What are some causes of nipple infection and how to treat?
1) Bacteria (purulent discharge): bactracin mupirocin cream applied after breastfeeding
2) Fungal (pain persistent not just on ltaching) - antifungal cream post feeds
3) herpes simplex (vesicular) - needs to stop brestfeeding, do not drink from affected side until all sores are healed
How do deal w Nipple vasospasm
breast tip pain/colour change esp when cold.
Manage:
1) warm temp during breast feeding
2) a magnesium supplement (up to 600 g)
3) nifedipine low dose (20 mg slow release daily
How to deal w Nipple atopic eczema or contact dermatitis
1) strong steroid mometasone OD after the infant has had a feed, for up to 10 days
make sure not persistent rash - may need to investigate pagets.
What is the cause of blocked ducts, how to treat?
Cause: poor flow/drainage
Treat: fully empty breasts, heat pads before, cold packs after.Gentle massage.
What are the symptoms of mastitis what is the treatment
1) differentiating factors of mastitis (compared to just blocked ducts) fever, painful lump, headache, myalgia (systemic)
Treatment: flucloxacillin or cephalexin (500 mg qid) as well as supportive treatments like cold packs, NSAIDs,.
If no response after 48hrs consider refer for IV abx
Need TRO abscess as well
What are some complications of excessive maternal wt gain?
- GDM
- Preeclampsia
- Miscarriage
- Infection
- Contributes to life-long risks of chronic disease
What are important parts of a diet for pregnant women?
A balanced diet, plus a supplement that contains folic acid and iodine, is essential for good maternal health and infant growth and development
What are the main differences between breastfeeding diet and pregnant diet
Breastfeeding: higher in protein and fluid requirement
Pregnant: higher in folate and iron requirement
When should a pregnant woman start taking extra calories?
First trimester
- extra food is not required
Second and third trimesters
Additional servings from some of the five food groups consumed should meet additional energy requirements
increasing your intake of:
1) Grain and cereal foods (wholegrain and high-fibre options)
2) Choosing foods that are high in iron (lean red meat or tofu–iron-rich foods)
3) Increasing calcium (drinking milk, and eating hard cheese and yoghurt, or calcium-enriched alternatives)
What is the recommended wt gain per week?
