Get Breastfeeding Assessment And Counseling Form

Completing the Breastfeeding Assessment And Counseling Form online can facilitate effective communication between counselors and users. This guide will help you understand each section of the form and provide clear instructions to ensure an accurate submission.

Follow the steps to fill out the Breastfeeding Assessment And Counseling Form online.

1. Press the ‘Get Form’ button to obtain the document and open it in your preferred online editor.
2. Begin with the Counselor Information section. Input your full name, clinic site or facility where the consultation is taking place, and the date of the consultation. Choose the type of consultation (in person or by telephone) and preferred language from the provided options.
3. Fill in the Mother Information section. Provide the mother’s name, date of delivery, and the delivery hospital. Include the date of birth, preferred phone number, and any alternate contact information.
4. Complete the method of delivery field by selecting vaginal or cesarean section. Indicate whether the delivery was medicated, and share the number of previous children, including how many were breastfed.
5. Address the returning to work/school section. Indicate the date of return and specify the hours of separation between the mother and infant, including travel time. Clarify the supportive employer status and whether there are accessible places for milk storage.
6. For the infant information, enter the infant's name, sex, gestation weeks, date of birth, and birth weight. Count how many times the baby nurses in 24 hours, note the baby's length, and specify who typically ends feeding.
7. Categorize the baby’s level of alertness using the provided options. Take notes on feeding behavior, position, and latch, assessing various indicators of successful breastfeeding.
8. Next, complete the Infant Weight Assessment section by recording the initial weight and post-weight of the infant, indicating whether the measurements were taken clothed, unclothed, or with only a diaper.
9. Fill in the Supplies Provided section, choosing the items and reasons for issuance. This may include breast pump types and sizes.
10. Finally, complete the Referrals section and include any follow-up needs. Make sure to include the participant's and counselor's signatures along with the corresponding dates.
11. Once all fields are completed, ensure to save the changes. You may then download, print, or share the completed Breastfeeding Assessment and Counseling Form as needed.

Start completing your Breastfeeding Assessment And Counseling Form online today to facilitate better support for breastfeeding mothers and their infants.