Nutrition through the Life Cycle Case Study Davis Family Lactation
Case Study: The Davis Family Lactation – Nutrition through the Life Cycle
Brianna (29 years old) developed pre-eclampsia at 32 weeks gestation and the twins were delivered by Caesarean section. Ashley weighed 3 pounds 7 ounces; Jonathan weighed 3 pounds 1 ounce. Ashley stayed in the hospital 26 days and Jonathan stayed 35 days.
The infants displayed a feeble and uncoordinated suction reflex. Initially, Brianna resorted to expressing breast milk and transporting it to the specialized ward for premature newborns (NICU). However, by the third day after giving birth, Brianna encountered intense breast swelling. Additionally, she experienced notable discomfort in her nipples. To alleviate her distress, her healthcare practitioner recommended a prescription of 5/300 mg hydrocodone/acetaminophen.
Brianna’s breast milk underwent a combination with Human Milk Fortifier and was administered to the infants via a nasogastric tube. As the babies progressed and their strength increased, Brianna engaged in brief breastfeeding sessions multiple times a day. By the time the infants were discharged from the medical facility, they had developed the ability to latch onto the breast and consume an adequate amount of milk for their nourishment and development. Throughout this process, Brianna received invaluable assistance from the hospital’s dedicated lactation specialist.
Brianna and her husband Kevin, both engineers, have three more months of paid family medical leave.
Brianna is 67” tall and weighed 183 pounds prior to pregnancy. She gained 70 pounds during the pregnancy, bring her weight to 253 by the end of the pregnancy. Her current weight is 220. She knows she needs to get back to her prepregnancy weight because she has a family history of type 2 diabetes and a personal history of PCOS. Her blood pressure is elevated now and controlled with medication. Because Kevin will be home for three months, Brianna is hopeful to start exercising as soon as possible.
Upon arrival at home, the babies are sleeping 2-3 hours at a time. The babies have 6-8 wet diapers a day and 2-3 very loose stools – yellowish and seedy. The couple bought an excellent breast pump. They have worked out a feeding system. Brianna feeds each twin every other feeding session. While she feeds one twin on one breast, she connects the pump to the other breast. She refrigerates the milk for the next feeding and Kevin feeds the other twin from the bottle at each feeding session. Still, Brianna feels like all she does is nurse.
One week after bringing both babies home, Brianna receives a diagnosis of mastitis, prompting a seven-day antibiotic treatment. Following this, Brianna experiences a significant improvement in her condition. However, two weeks later, she notices a persistent red and tender area on her right breast, despite attempting warmth and gentle massage. Once again, she undergoes antibiotic therapy to address the inflammation.
After a two-week period, Brianna continues to endure persistent and uncomfortable burning pain in her nipple area. In response, she receives treatment with fluconazole to combat a yeast infection. Following a seven-day course of this medication, Brianna’s healthcare provider prescribes nystatin ointment to alleviate the discomfort in her nipples. In addition, the babies are prescribed an oral suspension to address the issue as well.
Following a three-week period, Brianna remains committed to treating her nipples with nystatin ointment, observing a gradual improvement in her pain. However, she experiences another bout of mastitis, which prompts her healthcare provider to prescribe a 10-day course of antibiotics to address the condition.
The babies are now 12 weeks old. Briana is producing about 64 ounces per day. The babies are sleeping about 6 hours at night. Brianna is ready to have a gin and tonic now and then after she puts them to bed at night. She is ready for some recreational weed occasionally. She decides to talk to the lactation consultant about that.
Brianna and Kevin will return to work in one more month. They decided to hire a nanny to care for the babies at home. They will bring in the nanny two weeks before returning to work. Brianna plans to start dieting for weight loss and resume her trips to the gym tomorrow. She is really worried about how she will manage breastfeeding and full time employment.
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