A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply):
a. Giving medication to suppress lactation.
b. Encouraging and helping mother to breastfeed.
c. Teaching mother to feed breast milk by gavage.
d. Recommending use of a breast pump to maintain lactation until infant can suck.
ANS: B, D
The mother who wishes to breastfeed may need encouragement and support because the defect does present some logistical issues. The nipple must be positioned and stabilized well back in the infant's oral cavity so that the tongue action facilitates milk expression. The suction required to stimulate milk, absent initially, may be useful before nursing to stimulate the let-down reflex. Because breastfeeding is an option, if the mother wishes to breastfeed, medications should not be given to suppress lactation. Because breastfeeding can usually be accomplished, gavage feedings are not indicated.
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