MIDWIFERY CARE FOR MOTHER

Midwifery care for mother experiencing a breast feeding challenge of mastitis



Midwifery care for mother experiencing a breast feeding challenge of mastitis

Introduction

Raisler used focus groups to look qualitatively at the experience of low-income women around breastfeeding within the existing health care system. She identified helpful providers as those who had accurate information, established a caring relationship, had a repertoire of concrete actions to suggest, were enthusiastic about breastfeeding, and had a network of referral sources for management problems they themselves could not handle.

Most contemporary midwives, other health care providers, and parents acknowledge that breastfeeding is best. However, all too frequently in the United States, neither health care providers nor parents seem convinced that the method of feeding matters significantly, because infant formula preparations are viewed as an acceptable and accessible alternative. Breastfeeding mechanics are considered somewhat mysterious and not always worth the effort to pursue. On the other hand, the women indicated provider behaviors that were not helpful, including being hard to reach for questions, giving misinformation, encouraging formula supplementation as an answer to breastfeeding problems, and using a routine and impersonal approach.

Midwives can have an enormous impact on breastfeeding duration by enthusiastically conveying to women that breastfeeding is the standard, by having a system that guides the women to effective resources, and by increasing their availability to breastfeeding clients. By striving to bring their practice settings into compliance with the International Code of Marketing of Breast-milk Substitutes, midwives can insure that women benefit from continuity of care in a breastfeeding -friendly environment.

Breastfeeding as the infant feeding paradigm

Virtually all mothers and babies can successfully breastfeed. True contraindications to breastfeeding are extremely rare and include mothers receiving chemotherapy drugs or lithium, as well as women who are human immunodeficiency virus positive and have access to safe feeding alternatives. Infants with galactosemia cannot breastfeed, whereas those with some rare metabolic disorders, such as phenylketonuria, may need to combine breastfeeding with a specially developed formula to meet their metabolic needs. Occasionally, a mother may need to temporarily stop breastfeeding while she is taking a drug, but she can pump and discard the milk until the medication has cleared her system.

A careful history of breast problems and surgeries is important. If milk ducts have been cut during a surgical procedure, the ducts may no longer be connected to allow milk to flow to the nipple, or scar tissue may block the ducts. Surgical removal of benign breast masses is not a risk factor for insufficient milk production. However, the location of the incision and the amount of breast tissue removed may have some bearing on whether all of the milk glands can drain adequately. For example, a periareolar incision has the potential to involve the ducts and decrease enervation. Thus, although breast surgery is not a contraindication to breastfeeding, close early postpartum follow-up to assess milk transfer is important, at least until infant growth is well established.

With reduction mammoplasty, severing the milk ducts and damage to nerves in the ...