- Email: [email protected]
Establishing Breastfeeding with the Late Preterm Infant in the NICU
JOGNN
IN FOCUS CNE POST TEST
Establishing Breastfeeding with the Late Preterm Infant in the NICU Carrie-Ellen Briere, Ruth Lucas, Jacqueline M. McGrath, Mary Lussier, and Elizabeth Brownell
Continuing Nursing Education To take the test and complete the evaluation, please visit http://JournalsCNE.awhonn.org. Certificates of completion will be issued on receipt of the completed evaluation form, application and processing fees. Note: Accredited status does not imply endorsement by AWHONN or the American Nurses Credentialing Center of any commercial products displayed or discussed in conjunction with this activity.
Learning Objectives Upon completion of this activity, the learner will be able to 1. Identify and access guidelines and current practice policies related to breastfeeding the late preterm infant (LPI). 2. Describe additional research needed to best support the breastfeeding LPI. 3. Integrate recommended practices into clinical practice.
Questions 1. Every year _______________ preterm infants make up the largest group of premature infants that are born in the United States. a. Early b. Late c. Very 2. As described in this article through the work of Meier, Patel, Wright, et al. 2013 and Walker, 2008, the mother of a LPI in the NICU is best able to establish her milk supply when she understands ______. a. her infant’s NICU care schedule. b. her infant’s feeding, sleep, and alert states. c. the NICU’s support program for lactation. 3. According to the evidence in this article, when a mother who intends to breastfeed has her LPI admitted to the NICU,
http://jognn.awhonn.org
the mother’s nurse should encourage the mother to a. begin breast milk expression as soon as possible. b. begin expression after all medications are discontinued for the mother. c. wait to express until the mother is physically recovered from giving birth. 4. As described in this article, the World Health Organization (2001) recommends _____ breastfeeding for 6 months and ________ breastfeeding to at least one year of age. a. continued/exclusive b. exclusive/continued c. exclusive/exclusive 5. To support breastfeeding, NICUs should follow the Ten Steps to Successful Breastfeeding and implement the steps specific to the _____. a. LPI b. NICU c. very preterm infant 6. Alternative discharged recommendations are suggested for the LPI by Meier, Patel, Wright, et al., 2013 to support the difficulties often encountered with ________ the LPI. a. bottle feeding b. breastfeeding c. triple feeding 7. Following hospital discharge it is essential that breastfeeding LPIs receive follow-up care. Ahmed (2010) emphasized the importance of a follow-up visit with a pediatric care provider within ____ days of discharge. a. two b. four c. six 8. According to research by Hwang and colleagues (2013), LPIs are ____ likely to
C 2015 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
E1
IN FOCUS CNE POST TEST
Establishing Breastfeeding with the Late Preterm Infant in the NICU
initiate breastfeeding when compared to term infants. a. equally b. less c. more 9. Breastfeeding the LPI is often challenging, and the transition to exclusive direct breastfeeding may not occur during hospitalization for many. Follow-up support is critical to help mothers transition to exclusive direct breastfeeding. Lucas et al. (2014) found that the time to transition varies and an infant they followed took _____ to transition to exclusive direct breastfeeding. a. one month b. two months c. four months 10. Although its use is common in premature infants in the NICU, the impact of _______ on breastfeeding outcomes for LPIs is not known and needs further investigation. a. bottle feeding b. gavage feeding c. on demand feedings 11. A supportive practice for breastfeeding the LPI in the NICU includes
E2
JOGNN, 44, E1-E2; 2015. DOI: 10.1111/1552-6909.12537
a. frequent skin-to-skin contact b. increased maternal fluid intake c. intravenous fluids to prevent bottle feeding 12. It is important for health care providers to educate mothers on differences between feeding patterns and abilities of LPIs versus full term infants. Specifically, mothers should be taught that LPIs often have a ____________ that may affect milk transfer during breastfeeding. a. smaller tongue b. stronger suck c. weaker suck 13. Additional research is needed to examine the reason for breastfeeding cessation within the first ___________ of life. a. few days b. few weeks c. few months 14. The use of ________ needs further research regarding the benefits and its use in the LPI. a. maternal breast milk b. donor human milk c. formula
http://jognn.awhonn.org
IN FOCUS CNE POST TEST
Establishing Breastfeeding with the Late Preterm Infant in the NICU Carrie-Ellen Briere, Ruth Lucas, Jacqueline M. McGrath, Mary Lussier, and Elizabeth Brownell
Continuing Nursing Education To take the test and complete the evaluation, please visit http://JournalsCNE.awhonn.org. Certificates of completion will be issued on receipt of the completed evaluation form, application and processing fees. Note: Accredited status does not imply endorsement by AWHONN or the American Nurses Credentialing Center of any commercial products displayed or discussed in conjunction with this activity.
Learning Objectives Upon completion of this activity, the learner will be able to 1. Identify and access guidelines and current practice policies related to breastfeeding the late preterm infant (LPI). 2. Describe additional research needed to best support the breastfeeding LPI. 3. Integrate recommended practices into clinical practice.
Questions 1. Every year _______________ preterm infants make up the largest group of premature infants that are born in the United States. a. Early b. Late c. Very 2. As described in this article through the work of Meier, Patel, Wright, et al. 2013 and Walker, 2008, the mother of a LPI in the NICU is best able to establish her milk supply when she understands ______. a. her infant’s NICU care schedule. b. her infant’s feeding, sleep, and alert states. c. the NICU’s support program for lactation. 3. According to the evidence in this article, when a mother who intends to breastfeed has her LPI admitted to the NICU,
http://jognn.awhonn.org
the mother’s nurse should encourage the mother to a. begin breast milk expression as soon as possible. b. begin expression after all medications are discontinued for the mother. c. wait to express until the mother is physically recovered from giving birth. 4. As described in this article, the World Health Organization (2001) recommends _____ breastfeeding for 6 months and ________ breastfeeding to at least one year of age. a. continued/exclusive b. exclusive/continued c. exclusive/exclusive 5. To support breastfeeding, NICUs should follow the Ten Steps to Successful Breastfeeding and implement the steps specific to the _____. a. LPI b. NICU c. very preterm infant 6. Alternative discharged recommendations are suggested for the LPI by Meier, Patel, Wright, et al., 2013 to support the difficulties often encountered with ________ the LPI. a. bottle feeding b. breastfeeding c. triple feeding 7. Following hospital discharge it is essential that breastfeeding LPIs receive follow-up care. Ahmed (2010) emphasized the importance of a follow-up visit with a pediatric care provider within ____ days of discharge. a. two b. four c. six 8. According to research by Hwang and colleagues (2013), LPIs are ____ likely to
C 2015 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
E1
IN FOCUS CNE POST TEST
Establishing Breastfeeding with the Late Preterm Infant in the NICU
initiate breastfeeding when compared to term infants. a. equally b. less c. more 9. Breastfeeding the LPI is often challenging, and the transition to exclusive direct breastfeeding may not occur during hospitalization for many. Follow-up support is critical to help mothers transition to exclusive direct breastfeeding. Lucas et al. (2014) found that the time to transition varies and an infant they followed took _____ to transition to exclusive direct breastfeeding. a. one month b. two months c. four months 10. Although its use is common in premature infants in the NICU, the impact of _______ on breastfeeding outcomes for LPIs is not known and needs further investigation. a. bottle feeding b. gavage feeding c. on demand feedings 11. A supportive practice for breastfeeding the LPI in the NICU includes
E2
JOGNN, 44, E1-E2; 2015. DOI: 10.1111/1552-6909.12537
a. frequent skin-to-skin contact b. increased maternal fluid intake c. intravenous fluids to prevent bottle feeding 12. It is important for health care providers to educate mothers on differences between feeding patterns and abilities of LPIs versus full term infants. Specifically, mothers should be taught that LPIs often have a ____________ that may affect milk transfer during breastfeeding. a. smaller tongue b. stronger suck c. weaker suck 13. Additional research is needed to examine the reason for breastfeeding cessation within the first ___________ of life. a. few days b. few weeks c. few months 14. The use of ________ needs further research regarding the benefits and its use in the LPI. a. maternal breast milk b. donor human milk c. formula
http://jognn.awhonn.org