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Access the module for nipple shields (use, risks and complications, etc). Practice quiz below.

Self-learning package

Quiz

  1. If a baby is unable to latch, name three factors that should be explored before using a nipple shield?
Answer
  1. breastfeeding self-efficacy; 2. breastfeeding history – including with this baby; 3. baby’s oral anatomy; 4. birth
  1. If the health care provider is unable to support the breastfeeding dyad they should give the dyad the nipple shield so they can continue breastfeeding on their own. True or False
Answer

False. A plan should be created that works for the family and communicate with someone that can support the dyad. Mom and Baby can go home even if not latching if there is a good follow-up plan to ensure baby is fed and milk supply is maintained. *Communication between care providers is critical

  1. Name three risks/complications with using a nipple shield for mom or baby.
Answer
  1. In the first days after birth, moms and babies benefit from time to connect and recover. Babies begin to use their neuromuscular abilities to latch. The introduction of a nipple shield at this time can interfere with this process.
  2. Imprinting in babies is oral/tactile and when they become exposed to artificial nipples in their mouths at an early age they may have difficulty replacing it with their mother’s nipple.
  3. Nipple shields may decrease milk transfer by 25%.
  4. Nipple shields may put pressure on milk ducts and cause plugged ducts or mastitis.
  5. Some babies become so accustomed to the shield that they do not breastfeed without it, exposing mom and baby to risk #1 and #2 for much longer and decreasing duration of breastfeeding.
  1. Name two reasons why the correct nipple shield size and are fit important?
Answer

When nipple shield is too large:

  1. The nipple shield will cause the baby to choke on it and the baby will not effectively feed, which can lead to a nipple aversion making the baby not want to breastfeed.
  2. The baby will not take in enough of the breast tissue, causing a decrease in milk transfer and a reduction in milk supply.

When the nipple shield is too small:

  1. it may not stimulate active sucking, causing a decrease in milk transfer and reduction in milk supply
  2. the shield can interfere with milk flow and traumatize nipple tissue
  1. How is a nipple shield put on?
Answer
  1. Turn the shield almost completely inside out, so that the tip is still in the right position but the sides are folded up around it
  2. Moisten the side that goes against the breast to help the shield stay in place
  3. Centre the tip over the nipple and smooth the rim against the breast
  4. Wiggle the nipple section to pop it out, by using a series of small rotations while holding the tip of the shield

Access the self-learning module on harm reduction supply distribution. Practice quiz below

Self-learning package

Practice Quiz:

  1. Harm reduction is a pragmatic response that focuses on keeping people safe by minimizing death, preventing disease and injury associated with higher risk behavior, while recognizing that the behavior may continue despite the risks. True or False?
Answer

True

  1. Safer sex practices, safer drug use practices and other harm reduction tools are the most effective methods of preventing STBBI transmission. ? is not an achievable goal (or desired one) for most people and therefore, ? tools are the best strategy.
Answer

Abstinence
harm reduction

  1. Safer sex practices includes which of the following?
    a. using latex or polyurethane condoms and sex dams
    b. using gloves for all sex involving hands or fingers
    c. lubrication should be used to prevent damage to mucous membranes
    d. All of the above
Answer

d. All of the above

  1. When should someone have STBBI screening completed?
    a. every 6-12 months
    b. after every risky encounter
    c. more regularly when engaged in ongoing risk such as injection drug use
    d. All of the above
Answer

d. All of the above

  1. A “window period” is described as?
Answer

The time between exposure to an infection, and when a test is able to detect the infection. The length of a window period can vary depending on the infection.

  1. All drug use supplies can transmit HIV and Hep C infections if shared with an HIV-positive or Hep C-positive person. Drug use supplies that can transmit infections include:
    a. needles/syringes,
    b. water, filters,
    c. cookers/spoons,
    d. snorters/pipes and barrels
    e. All of the above
Answer

e. All of the above

  1. For clients who choose to smoke or snort their drugs: what should you recommended clients do to their pipes or tubing?
    a. clean pipes or tubing with alcohol swabs between each use
    b. never share pipes or tubes
    c. All of the above
Answer

c. All of the above

  1. Arrange in order of least risk to most risk

    a. huffing
    b. smoking
    c. sharing supplies
    d. snorting
    e. no use
    f. injecting
    g. swallowing
Answer

a. no use
b. swallowing
c. huffing
d. smoking
e. snorting
f. injecting
g. sharing supplies

  1. What are signs of an overdose from stimulants?
    a. fast heart rate, fever, blue lips, pale skin
    b. foaming at the mouth, vomiting, seizures, twitching or body shakes
    c. chest pains, going unconscious
    d. All of the above
Answer

d. All of the above

  1. What are signs of an overdose from depressants?
    a. breathing slows or stops (less than 18/min), heart rate slows or stops
    b. seizures, twitching or body shakes, vomiting, blue lips or skin, low body temperature
    c. confused or very hard to rouse, going unconscious or sleeping deeply/snoring and can’t be woken
    d. All of the above
Answer

d. All of the above

  1. ________________ ? is a drug that can be administered when a person has overdosed on an opiate to prevent death. Clients given ________________ ? should be monitored for 30-60 minutes, as once the ________________ ? wears off, they may experience overdose again.
Answer

Naxolone

  1. Good vein care includes:
    a. using a tourniquet to ensure that needle goes into a viable vein.
    b. rotating injection sites to minimize scarring and infection.
    c. saving a vein for medical care
    d. use of ascorbic acid for better vein health when using heroin and crack
    e. All of the above
Answer

e. All of the above

  1. If the client is using a new dealer, after detox, or if talk of “bad” drugs on the street, it is important to education the client to inject a smaller than normal dose of the drug prior to injecting a full dose. This is called:
    a. flavour
    b. bite
    c. taste
    d. All of above
Answer

c. taste

  1. Health care providers, such as _______________ ?, can provide referrals and/or linkages to agencies that can assist and provide support with behaviour changes i.e. AFM, mental health services.
Answer

public health nurses

  1. Can you think of other agencies that can assist and provide support?
Answer

Manitoba Addictions Helpline
Mental Health & Addictions Services in Manitoba

A global standard and important designation awarded to health organizations.

Why breastfeed?

  • provides normal and optimal nutrition for babies
  • increases babies’ immunity
  • provides protection for many illnesses and diseases for both mom and babies
  • breastmilk can’t be replicated artificially as it is always changing to provide what the baby needs throughout the day, week or month

Why not use formula?

  • provides no immunity and does not protect against infections
  • hard to digest and can cause bacterial infections
  • errors can be made when preparing formula

What is the International Code of Marketing of Breastmilk Substitute?

  • provides a minimum requirement that the facility has to meet to show the work we do related to infant feeding, is unbiased, face-based and free from commercial influences
  • applies to all regional messaging about infant formula, other milks, infant teas or juices, feeding bottles and pacifiers (no advertising or promotion of products)
  • encourages families to make informed decisions using evidence-based information on how to feed their baby

What is your role?

All staff will:

  1. Create a welcoming environment for breastfeeding families
    • all families who wish to breastfeed or pump breastmilk can do so in all Southern Health-Santé Sud facilities
    • offer a clean space with comfortable chairs
    • provide a private space if requested and available
    • do not display posters or other publications showing use of feeding bottles, pacifiers or infant formula
    • do not ask the breastfeeding family to leave, cover up or to use a restroom
  2. Know the basics of the Southern Health-Santé Sud breastfeeding policy and procedures
    • we support exclusive breastfeeding until the baby is 6 months old
    • we support breastfeeding up to 2 years and beyond with the introduction of complimentary foods at 6 months
    • we ensure materials distributed to the public by staff meet BFI standards (i.e. no ads re. formula)
  3. Refer mothers who have questions or need help with infant feeding to their local Public Health-Healthy Living nurse or the 24-hour Breastfeeding Hotline 204-788-8667 or 1-888-315-9257

References:

Search Breastfeeding in the Policy & Forms section for policy and supporting documents

BFI-Staff Information Handout

Breastfeeding Committee for Canada (BCC) – Global Strategy and Resources

Healthier people. Healthier communities. Thriving together.
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