span class="menu-item-title">Introduction</span></a></li><li><a href="topic_2-0.html"><span class="menu-item-icon">2.0 </span><span class="menu-item-title">Protection of Breastfeeding [Domain 1]</span></a><ol><li><a href="topic_2-1.html"><span class="menu-item-icon">2.1 </span><span class="menu-item-title">A Code History Timeline</span></a></li><li><a href="topic_2-2.html"><span class="menu-item-icon">2.2 </span><span class="menu-item-title">Marketing - the role of the International Code</span></a></li></ol></li><li><a href="topic_3-0.html"><span class="menu-item-icon">3.0 </span><span class="menu-item-title">Understanding the importance of skin-to-skin</span></a><ol><li><a href="topic_3-1.html"><span class="menu-item-icon">3.1 </span><span class="menu-item-title">Infant innate behaviours</span></a></li><li><a href="topic_3-2.html"><span class="menu-item-icon">3.2 </span><span class="menu-item-title">Skin-to-skin and the role of the Health Worker</span></a></li><li><a href="topic_3-3.html"><span class="menu-item-icon">3.3 </span><span class="menu-item-title">Addressing barriers to skin-to-skin</span></a></li><li><a href="topic_3-4.html"><span class="menu-item-icon">3.4 </span><span class="menu-item-title">The loving relationship</span></a></li></ol></li><li><a href="topic_4-0.html"><span class="menu-item-icon">4.0 </span><span class="menu-item-title">Postnatal Interventions</span></a><ol><li><a href="topic_4-1.html"><span class="menu-item-icon">4.1 </span><span class="menu-item-title">The chemistry of feeding</span></a></li></ol></li><li class="current mm-selected"><a href="topic_5-0.html"><span class="menu-item-icon">5.0 <i class="fa fa-caret-right" aria-hidden="true"></i></span><span class="menu-item-title">Special needs and infant challenges [Domain 6]</span></a><ol><li><a href="topic_5-1.html"><span class="menu-item-icon">5.1 </span><span class="menu-item-title">The 'late preterm' 'early term' baby</span></a></li><li><a href="topic_5-2.html"><span class="menu-item-icon">5.2 </span><span class="menu-item-title">Ankyloglossia</span></a></li></ol></li><li><a href="topic_6-0.html"><span class="menu-item-icon">6.0 </span><span class="menu-item-title">Managing common difficulties</span></a><ol><li><a href="topic_6-1.html"><span class="menu-item-icon">6.1 </span><span class="menu-item-title">Engorgement</span></a></li><li><a href="topic_6-2.html"><span class="menu-item-icon">6.2 </span><span class="menu-item-title">Hyperlactation</span></a></li></ol></li><li><a href="topic_7-0.html"><span class="menu-item-icon">7.0 </span><span class="menu-item-title">Supplementation</span></a><ol><li><a href="topic_7-1.html"><span class="menu-item-icon">7.1 </span><span class="menu-item-title">Feeding-line device at the breast or chest</span></a></li><li><a href="topic_7-2.html"><span class="menu-item-icon">7.2 </span><span class="menu-item-title">Cup feeding</span></a></li><li><a href="topic_7-3.html"><span class="menu-item-icon">7.3 </span><span class="menu-item-title">Finger Feeding</span></a></li></ol></li><li><a href="topic_8-0.html"><span class="menu-item-icon">8.0 </span><span class="menu-item-title">Closing session</span></a><hr></li><li class="appendix"><a href="references.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-book i-topic"></i></span><span class="menu-item-title">List of references</span></a></li><li class="appendix"><a href="contents.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-file-text-o i-topic"></i></span><span class="menu-item-title">Course contents</span></a></li><li class="appendix"><a href="full.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-print i-topic"></i></span><span class="menu-item-title">Print version</span></a></li></ol></nav><div id="content"><h1 id="top">5.0 Special needs and infant challenges [Domain 6]</h1><section class="section" id="Challenges"><h2>Challenges</h2> <div class="content-node"> <p>When we apply the '10 Steps to Successful Breastfeeding' along with excellent prenatal care and postpartum support, we can expect that most parents:</p> <ul> <li>are educated in breastfeeding skills and normal baby behavior,</li> <li>have a healthy pregnancy and a normal labour without interventions, and</li> <li>care for their babies in extended skin-to-skin contact</li> </ul> <p>Our aim is for as many mothers, parents, and babies to receive all of those things to get off to the best start. For some families, that is not entirely possible and it is crucial to quickly identify those families who are going to require additional assistance from you to establish breastfeeding or chestfeeding.</p> </div> </section><div class="box"><div class="box-title"><h3>Step 5. Support mothers to initiate and maintain breastfeeding and manage common difficulties</h3></div> <div class="content-node"> <p>(New Zealand) Step 5: Support mothers to initiate and maintain breastfeeding and manage common difficulties, even when baby is unable to be with mother.</p> <p>(Canada) Step 5: Support mothers/parents to initiate and maintain breastfeeding and manage common difficulties.</p> </div> <div class="content-node"></div> <img width="5001" height="5001" data-src="images/6-0_BFHI-Step5.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt=""> <div class="content-node"> <p></p> <p></p> <p><strong>Points 4 and 5 of the Seven-point Plan for Sustaining Breastfeeding in the Community:</strong><br>
Point 4. Support mothers to establish and maintain exclusive breastfeeding to six months<br>
Point 5. Encourage sustained breastfeeding beyond six months to two years or more, alongside the introduction of appropriate, adequate, and safe complementary foods.</p> </div> </div><section class="section" id="Identified_during_pregnancy"><h2>Identified during pregnancy</h2> <div class="content-node"> <h2></h2> <h3>Infant</h3> <ul> <li>twins, triplets, or more</li> <li>neuromotor problems (eg. Down Syndrome)</li> <li>facial or other abnormalities (eg cleft lip or palate)</li> </ul> <h3>Maternal</h3> <ul> <li>Diabetes (Type I, II, or gestational)</li> <li>History of difficulty breastfeeding</li> <li>History of breast reduction/surgery, chest injury, or radiation</li> </ul> </div> </section><section class="section" id="Identified_during_birthing"><h2>Identified during birthing</h2> <div class="content-node"> <h3></h3> <ul> <li>intrapartum analgesics and/or anesthetics</li> <li>birth trauma, assisted delivery (vacuum, forceps, or emergency c/section)</li> <li>low Apgar Scores, required resuscitation</li> <li>no or brief skin-to-skin care following birth</li> <li>preterm (&lt;34/6 weeks) or late-preterm birth (34/0-37/6)</li> </ul> </div> </section><section class="section" id="Identified_postpartum"><h2>Identified postpartum</h2> <div class="content-node"> <h3></h3> <ul> <li>small or large for gestational age</li> <li>breast refusal or inconsistent ability to latch-on</li> <li>hypoglycemia</li> <li>hyperbilirubinemia</li> <li>ankyloglossia</li> <li>excessive sleepiness or irritability</li> </ul> </div> </section><section class="section" id="When_a_referral_is_needed"><h2>When a referral is needed</h2> <div class="content-node"> <ul> <li>Don't endanger breastfeeding by delaying referral.</li> <li>Some conditions identified will require expertise beyond your own, or for a continuing period of time. Refer as early as possible to give them the best chance for breastfeeding success.</li> <li>Early identification ensures assistance is directed where most needed.</li> </ul> </div> </section><div class="captionBox"><img width="4000" height="3000" data-src="images/Early_support.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt="Early support is essential"><p>Early support is essential. <br>&copy; Carole Dobrich</p></div><div id="footer"><a href="topic_4-1.html" rel="prev" class="prev">&laquo; Prev</a><a href="topic_5-1.html" rel="next" class="next">Next &raquo;</a><br style="clear: both"><div class="floating-menu"><button class="theme-toggle" title="Toggle colors (dark or light)"><i class="fa fa-moon-o"></i></button><button class="gotoTop" title="Back to top"><i class="fa fa-chevron-up"></i></button></div><a href="javascript:%20window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2022 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: ["Carole Dobrich"]</p><p class="dateUpdated">Updated on Wed, 12 Oct 2022 23:23:13 +0000</p></div></div></body></html>
