A nurse is providing individualized counseling to a mother who wants to breastfeed her infant.

The nurse teaches the mother how to position the infant for optimal attachment.

Which of the following statements by the mother indicates a need for further teaching?

Applying lanolin cream or hydrogel pads to the nipples after each feeding can help soothe and heal sore nipples that are cracked and bleeding.Lanolin cream is safe for the baby and does not need to be washed off before feeding.Hydrogel pads can also provide cooling relief and create a moist wound healing environment.

Choice B is wrong because washing the nipples with soap and water before and after each feeding can dry out and irritate the skin, making the problem worse.The nipples do not need to be washed more than once a day with plain water.

Choice C is wrong because switching to formula feeding until the nipples heal completely can interfere with the establishment of breastfeeding and reduce the milk supply.Formula feeding can also increase the risk of infections and allergies for the baby.Breastfeeding should be continued as much as possible, even with sore nipples, as long as the baby is latched on correctly.

Choice D is wrong because using a nipple shield or a breast pump for every feeding can also affect the milk supply and the baby’s ability to breastfeed effectively.Nipple shields and breast pumps should only be used temporarily and under the guidance of a lactation consultant.They do not address the underlying cause of sore nipples, which is usually a poor latch.

The woman’s pre-pregnancy BMI is a factor that the nurse should consider when evaluating the adequacy of the woman’s weight gain.

BMI is a measure of body fat calculated from weight and height.The amount of weight a woman should gain during pregnancy depends on her BMI before pregnancy.For example, a woman with a normal BMI (18.5-24.9) should gain 25-35 pounds, while a woman with an obese BMI (30 or more) should gain 11-20 pounds.

Choice B is wrong because the woman’s age and parity are not factors that affect the recommended weight gain during pregnancy.The weight gain recommendations are the same for all women regardless of their age or how many children they have had.

Choice C is wrong because the woman’s food preferences and cravings are not factors that determine the adequacy of the woman’s weight gain.Food preferences and cravings may influence what and how much a woman eats, but they do not change the amount of weight she should gain for a healthy pregnancy.

Choice D is wrong because the woman’s activity level and lifestyle are not factors that affect the recommended weight gain during pregnancy.Activity level and lifestyle may influence how a woman gains weight, but they do not change the amount of weight she should gain for a healthy pregnancy.Physical activity and healthy eating habits are important for all pregnant women to maintain their health and well-being.