A case study of breastfeeding nursing for a parturient with inverted nipples based on evidence
一例基于循证的乳头凹陷产妇母乳喂养个案护理

摘要

总结1例两侧乳房不同程度凹陷患者的母乳喂养个案护理经验。护理要点：组建多学科团队照护模式；运用循证思维，使用高级健康评估方法评价产妇及新生儿健康状态以及产妇乳头凹陷程度；制订基于循证的全过程干预策略。孕晚期进行十字操练习，指导正确的乳房按摩方式、喂奶姿势；分娩后即刻EENC；产后指导挤奶以及乳头矫正器的应用；产妇产后第三天，右乳头纠正后与正常者无异，婴儿能含接，产妇哺乳能力良好，早吸吮效果好；左乳纠正无效，需要吸奶器挤奶，无堵奶发生，指导使用乳盾帮助婴儿含接。出院后当晚、1周、1个月、3个月持续随访跟进，无乳汁淤积、乳腺炎、乳腺脓肿发生，乳量逐渐上升达到供需平衡，婴儿生长发育正常水平，母乳喂养过程顺利，产妇身心舒适。

Abstract

Summarize the nursing experience of breastfeeding for a parturient with different degrees of inverted breasts on both sides. Key points of nursing: Establish a multidisciplinary team care model; Apply evidence-based thinking and use advanced health assessment methods to evaluate the health status of parturients and newborns and the degree of nipple inversion; Develop an evidence-based intervention strategy for the whole process. Cross exercises were performed in the third trimester to guide the correct breast massage method and feeding posture; EENC was performed immediately after delivery; milking and nipple corrector application were guided after delivery; On the third day after delivery, the parturient's right nipple was no different from that of a normal person after correction, the baby was able to latch, the parturient had good breastfeeding ability, and the early sucking effect was good; the correction of the left breast was ineffective, and a breast pump was needed to express milk, no milk blockage occurred, and the use of a breast shield was guided to help the baby latch. Follow-up was continued on the night, 1 week, 1 month, and 3 months after discharge. No milk stasis, mastitis, or breast abscess occurred. The milk volume gradually increased to a balance between supply and demand. The infant grew and developed normally. The breastfeeding process was smooth, and the mother was physically and mentally comfortable.