Question

Maria calls the OB unit. Her voice is high-pitched and she seems anxious. She states, "My baby Juan is 10 days old. He breastfeeds all the time- he acts like he is hungry and not content for more than 1-2 hours! I am exhausted. I have been keeping the diary like you said and he has 5-6 wet diapers and a couple of stools each day. I sometimes hear him swallow after he takes several sucks. He falls asleep after about 15 minutes on one breast. I feel him tug at my breast but it hurts my nipple sometimes too! My other breast is still full but it doesn’t leak; I only get 1 oz when I pump! My mother thinks I should just give him formula. My grandmother contacted the family curandera (female healer) and she suggested an herbal tea to increase my milk supply. I want to make an appointment with the lactation consultant but I can’t wait in a waiting room. My grandma is afraid of "mal aire" (bad air) that might enter mine or the baby’s body in the waiting room. I am so confused. I don’t know what to do! I have read about all of the good things breastfeeding does for me and Juan. What can I do to increase my milk supply and keep breastfeeding? SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY SHOULD BE IMPLEMENTED:

a."Maria, take 3 deep breaths in and exhale slowly while I count to 3."

b."An appointment can be made for first thing in the morning so you do not have to wait in the waiting room at the lactation clinic. The lactation nurse is an expert and will be able to help you."

c."You are a good mother, Maria. You are doing an excellent job of keeping the feeding diary and trying many options to help your baby. Bring your feeding diary with you to your appointment."

d."Spend time with Juan skin-to-skin before attempting to latch-on for feeding. Undress Juan down to his diaper to help him wake up for the second breast. Express milk using the pump if he doesn't feed 20 minutes on each side."

e."Sleep when Juan sleeps. Tell your mother and grandmother they can help you best by fixing meals and doing household chores so you can rest."

Answer 1

To help Maria, the first steps are providing immediate support by helping her relax, and setting up an early appointment with a lactation consultant to avoid waiting room concerns and address her breastfeeding issues.

Step-by-step explanation:

The first nursing actions that should be implemented to assist Maria in increasing her milk supply and continuing to breastfeed her son Juan are:

1. "Maria, take 3 deep breaths in and exhale slowly while I count to 3." This provides immediate support and may help alleviate Maria’s anxiety, allowing her to calm down. A relaxed state can improve her ability to focus on breastfeeding and may positively influence milk let-down.
2. "An appointment can be made for first thing in the morning so you do not have to wait in the waiting room at the lactation clinic." This addresses Maria’s concern about lingering in a waiting room and ensures that she receives professional guidance promptly.

It's important to reassure Maria that her efforts are noticed and that the lactation consultant can help troubleshoot specific issues like pain and lactation concerns.