Breastfeeding Telephone Triage and Advice

Maya Bunik, MD, MSPH, FABM, FAAP, is an associate professor of pediatrics at the University of Colorado Denver and medical director of the primary care teaching clinic at Children's Hospital Colorado. As a practicing pediatrician, she has been helping mother-baby pairs with breastfeeding for more than 15 years. Her experience also includes serving as director of the Pediatric Advice Line Call Center at Children's Hospital Oakland.

Triage Assessment Questions
A
Alcohol Use
Allergy
B
Biting Breast, Onset at 6 Months
Breast Mass
Breast Pain
Breast Pain, Chronic >1 Week
Breastfeeding in the First Few Weeks: Simplify Your Life (Advice Only)
Breastfeeding Station Supplies (Advice Only)
C
Child Care and Breastfeeding (Advice Only)
Clicking or Noisy Nursing
Color Change of Human Milk
Constipation in the Breastfed Baby
Contraception, Lactation Amenorrhea Method (Advice Only)
Cosleeping/Bed-Sharing and Breastfeeding (Advice Only)
D
Distraction, Onset at 4 Months
E
Early Weight Loss, Birth Hospital or First Week
Emotional Symptoms With Letdown
Engorgement
Environmental Exposures and Toxins
Exclusive Pumping
Expression of Human Milk: Pumping, Parts and Cleaning Equipment, Hand Expression(Advice Only)
F
Fathers (Advice Only)
Feeding More Frequently
Feeding the Baby With Cleft Lip or Palate
Feeding the Baby With Hypotonia
Feeding the Baby With Trisomy 21 (Down Syndrome)
Fortification of Human Milk Recipes (Advice Only)
Fussiness, Colic, and Crying in the Breastfed Baby
G
Gassiness in the Breastfed Baby
I
Itching of the Breast/Nipple Area
J
Jaundice, Newborn
L
Late Preterm Newborn
Lifestyle or Personal Care Questions (Advice Only)
Long-term Breastfeeding (Advice Only)
Low Milk Supply
Low Milk Supply in Older Baby >6 Months
M
Marijuana Use
Maternal Anesthesia/Analgesia (Advice Only)
Maternal Contraindications/Causes for Concern With Breastfeeding (Advice Only)
Maternal Illnesses (Advice Only)
Maternal Ingestion of Foods and Herbs (Advice Only)
Maternal Medications (Advice Only)
Maternal Methicillin-Resistant Staphylococcus Aureus
Maternal Postpartum Depression
Maternal Postpartum Vaginal Bleeding
Maternal Smoking and Cessation
Milk Leaking From Newborn's Breasts (Galactorrhea)
Milk Storage and Return to Work/School
Mistaken Milk Ingestion, Milk Sharing
Multiples (Advice Only)
N
Newborn Contraindications to Breastfeeding (Advice Only)
Nipple Abnormality: Flat/Short, Inverted, Large, or Bulbous
No Latch or Inability to Latch
Nursing Strike or Refusal
Nursing With Pregnancy
O
Overactive Letdown/Overabundant Milk Supply
P
Pacifiers and Slow-Flow Nipples (Advice Only)
R
Referral to Local Resources (Advice Only)
Refusing Bottle, Preferring to Nurse
S
Sleepy Newborn
Sore Nipples
Spitting Up (Reflux)
Substances of Abuse (Illicit Drugs)
T
Tandem Nursing
Taste Change of Human Milk
Tongue-tie
V
Vitamin D Supplementation
W
Weaning
Appendixes
Appendix A. Breastfeeding Touch Points for Overcoming Obstacles to Exclusivity
Appendix B. Quick Reference for Pain With Breastfeeding
References for All Protocols