Key points of operation
1. Preliminary evaluation: maternal symptoms, delivery time, delivery mode and feeding situation.
Step 2: Prepare
(1) prepared by prolactin himself: comprehensive preparation of gfd knowledge and technology.
(2) Material preparation: masks, hats, shoe covers, media, maternity registration pens, receipts, brochures and business cards are prepared in the work package.
3, on-site assessment
1) Assess parturient (wash hands before assessing parturient)
1. General conditions:
Ask about the general situation, medication, consciousness, vital signs, etc.
2. Local conditions:
Observe whether the breast skin is red, swollen, nodular and scarred, and whether the left and right sizes are symmetrical.
3, psychological state:
To know whether the parturient has bad psychological state such as anxiety, depression and fear, and the family's tolerance.
4. Health knowledge:
Objective: To understand the cognition of parturient to breast-feeding and breast-feeding food.
2) Evaluation environment: room temperature 22~24C, relative humidity 55% ~ 65%, clean, quiet, comfortable, safe, with good light, which meets the requirements of breastfeeding.
3) The parturient should be calm, understand the purpose of the operation and empty urine.
Step 4 perform
(1) Bilateral breast palpation: outer upper quadrant → outer lower quadrant → inner lower quadrant → inner upper quadrant.
(2) Hot compress: ① Use special breast care towel for parturient ② Wool.
The temperature of towel should be controlled at 40~50℃③ Avoid nipple and areola.
(3) Acupuncture, massage and other techniques.
(4) Clean the breast and the surrounding skin, wash things, help the parturient maintain a comfortable position, and breastfeed in time if conditions permit.
(5) Education: explain the dietary precautions to patients and their families, and write dietary prescriptions when necessary. And guide the correct knowledge of breastfeeding and parenting.
Milk massage process
1. Take a hot towel (40-50) and hot compress both breasts for about 5~ 10 minutes.
2. Press Zhongshan, Yutang, Shenfeng, Wuming, Yongchuang, Rugen and Tianxi 1 min in each group.
3. Apply moderate amount of medium oil.
4. Comb from breast root to nipple for 3-5 minutes.
5. Knead around the areola with thenar (four fingers) of the palm.
From the breast root to the nipple, the finger kneading method is applied along the direction of the mammary duct, and the "kneading three links and one" is adopted.
7. Use your thumb to open the breast from the root of the breast to the nipple in a rice line, 3 to 5 times in each direction.
Massage the breasts with relaxation massage.
Press Quchi, Hegu and Shaoze for one minute at nine o'clock.
10 breast cleaning
Less milk, no milk
insufficiency of Qi and Blood
One week after delivery or lactation, there is little or no milk, thin milk, soft but painless breasts, dull complexion, dizziness and fatigue, eating less loose stool, pale tongue, less fur and weak pulse.
Second, liver qi stagnation type
Little or no astringent milk, thick milk, breast pain, chest pain and discomfort, or slight heat upset, loss of appetite, thin yellow tongue coating, thready pulse.
Three, phlegm stagnation type
Postpartum milk is scarce or not at all, the breasts are plump, soft without swelling, the milk is not thick, the body is fat, the chest is tight and the stool is sparse, the tongue is fat with teeth marks, the fur is white and greasy, and the pulse is heavy and slippery.
Fourth, spleen and stomach disharmony.
Insufficient milk, loss of appetite, skin humiliation, and weakness of qi and blood.
Five, kidney deficiency type,
Kidney is the foundation of congenital.
Operational addition and subtraction
Deficiency of Qi and Blood: Point Zusanli, Zhongwan, Guanyuan, Qihai, Pishu and Shu Wei.
Stagnation of liver qi: Zhouchengmen and Taichong points.
Phlegm-qi stagnation type: point Zusanli and Fenglong points.
Disharmony between spleen and stomach: point Zusanli, Sanyinjiao, Ganshu, Pishu and Shu Wei.
Kidney deficiency type: congenital deficiency. Click on Zusanli, Zhao Hai, Taixi, Yongquan and Shenshu.
Milk stasis: breast lump, acute mastitis
Principle: from light to heavy, focus on communication.
Take a hot towel (40℃-50℃) and apply it to both breasts for about 2~3 minutes, and apply a proper amount of medium oil.
Healthy side
Comb from breast root to nipple for 3-5 minutes.
Knead with your fingers around the areola.
From the breast root to the nipple, the finger kneading method is applied along the direction of the mammary duct, and the "kneading three links and one" is adopted.
Pass the milk from the bottom of the breast to the nipple with your thumb, 3~5 times in each direction.
Massage your breasts with a relaxing massage.
Affected side
Gently expel milk from the mammary duct around the lump.
Gently drain the milk accumulated in the areola of the lump area, and then knead and dredge the lump to drain the milk accumulated in the lump as much as possible until the lump disappears.
Massage your breasts with a relaxing massage.
Wait until the lump is empty. Click on Shoulder Well for half a minute.
Bilateral breast swelling
If the breasts and feet are swollen like stones, the one with mild symptoms should be discharged first. Discharge milk from the areola, and then discharge milk from the areola until the lump disappears and the breast becomes soft.
Back to milk
Natural milk return and artificial milk return
Milk-returning food: barley malt, maltose, non-vegetables and peppers.
Avoid milk-secreting foods and soups.
Raw malt: strengthen the spleen and stomach, promote milk secretion, and be used for food shortage and milk stasis.
Stir-fried malt: promoting qi circulation, promoting digestion and returning milk, used for indigestion and weaning women.
Burnt malt: digestion and stagnation, used for indigestion, abdominal distension and pain, fried malt is preferred.
Milk-returning prescription
1, bromocriptine 2.5 mg twice a day, for 14 days. 2. External application of mirabilite
3. Stir-fry malt 60-90g, decoct in water, and add appropriate amount of brown sugar once a day for 5-7 days.
4, stir-fried malt 30 grams, hawthorn 30 grams, medicinal leaves 30 grams, decoction instead of tea, for 5-7 days.
5. 30g of raw malt, 30g of fried malt, 0/5g of burnt yeast/kloc-,0/5g of burnt hawthorn/kloc-,0/2g of green tangerine peel/kloc-,and 0/2g of dried tangerine peel/kloc-.One pair is boiled for 2-3 times, and three pairs are a course of treatment.
6, flower root 12 grams, 30 grams of brown sugar, 400 grams of water, fried into 250 grams. 7. Vitamin B6200, three times a day for three consecutive days.
Precautions for milk withdrawal
1, if the breast is full and uncomfortable, you can milk it, but you can't milk it completely, otherwise it will promote the secretion of milk, which is counterproductive.
2. During lactation, it is necessary to minimize the stimulation to breast nipples, the secretion of prolactin will decrease, and the secretion of milk will gradually decrease. Never let the baby suck milk again, and don't let the baby touch it. Avoid washing your breasts with hot water when taking a bath.
3. Ice packs can be used to reduce the feeling of swelling.
4. If a lump is found in the breast, it should be opened by hand in time to prevent mastitis.
5, the choice of diet When returning to milk, avoid foods that promote milk secretion, such as peanuts, trotters, crucian carp, soups and so on. And eat less foods rich in protein, protein can reduce milk secretion and reduce water intake in the diet.
6. Be patient during lactation. If the baby is crying and making noise, don't let the baby suck intermittently, and don't put pepper or other irritating things on the nipple. If lactation is due to swelling and pain, it will inevitably prolong lactation time.
7. Try to avoid using hormone drugs or breast needles. It is easy to cause breast atrophy or breast secretion problems.
Seven methods of scientific weaning
1, gradually reduce the feeding times.
2. Reduce the night first and then the day.
3, mother first physical examination and then weaning.
Don't wean your baby when he is sick.
5. Spend more time with your baby.
6, cruel weaning methods will hurt the baby's body and mind.
7. The weaning process should be decisive and cannot be delayed.
Milk-returning porridge
Malt has the function of returning milk.
Fructus Aurantii has the functions of regulating qi, relieving flatulence and eliminating swelling.
Japonica rice 100g, stir-fried malt 30g, bitter orange 6g, and appropriate amount of brown sugar, one dose per day, for 5-7 days.
Glauber's salt has the functions of purging heat, relaxing bowels, moistening dryness, softening hardness, clearing fire and reducing swelling. It can be used for constipation due to excess heat, dry stool, abdominal pain, swelling and pain of intestinal carbuncle, external treatment of breast carbuncle and hemorrhoid, and application of mirabilite to reduce swelling when breast feeding.