A premature newborn is unable to suck at the breast. The nurse plans care for the mother, who is going to hand-express milk. Arrange the steps for instruction to the mother in logical order to teach her this technique of milk expression
1. Roll the thumb and fingers simultaneously forward.
2. Position the thumb at 12:00 and forefinger at 6:00 around the areola.
3. Repeat the sequence multiple times to completely drain the breasts.
4. Stretch the areola back toward the chest wall without lifting the fingers off the breast.
2, 4, 1, 3
Rationale: Following this pattern will allow the mother to manually drain her breast of milk, and is referred to as the Marmet Technique of hand expression.
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