Trends in umbilical cord care: Scientific evidence for practice

To provide an increasing body of knowledge related to umbilical cord care, a literature review was conducted to study the evolution of umbilical cord care, to evaluate the scientific evidence used to guide practice changes, and to make recommendations for current practice. Historically, there has been a wide range of inconsistent practices related to umbilical cord care that have included a variety of cleansing agents and techniques. The findings of this literature review indicate that the current standard of umbilical cord care may be based on historic practices and traditions rather than scientific investigation and justification. There appears to be little support for continued alcohol use. Yet, insufficient evidence is available to support an immediate change in the standard of care from topical antimicrobial treatment of the umbilical cord to natural healing. Further research is recommended to evaluate natural healing and to establish evidence-based recommendations for practice.     

Breastfeeding and Maternal Medication Use

Drug therapy during lactation requires recognition of several elements, including drug properties, the status of the infant, the mother's milk production, and what is known about particular drugs. It is important to consider the various properties of a drug when evaluating its possible effects in the breastfeeding infant. In addition, the volume of milk the infant receives and its composition can influence exposure levels. Other factors of importance include the infant's age, frequency of feedings, recommended drug dosage, and whether the drug is short- or long-acting. Suggestions are offered for appropriate drug therapy when the mother is breastfeeding, including the safety of drugs commonly administered during lactation and questions to ask when a mother seeks assistance about suggested medication use.     

Midwifery management of breastfeeding: using the evidence

Strong evidence supports breastfeeding as the appropriate health choice for both mothers and infants. However, the mechanics of breastfeeding are frequently less well understood. This review of both the research and clinical evidence regarding appropriate breastfeeding management is designed to aid the midwife and other health care professionals in providing care and teaching, which will optimize maternal and infant health.     

Swimming Upstream: Breastfeeding Care in a Nonbreastfeedtng Culture

Women once gave birth and began breastfeeding within the cultural context of a traditional system of care; now they begin breastfeeding in a hospital. Historically, hospital care was arranged to fit artificial feeding. Little was known about the science of breastfeeding until recently. Basing our breastfeeding care on the cultural norm of bottle feeding has led to the development of many unfavorable attitudes and practices. Given an opportunity to learn how breastfeeding works and to improve our breastfeeding care skills, hospital nurses can play an important part in current efforts to make breastfeeding the community norm.