title: Preserving breastfeeding for the rehospitalized infant: a clinical pathway.
abstract: The benefits of feeding newborns with human milk are well established. Unfortunately some hospital practices do not support successful breastfeeding; practices such as early hospital discharge after birth, lack of appropriate follow-up primary care providers, and lack of access to breastfeeding support services can contribute to breastfeeding failure, as well as morbidity and mortality in the infant. Infants experiencing breastfeeding difficulties are sometimes admitted to the hospital with diagnoses such as hyperbilirubinemia/jaundice, dehydration/hypernatremia, rule out sepsis, and weight loss/failure to thrive. This article describes a clinical pathway developed with the express purpose of maintaining and enhancing lactation in mother-infant dyads experiencing breastfeeding difficulties. The goal of the pathway is to maintain lactation and breastfeeding while returning the infant to a state of health. A key focus of the pathway is milk transfer, a concept that is missing from much of the research on lactation difficulties. The pathway considers breastfeeding from both a maternal and an infant perspective, with a goal of preserving breastfeeding. It uses technology to support the breastfeeding process and could be useful for all practitioners working with mother-infant dyads experiencing breastfeeding difficulties.
authors.affiliation: University of Pennsylvania School of Nursing, and Children's Hospital of Philadelphia, USA. spatz@nursing.upenn.edu
authors.forename: Diane L
authors.initials: DL
authors.lastname: Spatz
authors.forename: Karen A
authors.initials: KA
authors.lastname: Goldschmidt
mesh_terms: D000359:Aftercare; D000465:Algorithms; D001942:Breast Feeding; D019091:Critical Pathways / Q000458:organization & administration*; D003663:Decision Trees; D003681:Dehydration / Q000150:complications; D005183:Failure to Thrive / Q000150:complications; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006776:Hospitals, Pediatric; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications; D006955:Hypernatremia / Q000150:complications; D007775:Lactation Disorders / Q000209:etiology / Q000517:prevention & control; D008487:Medical History Taking; D009035:Mothers / Q000193:education / Q000523:psychology; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment; D010353:Patient Education as Topic; D010359:Patient Readmission; D015143:Philadelphia; D018805:Sepsis / Q000150:complications; D012944:Social Support; D013396:Suction / Q000379:methods