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Baby:When you are done with the bottle can you change the channel to Doc Mcstuffins, I feel a tantrum coming. It is of the absolute necessity that any sleep-deprived Mum needs to get some immediate and practical baby-care support in her local community.
Otherwise, asking a grossly sleep-deprived postnatal her to write a baby sleep-diary or to continue demand feeding her incessantly hungry baby is not the immediate baby-sleep solution she is desperately looking for. Our aim is to resolve the root-causes to parental sleep deprivation by enabling you to initiate good and baby-friendly Sleep-training sleeping habits for your baby as soon as your baby is ready. What are the four Newborn parenting problems that contribute to poor baby sleeping habits ? The Newborn Body-clock parenting style is also backed up by extensive evidence based Newborn behavioural research, parental feedback from families all over the globe; plus effective babycare tips that work straight away and with long term results. Did you know that if a baby’s day or night feeding appetite is not satisfied, it makes it harder for babies to sleep asleep independently?
Make sure the room is at a comfortable temperature and fill the bath with about 5 cm of warm water.
Moisten a cotton wool ball with warm water and gently clean your newborna€™s eyelids, wiping from inner eye to outer eye. Use a soft washcloth to gently clean your newborna€™s face (1), then the neck and body (2), leaving the genitals and bottom till last (3). Babies can drown in less than 5 cm of water so never leave your newborn, or any child, unattended in the bath.
Ita€™s usually not necessary to use soap a€“ it can make your newborn slippery and hard to hold.
This article reviews the care and management offered to women who are experiencing sore or cracked nipples basing it on a case history of one woman’s care. In my role as a problem solving lactation midwife in the community, I am frequently asked to give advice to pregnant and postnatal women at the Breastfeeding Café where I am based.
I was contacted to give assistance to a first time mother with cracked and bleeding nipples.
She was still in the hospital postnatal ward and had given birth to a healthy full term 6.5lb baby three days earlier. Whilst the mother’s milk had just come in on day three, her nipples had already cracked open by day two. The midwives assisting this mother had already established whether there were any concerns about the way the baby was attaching to the breast as this is the main cause of nipple trauma (Wambach 2003). Appropriate midwifery care meant the immediate alleviation of the nipple pain this mother was experiencing while still enabling her to give breast milk to her baby.
Use of the nipple shield resulted in a very positive and immediate outcome as she experienced relief from pain when her baby latched on correctly the next time. My actions were based on a combination of knowledge about the physiology and anatomy of the breast, and on a range of research studies that help inform day to day practice. Given the constant wetting of skin from nursing and rapid drying in between feeds, the baby’s strong suction and powerful latch-on effect may predispose the tender moist skin of the nipple and areola to fissuring (Huml 2000). The pain of sore nipples within the first two to five days postpartum has been rated to be significantly more severe than at any time in cases developing four weeks later. The accepted treatment of cracked nipples involves advising nursing mothers to continue feeding their babies whilst rubbing breast milk on their nipples after feeds. As the outer layer of the nipple (stratum corneum) gets wet every time the baby nurses, the areola collectsmoisture in the skin tissue and swelling occurs. The breast tissue attempts to heal itself by forming a crusty scab, which consequentially blocks the smooth flow of epithelial cells from repairing the damaged area. First and foremost, women need an approach of immediate pain relief from the pain of cracked nipples. One study has shown that the temporary use of the nipple shield at the onset of cracked nipples might be of benefit (Powers & Tapia 2004). Studies have also shown that mastitis can result from nipple trauma, due to the impaired milk flow and let down reflex from the woman’s tension at breastfeeding.

Listening to women’s experiences about breastfeeding, then responding effectively to their individual needs ought to be the approach used by any midwife as part of their problem-solving strategy in woman-centred care. Against this background of conflicting evidence, the midwife is expected to organise care based on the best evidence for practice. When visiting a newborn  baby, it is so important to follow some simple etiquette so that you do not add to the stress of the new mom. Of course, this is only a synopsis but you can check out the above link to get a more extensive list of things to avoid when visiting a newborn baby.
I would also bring some food for the parents, as cooking can be difficult, if you know what I mean!
Including the fact that if a baby is not properly winded it results into an accumulation of painful baby gas, feeding difficulties and sleeping discomfort?
They will also quickly learn to self sooth themselves into a longer sleep and deep the moment you lay them down to sleep; nor dislike going to sleep each time their bodies touch their cribs or baby cot. Hence why a good feed and Jacqui’s colic busting burbling massage go together each time you feed your newborn baby.
Poor parental choices on baby sleep-positioning can make it longer for your baby to learn how to settle themselves into a good day and night sleeping pattern. Test the water temperature with your wrist or elbow a€“ it should be approximately 36A° C and should NOT feel hot on your skin. Cradling her head and shoulders with one hand and supporting her body with the other, gently lower her into the bath. However, if you do decide to use soap, consider an alternative such as sorbolene lotion which wona€™t irritate babya€™s skin.
Where breast milk and breast feeding has immediate and long term health outcomes for both the mother and the baby (NICE 2006, UNICEF 2008), the development of sore or cracked nipples threatens the establishment and overall duration of breastfeeding. However, this paper is based on a peer review project I carried out whilst on a postnatal ward of a busy hospital in London, which serves a population of considerable ethnic and social diversity.
The nipples were bruised black and blue, with the mother wincing in pain every time her baby latched on in her keen effort to demand feed her.
There did not seem to be any problem with this as the baby was taking in the areola area and not just suckling on the nipple itself but, although it had been ascertained that attachment was correct, instead of the pain from the mother’s nipples subsiding, it increased. Her baby did not appear to be put off by the silicon shield either — which meant that for the first time, this mother was empowered to feel confident about her skills to continue breastfeeding, and to be comfortable. The causes of cracked nipples despite correct latching, have been identified as being due to the changes that occur in pregnancy, where the areola expands to twice its normal size and continues to expand further during breastfeeding (Huml 2000).
However, there is a need to distinguish between sore nipples where the skin remains intact and cracked nipples where the skin surface is broken, which also has the potential to allow infection to enter into the breast (Buchanan et al 2002, Wambach 2003). The pain of cracked and bleeding nipples was cited as the main reason why many mothers with newborn babies early weaned their babies from breast milk to artificial formula milk within the first two to six weeks of giving birth. Then in between feeds, women are advised to keep their nipples clean but exposed to air as a means to aid healing using dry air. Tension then results on the outer layer, causing the top layer to crack and break, whilst further rapid drying in between feeds compromises the surrounding breast skin tissue to become brittle and thus more susceptible to fissuring due to the lack of sebaceous glands (Huml 2000). However, advice that mothers air dry their wet nipples with hair dryers or sunshine to rapid dry their cracked nipples as a means of preventing further trauma has now been questioned where this rapid air drying treatment may have the effect of only prolonging their pain (Huml 2000). There is now clearer evidence that allowing the skin surface to heal within a moist environment is likely to be more effective (Huml 2000, Buchanan et al 2002). Studies like Wilson-Clay (1996, also cited by Powers & Tapia 2004), prove that the judicious use of a nipple shield is the most holistic and therapeutic approach to soothe and decrease the pain from cracked nipple trauma. Where there are clogged milk ducks and painful engorgement, this may further impede breastfeeding and the baby’s difficulty at latching properly leads to difficulties in emptying the breast (Foxman et al 2002, Wambach 2003). As a background to this scenario, the paper by Powers and Tapia (2004) gives a very good description of how the authors themselves, as experienced lactation consultants, had to reconsider their original views on the use of the nipple shield when faced with the findings from their study.
It is essential that breastfeeding advice, support and recommendations are made for women as individuals within the guidance set by the Baby Friendly standards (NICE 2006, UNICEF 2008). While this list won’t be absolutely everyone’s cup of tea, they are points that are made many a time by new mothers.

Breast milk protects babies from gastrointestinal, urinary, respiratory and middle ear infections and some familial skin allergies while maternal benefits of breastfeeding include a reduced risk of premenopausal breast cancer (World Cancer Research Fund 2007) and some forms of ovarian cancer (Gwinn et al 1990). Therefore, at the point where I was asked to visit, she was in urgent need of support to enable her to breastfeed her baby successfully.
By the third day postpartum, the mother was in agony and dreading the experience of feeding her first newborn baby despite midwifery assurances that the soreness would improve with time. This suggestion was then discussed with her and her consent obtained to take this course of action as underpinned by the rules and code of practice for midwifery (NMC 2004). However, contrary to popular belief, the areola itself does not have sebaceous glands to keep the tender skin lubricated or the nipple area antiseptic. Both the advice and suggested treatment may differ depending on whether the nipples are sore or cracked.
A study identified that while applying hind breast milk on the injured area did not offer women immediate therapeutic pain relief, it did aid the eventual healing of cracked nipples.
One approach to providing such an environment within the challenges of frequent breastfeeds has been to apply some form of barrier lotion, the most common form of this is found in an organic lanolin that is said to aid the healing process by allowing air and moisture to co-exist to promote healing. However, despite the obvious benefits, studies like Brigham (1996) have led to the general consensus that nipple shields may restrict breast milk flow. This was for a range of reasons, with 62% of women using it to help with problems of flat nipples, 23% to relieve pain from sore (not defined as sore or cracked) nipples and 15% due to engorgement.
When reviewing the literature on the topic of sore and cracked nipples, it is puzzling to realise how sparse the framework is for evidence on treatments. Otherwise, professionals offering advice to breastfeeding women run the risk of dogmatically following outdated or anecdotal advice without considering the basic physiology of the woman’s delicate breast tissue and the original cause of the nipple trauma. To maximise these health benefits, lactation needs to be established so that breast milk provides all the baby’s nutritional requirements within the first six months of life. Hence, I was also elated at being able to provide woman-centred care through effective teamwork (Davies 2000, Schroter et al 2004). Instead, Menz (1994), a lactation dermatologist, explains that the areola and nipple tissue are made of a very thin layer of skin much like the delicate tissue on our lips.
However, a study of 150 mothers with sore nipples in Australia (Reay 1998) recruited 75 women who used lanolin moist healing and a control group of 75 women who used hind milk dry healing, and compared the speed of healing between the two groups. Where women had started using the nipple shield and then discontinued using it, 67% continued to breastfeed.
A Cochrane review on treatments for sore nipples has been withdrawn on the basis that more specificity is required for this topic, and it is to be hoped that an updated review will be more informative, although the research base of evidence for their enquiry does not appear to be overwhelming. The best thing you can do is to ask, not assume or take it upon yourself to do what you’d like for yourself.
Where women develop sore and cracked nipples within the first two to five days of giving birth, there is a need for appropriate advice, support and treatment to ensure that the breast milk continues to be produced and that a way can be found to continue breastfeeding for a longer duration.
She also states that there is no evidence to support the belief that the Montgomery glands provide nipple lubrication and antisepsis, although breast milk does contain antibodies, which is why its use on the nipple has been advocated for healing (Akuzzu & Taskin 2000, Huml 2000). The results showed that by the end of the two week follow-up period, the control group required 40% more home visits than the experimental group using the emollient. This is the key to maintaining strong, close relationships with those who have just had a baby.
This article offers some discussion about the occurrence of sore or cracked nipples and the current advice given to women about their management and treatment. Therefore, the argument for using a suitable emollient is based on the understanding that why not apply the same principles of healing chapped lips to cracked nipples to prevent further breakdown of skin tissue, whilst the nipple shield would protect the new tissue from being removed every time the baby’s strong suction loosened the scab formation on top of the delicate healing skin. The healing process was also observed to be faster in the latter group, whilst the former group experienced more complications and mothers had more adverse comments about their pain (Sharp 1992 cited by Huml 2000). There is still some lack of consistency in the advice surrounding use of nipple shields and it is probably appropriate to note the time frame of use of nipple shields as a temporary measure, as there is still a need to try to discover what caused the trauma to the nipple in the first place.

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