Question

Please help answer these question

1. How do we assess attachment/bonding behaviors?

• Breastfeeding/milk production:

2. When does mother's full milk actually "come in"? (Typically day 3-4 after the birth, she would be able to pump approx 1 ounce of milk from each breast)

3. How can mom manage engorgement?

4. How can nurses help mom and baby establish feeding and ensure mom is getting breast stimulation so she produces milk later

Answer 1

1.The attachment/bonding behaviours can be assessed in the following way

• In case of newborn, the warmth,heartbeat often mother can indirectly and intensely create a bond with them .This can make them to recognize and identify the mother eadiky and gets attached to them without any external forces
• Breast feeding can improve the bond
• Cuddling the baby increases the mother baby relationship
• In grown up children the interaction and active participation with the family members
• Searching the parents often for supervision on what they do can be categorized to pre attachment behavior where the child can smile ,cry to grab attention of parents
• During two to six months the caregiver can be differentiated by the child
• Assess for tenate period of the child.

2.The initial milk which is often thick and yellow is called as colostrum.In case of mother for the first time the full milk is expected in 3 to 4 days because continuous feeding will stimulate the prolactin hormone to produce milk when the baby suckle or when mother feels that she has to feed her baby.

The normal amount of milk which can received in first 3 to 5 days can be about 15 to 30ml totally

3.The engorgement can be managed in the following ways

• Encourage mother to feed regularly and completely for atleast 20 minutes in each breast
• The breast milk can be expressed and stored in the food of refrigerator in case of excess milk
• Warm compressing can relieve pain
• Wear proper fitting bra

4.The nurse can help then in the following ways

• Health educate about the need and benefits of breast feeding
• Teach the feeding techniques
• Provide the baby open so that the baby can attach to the mother and establish skin contact to improve bonding
• Feeding every 2 hours not exceeding more than 3 hours between each feed
• The feed as to be atleast for 20 minutes in a breast because the high fat milk can be received in a longer feed time.
• To ensure mom is getting stimulation
  • Proper balanced nutritional diet high in milk and 8ts products,certain fish can increase milk production
  • Encourage to stay happy and feel the motherhood
  • Wetting can occur when there is adequate milk ,so breast pads can be used
  • Touching or gentle stroke near the nipple can enable release of prolactin and order for milk ptoduction