Question

Chrissy, G1 P1 is receiving postpartum teaching prior to discharge. She is a 17-year-old single mother living with her parents and wanting to try to continue breastfeeding. What are your priority concerns as her nurse and what would you include in her plan of care? Create a concept map identifying her priority needs.

Answer 1

Teenage Pregnancy and Breastfeeding:

Teen mothers face many challenges to successful breastfeeding and are likely to breastfeed than any other population group.Challenges includecoping with the stigma and embarrassment related to being a teen mother,lack of parenting readiness,need for peer acceptance and dependence on social support systems that may not be supportive of breastfeeding.Many teen mothers will be going to school or working after the birth of her baby.Let her know that it us possilble to work or go to school while continuing to breastfeed.Even if dosent want to pump,breast feeding is not all or nothing,she can nurse her baby when they are together and supplement when she is away.
Nutritional status of the mother has a direct influence on the quality and quantity of her breastmilk. A breastfeeding mother needs to consume an adequate and balanced diet. There is an extra demand for nutrients, especially to secrete adequate quantity/quality of milk and to safeguard your own health.

Health Education about Diet and Nutrition:

Get Hydrated:
Breastfeeding every 2 to 4 hours can be dehydrating. Drink at least 8-10 glasses of water. Fluids also help to keep up milk production. Consume milk, fruit juices and soups. Reduce caffeine intake by cutting down on coffee, tea, cola and chocolate drinks.

DHA:
DHA is important for healthy visual and mental development of baby through infancy. DHA from mother’s milk improves psychomotor development and attention. DHA content of breastmilk depends on the mother’s diet.

Iron:
Iron is required to fulfill the additional demands in breastmilk. Iron rich foods include pulses and legumes, garden cress seeds, green leafy vegetables, watermelon, egg, red meat etc.

Calcium and Vitamin D:
Calcium is important for the normal development of bones of the growing infant. The best source of calcium is milk & milk products such as yoghurt, cheese, paneer and green leafy vegetables, ragi etc. For Vitamin D, include fatty fish like tuna, salmon and mackerel, egg yolk. Exposure to morning sunlight will also help to meet your vitamin D requirement.Eat at least 3 Nutritious Meals a Day and Do Not Skip Breakfast.Mothers can get hungry easily while breastfeeding. This is because breastfeeding uses up calories, thus mothers should have 3 regular meals and 2 to 3 light snacks a day as part of their lactation diet. Do not skip meals, particularly breakfast. Some snacking options include fruit smoothies, handful of nuts, veg. rolls, sandwiches, fruit platters, etc.Limit foods high in Sugar and Fat
Cut down on high fat and high sugar foods like potato crisps, chocolates, cakes and soft drinks. These foods are full of “empty” calories and have little nutritional value.

Avoid Alcohol & Smoking:
Alcohol passes quickly into breast milk and can affect baby. Avoid smoking and tobacco use.

Avoid “Dieting” during Breastfeeding:
Dieting during breastfeeding might reduce the quantity and quality of your milk. To lose your pregnancy weight, limit the intake of foods that are high in fat and sugar. Try to incorporate some moderate exercises like brisk walking or swimming 3 times a week.

Proteins:
During lactation, protein requirement increases to support the rapid growth of the baby. Includes foods like eggs, milk & milk products – cheese, paneer, chicken, fish, pulses and legumes etc. to meet your requirements.

Use of Galactogogues:
In India, herbs such as methi seeds, jeera, dill (suva) and special preparations such as goand laddu (edible gum), methi laddu, almond halwa, dried ginger (saunth) burfi, & recipes using bajra and green leafy vegetables are recommended for increasing milk production and improve lactation. Herbs and spices like ajwain, fennel (saunf), garlic believed to help in digestion and avoid colic pain in baby while the above mentioned food preparations increase the milk production. However, eat these preparations in moderation as they are high in fat and calories.

Support Starts at Home:
A teen pregnancy can strain the teen’s relationship with her family, leaving the new mom feeling isolated from her most direct support system.Building these champions starts with open conversations that rally everyone around a common goal: the importance of helping the new baby have the best chance at a healthy start. By establishing this shared understanding, health professionals can create a sense of communal alliance and then transition the conversation to discuss breastfeeding—its benefits for both mom and baby, and the need to build up the new mother’s resiliency so that she can breastfeed successfully.

Elevate the relationship between mother and baby:
Strengthening a teen mother's bond with her new baby will build resiliency in and of itself.As a new mother
connects with her baby,she becomes more confident in her role,and in turn more likely to breastfeed.
Just as a strong mother-baby connection encourages breastfeeding so too does breastfeeding
strengthen that connection,the one building off the other.Breastfeeding helps teen mothers feel a sense of
contribution each time they breastfeed immediately ,but we need to be especially mindful of its importance for teen mother's.Early initiation sparks a positive feedback loop that helps balance out the insecurities that
come with their age.Breastfeeding enpowersthem as mother's.