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| Preface | |
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| Acknowledgments | |
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| Foreword | |
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| Breastfeeding Promotion in the Modern World | |
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| Infant Feeding Practices Historically | |
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| Increased Separation of Mothers and Babies | |
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| Breastfeeding Revisited | |
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| Breastfeeding Rates | |
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| Breastfeeding as an Infant Health Issue | |
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| Breastfeeding as a Women's Health Issue | |
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| Physical and Emotional Effects of Breastfeeding on Women | |
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| Cultural Influences on Infant Feeding | |
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| Current Breastfeeding Recommendations | |
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| The Ten Steps to Successful Breastfeeding | |
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| The Lactation Consulting Profession | |
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| The Lactation Consultant as Part of the Health Care Team | |
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| Functioning as a Lactation Consultant | |
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| Sharing Information with Physicians | |
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| The Lactation Consultant's Role with Mothers | |
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| Services to Mothers | |
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| Educating Mothers About Breastfeeding Management | |
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| Practice Settings for Lactation Consultants | |
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| Practicing in a Hospital | |
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| Practicing in a WIC Clinic | |
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| Practicing in a Physician Group | |
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| Practicing in Home Health Care | |
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| Working in Private Practice | |
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| Relationship of the Lactation Consultant and Peer Counselor | |
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| Mother-to-Mother Support Groups | |
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| The Lactation Consultant's Services to the Group | |
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| Non-Salaried Volunteer in a Breastfeeding Center | |
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| Empowering Women Through Your Attitude and Approach | |
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| Empowerment through Breastfeeding | |
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| Making the Breastfeeding Assumption | |
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| Addressing the Issue of Guilt | |
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| Health Consumerism | |
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| Informed Consent | |
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| A Parent's Role in the Health Care System | |
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| The Lactation Consultant's Role in Health Consumerism | |
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| Relinquishing Control | |
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| Trusting in Mothers and Babies | |
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| Using an Adult Learning Approach | |
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| Making Positive Impression on Adult Learners | |
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| Creating an Effective Learning Climate | |
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| Using Humor as a Communication Tool | |
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| Components of Communication | |
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| The Importance of the Spoken Word | |
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| The Effect of Voice Tone | |
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| The Effect of Body Language | |
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| Counseling: Learning to Help Mothers | |
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| Understanding the Counseling Process | |
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| Counselor Traits | |
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| The Mother's Needs | |
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| Methods of Counseling | |
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| Using Counseling Methods and Skills | |
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| The Guiding Method | |
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| The Leading Method | |
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| Combining the Guiding and Leading Methods | |
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| The Follow-up Method | |
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| Counseling Examples | |
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| Counseling Example with Pregnant Woman | |
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| Comparison of Two Lactation Consultants | |
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| Client Consultations | |
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| Reaching Out Through Anticipatory Guidance | |
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| The Timing of Anticipatory Guidance | |
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| Comparing Anticipatory Guidance and Crisis Intervention | |
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| Providing Anticipatory Guidance | |
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| Using a Problem-Solving Approach | |
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| Using Counseling Skills to Determine the Problem | |
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| Working Toward a Solution | |
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| A Similar Approach to Problem Solving | |
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| Telephone Counseling | |
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| Deciding When a Consultation Is Required | |
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| Last Resort Help | |
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| Elements in a Consultation | |
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| Consent | |
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| Assessment | |
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| Writing Physician Reports | |
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| Evaluation | |
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| Evaluating Your Counseling Skills | |
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| Hospital Documentation | |
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| BREASTfeed Observation Form | |
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| Charting with Breastfeeding Descriptors | |
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| The LATCH Method | |
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| Developing a Plan of Care for Hospital Discharge | |
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| The Science of Lactation | |
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| Anatomy of the Breast | |
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| Skin | |
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| Nipple | |
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| Areola | |
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| Montgomery Glands | |
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| Supportive and Sustaining Tissue | |
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| Mammary Growth and Development | |
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| Mammary Growth during the Fetal Stage | |
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| Mammary Growth between Puberty and Pregnancy | |
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| Mammary Growth during Pregnancy | |
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| Lactogenesis | |
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| Hormonal Impact on Lactation | |
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| Colostrum Production | |
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| Milk Synthesis | |
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| Milk Ejection Reflex (Letdown) | |
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| Variations In Breast Structure and Function | |
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| Examining the Mother's Breasts | |
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| Differences in Nipples | |
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| Lumps in the Breast | |
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| Maternal Health and Nutrition | |
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| Counseling Women Regarding Their Nutritional Needs | |
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| Nutritional Issues in Pregnancy and Lactation | |
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| The Food Pyramid | |
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| The Basic Nutrients | |
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| Food Selection | |
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| Reading Food Labels | |
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| Food Additives and Processing | |
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| Causes of Hunger and Fatigue | |
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| Offering Nutrition Advice to Breastfeeding Women | |
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| Diet Improvement | |
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| Special Nutrition Programs | |
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| Weight Loss and Exercise | |
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| Group Instruction in Nutrition | |
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| Properties of Human Milk | |
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| Colostrum: The Early Milk | |
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| Transition to Mature Milk | |
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| Appearance of Mature Milk | |
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| Milk Volume | |
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| Composition of Human Milk | |
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| Calories | |
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| Fat | |
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| Carbohydrates | |
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| Protein | |
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| Vitamins | |
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| Minerals | |
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| Other Constituents | |
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| Health Benefits of Human Milk | |
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| Immunologic Properties | |
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| Allergy Protection | |
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| Human Milk for the Premature Infant | |
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| Impurities in Human Milk | |
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| Drugs and Contaminants | |
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| Effect of Contaminants on the Breastfeeding Infant | |
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| Giving Advice about Medications | |
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| Social Toxicants | |
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| Breast Implants | |
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| Environmental Contaminants | |
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| Guidelines for Counseling a Mother about Impurities | |
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| Differences between Human Milk and Infant Formula | |
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| Risks of Artificial Baby Milk | |
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| Deficiencies in Infant Formula | |
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| Informing Parents of the Risks of Artificial Feeding | |
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| Choosing and Preparing An Artificial Baby Milk | |
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| Prenatal Considerations | |
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| Making the Decision to Breastfeed | |
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| Factors That Influence a Woman's Decision to Breastfeed | |
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| Realistic Expectations Regarding Breastfeeding | |
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| Conditions That Contraindicate Breastfeeding | |
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| Preparation for Breastfeeding | |
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| Learning about Breastfeeding | |
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| Prenatal Breast Care | |
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| Practical Planning Suggestions | |
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| Physician for Mother and Baby | |
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| Factors to Explore in Selecting a Physician | |
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| Recommending Physicians | |
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| Questions to Ask the Baby's Physician | |
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| Working with the Physician | |
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| When the Physician's Advice Seems Detrimental to Breastfeeding | |
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| Hospital Practices That Support Breastfeeding | |
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| Setting the Stage Prior to Birth | |
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| Establishing Supportive Breastfeeding Policies | |
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| Teaching Breastfeeding Management to Staff | |
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| Educating Pregnant Women | |
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| Labor and Delivery Practices That Support Early Breastfeeding | |
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| Provide Labor Support | |
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| Limit Interventions | |
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| Promote Bonding | |
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| Help Mothers Initiate Breastfeeding | |
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| Creating a Supportive Postpartum Climate | |
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| Eliminate Negative and Unnecessary Practices | |
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| Promote Practices That Support Breastfeeding | |
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| A 48-Hour Plan of Care for Breastfeeding Management in the Hospital | |
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| Baby Friendly Hospital Practices | |
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| Infant Assessment and Behavior | |
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| Assessment of the Newborn | |
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| Posture | |
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| Skin | |
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| Head | |
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| Oral Cavity | |
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| Clavicle | |
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| Reflexes | |
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| Digestion | |
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| Burping | |
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| Spitting Up | |
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| Projectile Vomiting | |
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| Gastroesophageal Reflux | |
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| Elimination | |
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| Infant Communication | |
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| Approach and Avoidance Behaviors | |
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| Feeding Cues and Stages of Alertness | |
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| Infant Behavior Patterns | |
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| Average Baby | |
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| Easy Baby | |
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| Placid Baby | |
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| Active and Fussy Baby | |
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| Infant Growth | |
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| Caloric Intake | |
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| Weight Gain | |
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| Sleeping Patterns | |
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| Encouraging Baby to Sleep | |
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| Breastfeeding Issues with Sleep | |
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| Cosleeping | |
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| Sudden Infant Death Syndrome | |
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| Crying and Colic | |
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| Crying | |
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| Identifying the Cause of Crying | |
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| Distinguishing Crying from Colic | |
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| Cow and Soy Milk Intolerances | |
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| Mother's and Infant's Diets | |
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| Lactose Overload | |
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| Getting Breastfeeding Started | |
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| Getting Ready to Nurse | |
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| Establishing a Breastfeeding Routine | |
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| Encouraging Baby-Led Feeds | |
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| Positioning for Feeding | |
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| The Mother's Body: Zone One | |
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| The Mother's Breast: Zone Two | |
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| The Baby's Body: Zone Three | |
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| The Baby's Mouth: Zone Four | |
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| Using a Variety of Breastfeeding Positions | |
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| Cradle Hold | |
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| Clutch (Football) Hold | |
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| Dominant Hand Position | |
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| Lying Down Position | |
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| Posture Feeding | |
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| Other Creative Breastfeeding Positions | |
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| Assisting at a Feed | |
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| Observing the Feed | |
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| Assisting the Reluctant Nurser | |
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| Ending the Feed | |
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| Infant Attachment and Sucking | |
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| Sucking and Suckling | |
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| The Infant's Sucking Pattern | |
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| Physiology of Suckling | |
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| Suckling at the Breast Versus Sucking on a Bottle | |
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| Latching the Baby On | |
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| Principles of a Good Latch | |
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| The Baby's Latch in the First Few Days | |
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| The Transfer of Milk to the Baby | |
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| Problems Getting the Baby Latched onto the Breast | |
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| Feeding Adjustments to Improve Latch-On | |
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| The Baby Who Cannot Stay Attached | |
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| Consequences of a Poor Latch | |
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| Babies Who Have Difficulty Suckling | |
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| The Baby Who Attaches and Is Not Suckling Nutritively | |
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| Developing a Plan of Care | |
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| Noninterventive Techniques | |
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| Minimal Level of Intervention | |
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| Low-Level Intervention | |
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| Moderate-Level Intervention | |
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| High-Level Intervention | |
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| Breastfeeding Issues in the Early Weeks | |
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| Confidence and Commitment to Continue Breastfeeding | |
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| Misconceptions That Interfere with Breastfeeding Management | |
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| Establishing Milk Production | |
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| Signs of Sufficient Milk | |
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| One Breast or Two | |
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| Duration of Feeds | |
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| Frequency of Feeds | |
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| Leaking | |
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| Causes of Leaking | |
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| When Leaking Poses a Problem | |
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| Measures to Control Leaking | |
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| Excessive or Inappropriate Leaking | |
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| Nipple Soreness | |
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| Causes and Prevention of Nipple Soreness | |
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| Assessment of Sore Nipples | |
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| Treatment and Plan of Care | |
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| Alternating Breastfeeding Positions | |
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| Cracked Nipples | |
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| Yeast Infections | |
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| Engorgement | |
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| Problems Caused by Engorgement | |
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| Preventing Engorgement | |
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| Helping Mothers Relieve Engorgement | |
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| Guidelines for Pumping When Engorged | |
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| Plugged Ducts | |
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| Mastitis | |
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| Causes of Mastitis | |
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| Treatment of Mastitis | |
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| Recurrent Mastitis | |
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| Abscessed Breast | |
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| Breastfeeding Beyond the First Month | |
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| Patterns of Growth in a Breastfed Baby | |
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| Overfeeding a Breastfed Baby | |
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| Infant Developmental Stages | |
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| Newborn Development | |
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| Two to Three Months | |
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| Four to Five Months | |
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| Six Months | |
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| Seven to Nine Months | |
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| Ten to Twelve Months | |
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| Beyond One Year | |
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| Developmental Factors Associated with Sleep | |
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| Breastfeeding as Baby Grows | |
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| Breastfeeding in Public | |
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| Traveling with a Breastfeeding Baby | |
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| Teething and Biting | |
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| Complementary Feeds | |
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| Pressure to Begin Solid Foods | |
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| Choosing the Appropriate Time to Introduce Solid Foods | |
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| Signs of the Baby's Readiness for Solid Foods | |
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| How to Introduce Solid Foods | |
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| Allergy Considerations | |
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| Weaning | |
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| After Weaning | |
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| Problems with Milk Production and Transfer | |
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| The Perception of insufficient Milk Supply | |
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| Reasons for a Perceived Low Milk Supply | |
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| Recognizing Sufficient Milk Production | |
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| Identifying Problems with Infant Growth | |
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| Newborn Dehydration | |
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| Concerns with Infant Weight Gain | |
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| Identifying Mothers at Risk for Low Milk Production or Transfer | |
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| Warning Signs That a Baby Is Not Gaining Adequate Weight | |
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| Failure to Thrive | |
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| Issues to Address with the Mother | |
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| Reversing the Trend of Failure to Thrive | |
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| Measures to Increase Milk Production | |
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| Changes in the Family | |
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| Acquiring the Parental Role | |
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| Emotional Adjustments to Becoming a Mother | |
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| The Mother's Physical Recovery Following Birth | |
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| Becoming a Father | |
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| Changes in Family Relationships | |
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| Sexual Adjustments | |
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| Menstruation and Fertility | |
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| Sibling Reactions and Adjustments | |
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| Helping Siblings Prepare for the New Baby | |
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| Preparing for the Mother's Absence | |
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| Adjusting to the New Baby | |
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| Special Counseling Circumstances | |
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| Opposition to Breastfeeding | |
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| Opposition from Strangers | |
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| Opposition from Friends | |
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| Opposition from the Mother's Employer | |
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| Opposition from a Physician | |
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| Opposition from Grandparents and Other Relatives | |
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| Opposition from the Baby's Father | |
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| Mother's Confidence | |
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| Mother's Environment | |
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| Low-Income Mother | |
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| Single Mother | |
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| Teenage Mother | |
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| Mothers with Cultural Differences | |
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| Mother-to-Mother Support Groups | |
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| Outreach Counseling | |
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| Meeting the Needs of the Mothers | |
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| Regular Meetings for Mothers | |
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| When No Support Group Is Available | |
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| Breastfeeding Techniques and Devices | |
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| Breastfeeding Techniques | |
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| Pinch Test | |
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| Breast Massage | |
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| C-Hold | |
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| Dancer Hand Position | |
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| Breastfeeding Devices | |
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| Lubricants on the Breast and Nipple | |
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| Inverted Syringe for Flat or Inverted Nipples | |
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| Breast Shells | |
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| Nipple Shield | |
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| Pacifiers | |
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| Evaluator Techniques | |
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| Finger to Pacify Baby | |
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| Finger to Evaluate Oral Cavity | |
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| Suck Reorganization | |
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| Suck Training | |
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| Milk Expression | |
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| Manual Expression | |
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| Use of a Breast Pump | |
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| Selecting a Breast Pump | |
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| Collecting and Storing Human Milk | |
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| Human Milk Banks | |
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| Alternate Feeding Methods | |
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| Cup Feeding | |
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| Tube-Feeding Device | |
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| Finger Feeding | |
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| Syringe Feeding | |
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| Bottle Feeding | |
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| Artificial Baby Milk | |
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| Acceptable Medical Reasons for Foods Other Than Human Milk | |
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| Choosing an Infant Formula | |
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| Safety Tips from the American Academy of Pediatrics | |
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| Temporary Breastfeeding Situations | |
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| Hyperbilirubinemia (Jaundice) | |
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| Types of Jaundice | |
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| Risks and Treatment of High Bilirubin | |
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| Parental Concerns Associated with Jaundice | |
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| Delayed Onset of Breastfeeding | |
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| Expressing Milk to Maintain Lactation | |
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| Transition from Milk Expression to Breastfeeding | |
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| Mothers Who Return to Bottle Feeding | |
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| Relactation | |
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| Maternal Motivation | |
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| The Process of Relactation | |
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| Increasing the Mother's Success | |
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| Nursing an Adopted Baby | |
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| The Process of Inducing Lactation | |
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| Baby Losing Interest in Breastfeeding | |
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| Possible Causes of the Baby's Disinterest | |
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| What the Mother Can Do | |
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| Baby Who Prefers One Breast | |
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| Encouraging the Baby to Feed at Both Breasts | |
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| High-Risk Infants | |
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| Prolonged Hospitalization of the High-risk Infant | |
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| Parents' Reactions | |
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| Baby's Care | |
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| The Neonatal Intensive Care Unit Environment | |
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| Taking the Baby Home | |
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| Babies Not Born at Term | |
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| Small for Gestational Age Infants | |
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| Prematurity | |
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| Postmaturity | |
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| Counseling a Mother Whose Baby Has Died | |
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| Breastfeeding Concerns | |
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| Support Systems for Parents | |
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| When Breastfeeding Is Interrupted | |
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| Managing Breastfeeding through a Separation | |
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| The Mother's Needs | |
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| Considerations for Timing of the Separation | |
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| Maintaining Milk Production | |
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| Nourishing the Baby during the Absence | |
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| Motivation to Continue Nursing | |
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| Coping with Difficulties | |
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| Following the Separation | |
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| Short-term Separations | |
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| Hospitalization of Mother or Baby | |
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| When the Mother Is Ill | |
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| Hospitalization of the Mother | |
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| When the Baby Is Ill | |
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| Supporting the Working Mother | |
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| Making the Decision to Return to Work | |
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| Before Returning to Work | |
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| Returning to Work | |
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| The Baby-Friendly Workplace | |
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| Mothers and Babies with Long-Term Special Needs | |
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| Multiple Birth | |
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| Breastfeeding Management | |
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| Parenting Challenges with Multiples | |
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| Tandem Nursing | |
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| Breastfeeding during Pregnancy | |
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| Breastfeeding Siblings | |
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| Special Maternal Health Conditions | |
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| Diabetes | |
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| Hypothyroidism | |
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| Cystic Fibrosis | |
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| Maternal Phenylketonuria | |
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| Tuberculosis | |
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| Hepatitis C | |
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| Herpes | |
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| Human Immunodeficiency Virus (HIV) | |
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| Special Infant Health Conditions | |
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| Infant with Phenylketonuria | |
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| Galactosemia | |
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| Cleft Lip and Cleft Palate Infant | |
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| Neurologically Impaired Infant | |
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| Professional Considerations | |
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| Acquiring the Role of Lactation Consultant | |
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| Anticipatory Stage | |
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| Formal Stage | |
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| Informal Stage | |
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| Personal Stage | |
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| Facilitating the Role Acquisition | |
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| Preparing for the Profession | |
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| Educational Preparation | |
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| Clinical Experience | |
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| Other Educational Experience | |
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| Professional Networking | |
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| Certification | |
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| Standards of Practice for the Lactation Consultant | |
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| Standards of Practice for Plan of Care | |
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| Standards of Practice for Education and Counseling | |
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| Standards of Practice for Professional Responsibilities | |
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| Standards of Practice for Legal Considerations | |
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| Standards of Practice for Ethical Issues | |
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| Developing Resources | |
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| Promoting Your Services | |
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| Referral System | |
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| Community Awareness | |
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| Writing a Resume or Curriculum Vitae | |
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| Developing a Lactation Consultant Job Description or Proposal | |
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| Staff Education | |
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| Creating Enthusiasm Among Staff | |
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| Maturing Through Consulting Experiences | |
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| Mothers Who Do Not Follow Your Advice | |
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| Medical Complications | |
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| External Interference | |
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| Professional Burnout | |
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| Avoiding Pitfalls in Consulting | |
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| Critical Reading and Review of Research | |
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| Types of Articles in Scientific Journals | |
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| Structure of a Scientific Article | |
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| Critical Reading of a Scientific Article | |
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| Practicing Critical Reading Skills | |
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| Breastfeeding Promotion and Change | |
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| Traits of a Strong Leader | |
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| Becoming a Change Agent | |
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| Beginning the Process of Change | |
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| The Infant Formula Industry | |
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| Promoting Baby-Friendly Practices | |
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| Glossary | |
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| Professional Resources | |
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| Organizations | |
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| Sources for Lactation Resources | |
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| Drug Hot Lines | |
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| Recommended Reading | |
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| Professional Publications | |
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| Journals and Newsletters | |
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| Index | |