A nurse is discussing the plan of care of a client who is 4 hr postoperative and has a urostomy with assistive personnel.

Which of the following statements should the nurse include in the discussion?

Having the baby latch on to both the nipple and areola during breastfeeding is essential for effective milk transfer and optimal breastfeeding. The baby should take in a good portion of the areola along with the nipple to ensure a proper latch and a comfortable feeding experience for both the mother and the baby. This allows the baby to obtain enough milk and stimulates milk production in the mother.

Let's briefly discuss the other statements:

A- "My baby should breastfeed 5 to 10 minutes on each breast": The duration of breastfeeding can vary from baby to baby, but it is generally recommended to allow the baby to breastfeed until they are satisfied and have emptied one breast before switching to the other breast. This ensures that the baby receives both the foremilk and the hindmilk, which are important for adequate nutrition.

B- "I should not wake my baby during the night to breastfeed": In the early days after birth, it is important to establish frequent and regular breastfeeding to support milk production and ensure the baby receives enough nourishment. Newborns typically need to breastfeed at least 8 to 12 times in 24 hours, including during the night. If the baby is sleeping for a long period, it may be necessary to wake them for feeding to ensure proper nutrition and hydration.

C- "I should keep my baby on a strict feeding schedule": Breastfeeding should be based on the baby's cues and demand rather than a strict schedule. Newborns should be breastfed whenever they show hunger signs, such as rooting, sucking motions, or increased alertness. This helps establish a good milk supply and allows the baby to feed according to their individual needs.

A.Securing the tubing to the child's abdomen helps prevent accidental dislodgement or pulling of the gastrostomy tube. This can be done using appropriate securing devices, such as adhesive dressings or commercially available tube holders, as recommended by the healthcare provider.

B.Some gastrostomy tubes require an extension set for feeding, especially low-profile devices (e.g., button-type gastrostomy tubes). This extension makes it easier to administer feeds or medications and can be removed afterward. However, this is not typically part of routine site care.

C.Applying lubricant to the site is not necessary or recommended. The gastrostomy tube should be kept clean and dry. If any secretions or debris are present, they should be gently cleaned with mild soap and water, followed by thorough rinsing and drying.

D.Taping the tube to the child's cheek is not a recommended practice. It can cause skin irritation, discomfort, or even accidental removal of the tube. Proper securing of the tube to the abdomen using appropriate devices is the preferred method to prevent dislodgement.