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Nipple Soreness in Lactation

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41. Oral Thrush - Guidelines for Prescribing Oral Nystatin

and adults: Swish and swallow 4 to 6 ml orally 4 times daily for 7 days minimum or 2 days after symptoms improve. May extend treatment to 14 days if needed. Infants: 1 or 2 ml 4 times daily - may use cotton swab or finger to apply. Pregnancy: Safe for use during all trimesters. Lactation: Compatible with breastfeeding. Poorly absorbed orally and does not enter breast milk. Directions for use: Adults and children: Swish, retain in mouth for as long as possible, up to a few minutes and swallow. Repeat (...) (e.g. chlorhexidine 0.12 % oral rinse) Burns will cause significant redness and swelling in the mouth, which should not be seen with oral thrush. Common in bottle-fed infants. causes chronic lesions seen mostly in smokers and males over 30. These are small, translucent white plaques, usually on the tongue. The plaques cannot be wiped off as easily as oral thrush. These lesions can be cancerous, so a biopsy is recommended if this condition is suspected. are one or more shallow, usually painful sores

2017 medSask

42. Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis

the placenta when administered systemically. The effects of topical fusidic acid have not been studied in pregnancy, although there are no reports of teratogenicity. Systemic agents (penicillins, cephalosporins, clindamycin and erythromycin) are indicated for folliculitis and furuncles, and are safe in pregnancy, so may be an appropriate alternative if non-pharmacolgic treatment does not suffice Lactation: Fusidic acid is excreted to a certain extent in breast milk. The effects of topical fusidic acid have (...) of impetigo Begins as a single, red sore which forms a blister When the blister breaks, a yellowish exudate dries to form a crust Areas affected are most commonly the face and extremities (arms, legs) Sores are not painful, but may be itchy Multiple lesions may form Minimal redness around lesion Fever is rare Lymph nodes may be tender More severe form of impetigo Presents initially as rapidly enlarging soft bullae with sharp margins Blisters do not have a red border, but surrounding skin may be reddened

2017 medSask

43. Supplementary Feedings in the Healthy Term Breastfed Neonate Full Text available with Trip Pro

., ankyloglossia) are more important. There is no evidence that limiting time at the breast will prevent sore nipples. The nipple should not be rubbed or compressed during breastfeeding even if the feedings are frequent or “clustered.” Problem with latch not addressed. Risk of decreasing breastfeeding duration or cessation of breastfeeding. Risk of breast engorgement. Table A1. Inappropriate Reasons for Supplementation in the Context of a Healthy Newborn and Mother, Responses, and Risks Appendix A2: Sample (...) ). • Complementary feedings: Solid or semisolid foods provided to an infant in addition to breastfeeding when breast milk alone is no longer sufficient to meet nutritional needs. • Term infant : In this protocol “term infant” also includes early-term infants (gestational age 37–38 6/7 weeks). Background Given early opportunities to breastfeed, breastfeeding assistance, and instruction the vast majority of mothers and infants will successfully establish breastfeeding. Although some infants may not successfully

2017 Academy of Breastfeeding Medicine

44. Newborn Nursing Care Pathway

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Behavioral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Crying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Infant Feeding Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Breast Milk Substitute – Formula Feeding . . . . . . . . . . . . . . . . . . . . 36 Health Follow-Up Health Follow-Up (...) /cfyt/dental_ care_children/tooth_decay.asp Variance • Refer to POS Intervention • Refer to POS and >24 – 72 hr Variance – thrush Candida (fungus) • White, cheesy patches on the tongue, gums or mucous membranes – won’t rub off • Diaper area – red rash Intervention – thrush Candida (fungus) • Discuss signs, symptoms & treatment • Assess mother’s nipples for thrush (red, itchy, persistent sore nipples, burning, shooting pain) • Both mother and baby need treatment • May affect baby’s feeding • If using

2015 British Columbia Perinatal Health Program

45. Acute pain management: scientific evidence (3rd Edition)

359 10.7.1 Peripheral nerve blocks 359 10.7.2 Central neural blockade 361 10.8 Acute pain in children with cancer 365 10.8.1 Cancer-related pain 365 10.8.2 Procedure-related pain 365 10.8.3 Treatment-related pain 366 References 367 Acute Pain Management: Scientific Evidence xvii CONTENTS 11. OTHER SPECIFIC PATIENT GROUPS 385 11.1 The pregnant patient 385 11.1.1 Management of acute pain during pregnancy 385 11.1.2 Management of pain during delivery 390 11.1.3 Pain management during lactation 394 (...) with spinal cord injury 248 9.2 Simple analgesics for the treatment of migraine 266 9.3 Table of triptans 267 9.4 Pooled effectiveness data from emergency department studies of the treatment of migraine 296 10.1 Acute pain intensity measurement tools — neonates 344 10.2 Composite scales for infants and children 345 10.3 Self-report tools for children 346 11.1 ADEC drug categorisation according to fetal risk 387 11.2 Categorisation of drugs used in pain management 388 11.3 The breastfeeding patient

2015 National Health and Medical Research Council

46. Corticosteroids - topical (skin), nose, and eyes

. The risk of systemic absorption can be minimized by using the weakest potency possible, for the shortest period of time. Only the lower potency topical corticosteroids (such as hydrocortisone and triamcinolone) should be used on the nipple or areola. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking. If the topical corticosteroid is applied to the breasts, it should be washed off before (...) breastfeeding to prevent the infant ingesting it. Basis for recommendation Basis for recommendation Pregnancy These recommendations are based on information published by the UK Teratology Information Service [ ], the textbook Drugs during pregnancy and lactation [ ], the British National Formulary [ ], and the Cochrane systematic review Safety of topical corticosteroids in pregnancy [ ]. A Cochrane systematic review identified two cohort studies and five case-control studies (with 659,675 participants

2018 NICE Clinical Knowledge Summaries

47. Mastitis and breast abscess

breast milk in the CKS topic on . If the affected breast is not completely empty after feeding, advise the woman to express the remaining milk (by hand or using a breast pump). If the woman does not wish to continue breastfeeding, give advice on . Identify and manage any for mastitis. For example: Advise the woman to rest and avoid wearing a bra, especially at night. If there is nipple soreness or damage, see the CKS topic on for detailed information on management. Prescribe an oral antibiotic (...) early cessation of breastfeeding. Inability to breastfeed in the future — future lactation may be compromised in up to 10% of women who have had a breast abscess. Diagnosis Diagnosis of mastitis When to suspect mastitis When should I suspect mastitis? Suspect mastitis in a woman who presents with: A painful breast. Fever and/or general malaise. A tender, red, swollen, and hard area of the breast, usually in a wedge-shaped distribution. Be aware that the symptoms and signs of non-lactational mastitis

2018 NICE Clinical Knowledge Summaries

48. Acute Pain Management: Scientific Evidence

Nonpharmacological therapies 484 References 485 10. OTHER SPECIFIC PATIENT GROUPS 515 10.1 The pregnant patient 515 10.1.1 Management of acute pain during pregnancy 515 10.1.2 Pain syndromes in pregnancy 517 10.1.3 Management of acute pain during labour and birth 522 10.1.4 Pain management during lactation 533 10.1.5 Pain in the puerperium 538 10.2 The older patient 540 10.2.1 Physiology and perception of pain 540 10.2.2 Assessment of pain 542 10.2.3 Pharmacokinetic and pharmacodynamic changes 544 10.2.4 Drugs (...) of observational pain assessment scales for intellectually disabled children 420 Table 9.5 Suggested paracetamol dosing for infants and children 422 Table 9.6 Block height following caudal injection in children using different formulae 454 Table 9.7 Incidence of adverse effects in large-scale audits of paediatric regional analgesia 460 Table 10.1 TGA medicine categorisation according to fetal risk 519 Table 10.2 Categorisation of medicines used in pain management 519 Table 10.3 The breastfeeding patient

2015 Clinical Practice Guidelines Portal

49. Management of Genital Herpes in Pregnancy

simplex PCR. ? A lumbar puncture is not necessary. ? Empirical treatment with intravenous aciclovir (20 mg/kg every 8 hours) should be initiated until evidence of active infection is ruled out. ? Strict infection control procedures should be put in place for both mother and baby. ? Breastfeeding is recommended unless the mother has herpetic lesions around the nipples. ? Parents should be warned to report any early signs of infection such as poor feeding, lethargy, fever or any suspicious lesions (...) management is recommended. ? Liaise with the neonatal team. ? Swabs from the neonate are not indicated. ? No active treatment is required for the baby. ? Normal postnatal care of the baby is advised with a neonatal examination at 24 hours of age, after which the baby can be discharged from the hospital if well and feeding is established. ? Parents should be educated regarding good hand hygiene and due care to reduce risk of postnatal infection. ? Parents should be advised to seek medical help

2014 Royal College of Obstetricians and Gynaecologists

50. Candida - oral

(burning and itching sensation); however, chronic forms may involve the oesophageal mucosa, leading to dysphagia and chest pains. It most commonly occurs in neonates, elderly people, people who are immunocompromised (especially people with AIDS, diabetes, cancer, or taking broad spectrum antibiotics), and people with xerostomia. Acute erythematous oral candidiasis (acute atrophic oral candidiasis) presents with marked soreness and erythema, particularly on the palate and dorsum of the tongue (...) . The filiform papillae disappear, and the dorsal surface of the tongue appears smooth. It is usually asymptomatic or is accompanied by a mild burning and itching sensation. It is the most common presentation in both immune depressed and immunocompetent people, and commonly occurs after treatment with oral antibiotics. Denture stomatitis (chronic erythematous candidiasis or chronic atrophic oral candidiasis) presents with redness, and rarely soreness, in the denture-bearing area. It affects about 50–70

2017 NICE Clinical Knowledge Summaries

51. The Effect of (Abstract)

The Effect of Nipple fissure is a common problem during breastfeeding. Zizyphus Jujube Fruits is one of the oldest medicinal plants which can heal wounds through its antimicrobial and anti-inflammatory properties. This study aimed to determine the effect of jujube lotion on the recovery of breast fissure. This double-blind clinical trial recruited 100 primiparous lactating women who were randomly divided into two groups. In Jujube group, mothers used 0.5 mL of Fruit Lotion, and in control group (...) mothers applied 4-5 drops of their breast milk five times a day, after breastfeeding. Both groups were examined on the 7th and 14th days after childbirth. The damage severity was assessed using the Amir scale and the presence or absence of nipple discharge was recorded. A significant difference was observed between the two groups in the extent of nipple damage before intervention on the 3rd day after childbirth and after intervention on the 7th and 14th days after childbirth (P = 0/02، P = 0/000

2018 Iranian journal of pharmaceutical research : IJPR Controlled trial quality: uncertain

52. Case Collection Study in the Evaluation of Doubling Time Rates in Non-Suspicious Breast Masses Using QT Ultrasound Technology

of breast cancer History of treated or untreated cancer of a non-breast origin which in the judgment of the Principal Investigator would be a concern for metastatic disease to the breast Physical inability to tolerate the QT scan, i.e. inability to lie prone and still for up to 30 minutes at a time Open wounds, sores or skin rash present on the breast(s) or nipple discharge from the scanned breast(s) Breasts too large for scanner, i.e. bra size larger than DDD or inability to successfully "fit" breast (...) an ultrasound-guided needle breast biopsy if performed after enrollment in the study Willing and able to provide Informed Consent prior to any research-related procedure(s) Have an identified solid non-suspicious breast mass Exclusion Criteria: Pregnancy Currently breastfeeding Magnetic material in the chest which in the judgement of the Principal Investigator would interfere or be impacted by the magnets utilized with the study device. Not willing to provide information for primary care physician History

2018 Clinical Trials

53. Mammary candidiasis: A medical condition without scientific evidence? Full Text available with Trip Pro

Mammary candidiasis: A medical condition without scientific evidence? Many physicians, midwives and lactation consultants still believe that yeasts (particularly Candida spp.) play an important role as an agent of nipple and breast pain despite the absolute absence of scientific proofs to establish such association. In this context, the objective of this study was to investigate the microorganisms involved in sore nipples and/or painful "shooting" breastfeeding by using a variety of microscopy (...) ". Nipple swabs and nipple biopsy samples were also collected from the participating women. Results showed that the role played by yeasts in breast and nipple pain is, if any, marginal. In contrast, our results strongly support that coagulase-negative staphylococci and streptococci (mainly from the mitis and salivarius groups) are the agents responsible for such cases. As a consequence, and following the recommendations of the US Library of Medicine for the nomenclature of infectious diseases, the term

2017 PLoS ONE

54. The Effect of Chinese Herbal Medicine for Reducing the Application of Antibiotics in the Treatment of Acute Mastitis

or developmental defects fail to breastfeed; Participants with other breast diseases are not appropriate to breastfeed; Participants with severe cognitive or metabolic diseases will affect breastfeeding; Participants who have been allergic to penicillin and cephalosporin. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer (...) : No Keywords provided by Xiaohua Pei, Beijing University of Chinese Medicine: Pugongying Herba Taraxaci Acute Mastitis Cefdinir Randomized controlled trial Postpartum Breastfeeding Lactation multicenter Chinese herb Traditional Chinese medicine Cephalosporin Antibiotics Additional relevant MeSH terms: Layout table for MeSH terms Mastitis Puerperal Disorders Pregnancy Complications Breast Diseases Skin Diseases Anti-Bacterial Agents Cefdinir Antibiotics, Antitubercular Anti-Infective Agents Antitubercular

2018 Clinical Trials

55. Mastitis

. The yeast connection: Is Candida linked to breastfeeding associ- ated pain? Am J Obstet Gynecol 2007;197:424.e1–e4. 40. Panjaitan M, Amir LH, Costa A-M, et al. Polymerase chain reaction in detection of Candida albicans for con?rmation of clinical diagnosis of nipple thrush. Breastfeed Med 2008;3:185–187. 41. Amir LH, Donath SM, Garland SM, et al. Does Candida and/or Staphylococcus play a role in nipple and breast pain in lactation? A cohort study in Melbourne, Australia. BMJ Open 2013;3:e002351. 42 (...) breastfeeding. J Hum Lact 2013;29:328–331. 13. Sachs HC; Committee on Drugs. The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics 2013;132:e796–e809. 14. Amir LH, Garland SM, Lumley J. A case-control study of mastitis: Nasal carriage of Staphylococcus aureus. BMC Fam Pract 2006;7:57. 15. Kvist LJ, Larsson BW, Hall-Lord ML, et al. The role of bacteria in lactational mastitis and some considerations of the use of antibiotic treatment. Int Breastfeed J 2008;3

2014 Academy of Breastfeeding Medicine

56. Guidelines for identification and management of substance use and substance use disorders in pregnancy

. Guidelines on HIV and Infant Feeding 2010 http://www.who.int/maternal_child_adolescent/documents/9789241599535/en/index.html Contains recommendations on postnatal care in HIV-positive women relevant to intravenous drug users. Acceptable Medical Reasons for Use of Breast-milk Substitutes http://whqlibdoc.who.int/hq/2009/WHO_FCH_CAH_09.01_eng.pdf Contains recommendations on circumstances when breastfeeding is not advised. * Although these guidelines were published in 2001, prior to establishment of current (...) -benefit analysis should be conducted for each woman. Conditional Very low ? Pregnant patients with opioid dependence should be advised to continue or commence opioid maintenance therapy with either methadone or buprenorphine. Strong Very low Breastfeeding with maternal alcohol and/or substance dependence ? A. Mothers with substance use disorders should be encouraged to breastfeed unless the risks clearly outweigh the benefits. B. Breastfeeding women using alcohol or drugs should be advised

2014 World Health Organisation Guidelines

57. HIV, viral hepatitis and STIs - a guide for primary care

and after delivery, and other interventions, such as caesarean section and avoidance of breast-feeding. 16 In Australia there have been 34,029 new diagnoses of HIV infection, with 10,872 cases of acquired immune deficiency syndrome (AIDS) to the end of 2012 and 6,852 AIDS-related deaths. 17 HBV Most HBV cases result from perinatal transmission, which accounts for high prevalence in people from endemic countries, particularly China and South East Asian and Pacific nations. Transmission is effectively (...) by the patient’s own fingers. 23 HSV-1 and HSV-2 Sexual transmission is a highly significant method of transmission of these viruses. 24 However, most people with oral and labial cold sores acquire infection with HSV-1 in childhood usually by being kissed on or near the mouth by family or relatives. When they grow up and become sexually active, they can pass HSV-1 on to various anatomical sites in one or other of their sexual partners by kissing or by oro-vulval, oro-penile or oro-anal sex. A significant

2014 Clinical Practice Guidelines Portal

58. Treatment and Recommendations for Homeless Patients with Chlamydial or Gonococcal Infections

is suspected. ? Prior STIs Ask about history of STIs in both male and female patients. ? Reproductive health Obtain gynecological history including best possible menstrual history for females. ? Readiness to change Assess patient's developmental level and readiness to change. ? Partner history Always ask whether partner needs to be treated. Physical Examination ? Preventive care For female patient, do breast exam with pelvic exam to address preventive as well as acute care needs. For male patient, include (...) presents for the first time at the clinic with complaint of cough, sore throat, and runny nose for three days. Review of symptoms: The patient reports a two-day history for cough, nasal discharge and pharyngitis. She denies fever, chills or rigors. On further history, the patient reports a “main concern” of malodorous, “green” vaginal discharge for the past week. She reports itching, redness and irritation around her introits. She denies abdominal pain, nausea, vomiting or diarrhea. Pertinent medical

2013 National Health Care for the Homeless Council

59. Common Breast Problems

as listed previously in the guideline can also be utilized. Persistent breast pain requires further evaluation (see breast pain). Nipple discharge. Nipple discharge is another common symptom in pregnancy and is often related to hormonal changes in preparation for lactation. Galactorrhea is the most common form of nipple discharge in pregnancy and can be managed conservatively. Galactorrhea that persists longer than 6-12 months following completion of pregnancy/lactation requires investigation for other (...) of Palpable Breast Masses. Am Fam Physician 2005;71:1731-38. Overview and recommendations for evaluation of breast masses, including summary of the strength of the evidence behind the recommendations. Jardines L. Management of nipple discharge. Am Surg, 1996; 62(2:119-122. Recommendations for evaluation and management of nipple discharge. Sabate, J, et al. Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics 2007;27:S101-124. 12 UMHS Breast Problems Guideline, June

2013 University of Michigan Health System

60. Case Collection Study to Determine the Accuracy, Call Back and Cancer Detection Rates of QT Ultrasound in Breast Imaging

Oblique (MLO) views - for one or both breasts, within 3 months, before or after, their QT scan. Cohort C 1. Willing and able to submit available breast imaging - for one or both breasts, before or after, their QT scan. EXCLUSION CRITERIA All Subjects Pregnancy Currently breastfeeding Allergies to device materials Physical inability to tolerate the procedure on the scanner, i.e. inability to lie prone and still for up to 30 minutes at a time Open wounds, sores or skin rash present on the breast(s (...) prone on a table, the breast is submerged in a warm water bath. The transmitter and receiver assembly moves around the suspended breast to record data for successive sub-volumes of targeted tissue. More than 2000 elements in the curvilinear transducer's array encircle the breast to gather data from the tissue structures of the breast, from nipple to chest wall. Information gathered from this automated QT scan encompasses the entire breast which is currently not commercially available using any other

2017 Clinical Trials

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