1 1 year 1 month ~ 20 1 year1month 105 an example of cesarean section in the lower uterus, the age was 23 ~ 33 years old, with an average of 28 years old; 97 cases were successful (9 1%) and 8 cases failed, including 7 cases of chapped nipple and 0/case of mastitis. All operations were performed under epidural anesthesia.
Common nursing problems of breast-feeding after cesarean section
Lack of correct understanding of colostrum: most rural women and their families think that colostrum is yellow and white, so they feed milk powder instead of letting the baby eat it; After operation, the parturient can't eat and give milk late. Some people mistakenly think that they add milk powder to their babies without milk.
Don't touch, don't suck: After cesarean section, the parturient will suck early after skin contact within 30 minutes. However, due to postoperative incision pain, mothers often can't stand 30 minutes of skin contact and suck early, and newborns don't have the habit of sucking breast milk. If you can't wait to feed the newborn with milk powder from a bottle at this time, the newborn won't suck its mother's nipple. Because the nipple of the bottle is long and easy to suck; Mother's nipples suck badly.
Incorrect feeding posture and difficulty in feeding: Many young mothers have difficulty in feeding, so they can only suck nipples and cannot completely suck nipples and most areola into their babies' mouths. Coupled with nipple depression, breast-feeding itself is very laborious, and it is difficult to accommodate nipples and areola.
Chapped nipple: The parturient does not know how to care for the nipple skin, and scrubs the nipple with alcohol or soap, which leads to the nipple skin cracking. It hurts when the nipples are connected, and the nipple posture is incorrect.
Breast pain and mastitis: related to the lack of relevant knowledge of parturient. Most parturients don't understand the importance of diligent sucking; If you don't know that milk can't be eaten, you should squeeze it out, otherwise it will cause milk stasis, fever and mastitis.
Nursing countermeasures
Do a good job in publicity and education: publicity and education is the key to improve the breastfeeding rate. The benefits of breastfeeding are introduced to pregnant women and their families through audio, video and pamphlets from the time when pregnant women are admitted to the clinic for prenatal examination. At the same time, make pregnant women understand the importance of mother-infant sharing room and breast-feeding on demand, as well as correct breast-feeding knowledge, so that pregnant women can gain correct breast-feeding knowledge, establish confidence in breast-feeding and get the cooperation of their families.
Early sucking promotes milk secretion: nurses should patiently explain the significance and benefits of early sucking. For example, early sucking can make the baby eat colostrum with high immune value, realize the first immunization after birth and enhance the disease resistance; Early sucking can promote mother's uterine contraction, reduce postpartum hemorrhage and promote meconium discharge. And wait by the maternal side until the mother-to-child contact is completed. The success of breastfeeding for the first time can dispel the mother's concern that she is unwilling to breastfeed because of the restriction of receptor position, and establish the confidence of breastfeeding.
Timely treatment of problems in the process of breastfeeding: Nurses should solve and deal with some problems in the process of breastfeeding in time, and explain to the parturient the causes of these problems, such as chapped nipple, pain, etc., because the baby only sucks the nipple and does not completely suck the nipple and most areola into the baby's mouth, but the correct breastfeeding posture can be sitting or lying. The baby's body turns to the mother and clings to the mother's body. The child's head and body are in a straight line. The tip of the nose is facing the nipple, and the lower forehead is close to the breast. The baby opens his mouth, holds the nipple and most areola in his mouth, with his lower lip everted, his tongue spoon-shaped around the nipple and his cheeks rounded. When you hug, you can see that there are more areola in the upper part than in the lower part, there is slow and deep sucking, and you can see the action and sound of swallowing. Most of the causes of breast pain are that there is no need to breastfeed in the first few days after birth, the breastfeeding time is short or the hug posture is incorrect.
Instruct the mother to have correct breastfeeding knowledge: The mother's correct breastfeeding posture can make the baby suck effectively, stay in the same room for 24 hours and breastfeed as needed. In normal sleep, there is no need to wake up the baby unless the mother feels that her breasts are full. In case of special circumstances, such as separation of mother and baby, nurses should correctly instruct mothers to milk, that is, teach mothers separated from their babies to start milking 6 hours after birth, at least 6 to 8 times within 24 hours. Squeeze one breast for at least 3 ~ 5 minutes. When there is less milk, squeeze the other breast, and repeat this several times to stimulate breast lactation.
Teach nursing skills patiently and carefully: nurses should explain the nutritional components and nursing skills of colostrum to help it contain correctly. For those with sunken nipples, teach them to learn "cross exercises" to make their nipples protrude outward. A small amount of milk is squeezed out before feeding, and the areola softens before feeding, so it is easy to suck out the whole nipple and most areola. After each feeding, squeeze 1 ~ 2 drops of milk and apply it to nipple and areola, which can effectively prevent nipple from chapping and bursting. If there is a chapped nipple, you should suck out the slightly damaged breast first, and apply a little edible sesame oil to the cracked part of the chapped nipple to promote improvement, so you should wash it when feeding next time. For patients with breast pain, wet and hot compress the breast for 3-5 minutes before each feeding, and gently pat and massage. Feed the swollen side first, then suck the other side. If there is milk flowing out naturally, it can't be stopped artificially. Once mastitis occurs, empty the breast with a breast pump, and give wet and hot compress and physical therapy. Give anti-inflammatory treatment when necessary. Return to the ward within 30 minutes after operation, make local skin contact between mother and baby, inhale early for 30 minutes, patiently explain and actively help and guide breastfeeding, and establish mother-child affection. Instruct mother's nursing skills, especially the first feeding, so that mother can relax and take a comfortable lying position. At the beginning of breastfeeding posture, you can choose the lying position, demonstrate and explain the baby's grounding reflex, and use it to help the baby connect the nipple and most of the areola to form effective sucking. The mother holds the baby in one hand, and the thumb of the other hand is separated from the other four fingers, holding the breast in a "C" shape to help suck. After the incision pain is relieved, encourage the parturient to sit up and embrace breastfeeding, because this is the best posture. Embracing breast-feeding makes the baby's weight supported by the pad, and the mother only needs to hug the baby's upper body, which reduces the burden of the mother holding the baby, eliminates the tension and fear, and can control the head well, so that the baby's chest is close to the mother's chest, and the baby can easily hold the nipple and most of the areola for effective sucking. Instruct lying-in women to breastfeed on demand, suck both breasts effectively, do a good job in nursing breast distension, and teach them the method of artificial milking when breast distension occurs. For mothers with sunken or flat nipples, do nipple exercises or suck out nipples with a breast pump before breastfeeding every time; For mothers with painful or chapped nipples, squeeze out a small amount of milk after breastfeeding and smear it on the nipples and keep it dry. Mother should have enough sleep, 8 ~ 9 hours a day, and keep a happy mood. Don't be overtired and ensure adequate fluid intake. After 6 hours, she can eat liquid food, such as rice soup, chicken soup, fish soup, etc., to ensure milk secretion. Supervision and inspection, family support: a few parturients are selfish, afraid of incision pain, and afraid that breastfeeding will affect their beauty. Nurses should do more maternal work, actively breastfeed babies, and let newborns get full and effective breastfeeding. Don't be short of milk. When giving birth to a child, the breast secretes 800 ~ 1500ml of milk every day. When twins are born, they secrete 2500 ml of milk every day. In other words, if you eat more, you will produce more. Therefore, you must feed as needed to make your mother secrete more milk. At the same time, the husband should be considerate and care about his wife and keep her in a good mood; In order to ensure that you eat more liquid food during lactation.
Follow-up after discharge: Pay attention to the family follow-up work of lying-in women after discharge, help solve the problems existing in breastfeeding, and make breastfeeding persist successfully.