Recognizing and Treating Delayed or Failed Lactogenesis II

Authors and Disclosures

Nancy M. Hurst, RN, DSN, IBCLC, Texas Children's Hospital Lactation Program; Mother's Own Milk Bank, Houston, Texas; Baylor College of Medicine

Appendix: Clinical Lactation Assessment

Breast History (Check if applicable.)

A. Breast surgery: □ Yes □ No

If yes, what type?:  □ Biopsy □ Augmentation □ Reduction □ Radiation  □ Other________

Which breast was involved?: □ Both □ Left □ Right

Year of procedure:________

If augmentation, type of incision used:

□ Periareolar □ Submammary □ Axillary □ Transumbilical

If reduction, type of procedure used: □ Free nipple transplantation □ Pedicle technique

Loss of nipple sensation? □ Yes □ No

B. Did your breasts enlarge during puberty?: □ Yes □ No

C. Did your breasts change during this pregnancy?: □ Yes □ No

D. Have you breastfed before?: □ Yes □ No

If yes, how many times?_________

How long with each child?: _________

E. Did you supplement with formula?: □ Yes □ No

Reason(s) for supplementing: ____________

Breast Assessment

General breast shape:

□ Round, normal lower medial and lateral quadrants

□ Hypoplasia of the lower medial quadrant

□ Hypoplasia of the lower medial and lateral quadrants

□ Severe constrictions, minimal breast base

Breast symmetry: □ Symmetrical □ Noticeable asymmetry

Intramammary distance: □ < 1.5 inches □ ≥ 1.5 inches

Nipple type (appearance at rest): □ Everted □ Flat □ Inverted

Nipple protractility (movement with areolar compression): □ Evert □ Flatten □ Retract inward