Lactation Care Plan (After Visit Summary)

Date: [date and time with time zone]

Visit type: [in-person / video / phone], [location]

Your care team: [provider name(s) and role(s)]

Questions? Call [daytime contact number]. After hours: [after-hours guidance]

Emergency: If you think this is an emergency, call 911.

(Use plain language, active voice, and "you/your baby" phrasing throughout. Put the most important information first. Keep bullets concise. Every time-dependent instruction must include an explicit timeframe. Omit any section labeled "include only if" when not applicable, and do not leave placeholder text behind. Keep total length to about one printed page.)

At a Glance

Today's focus:

• [Main issue 1]
• [Main issue 2] (Include only if discussed)
• [Main issue 3] (Include only if discussed; keep to max 3)

Your next steps: (List the top 3 actions with explicit timeframes; put the most important first)

• [Action 1 with timeframe, e.g., "for the next 48 hours"]
• [Action 2 with timeframe]
• [Action 3 with timeframe]

Watch for these warning signs:

• [Infant red flag 1] (Keep to top 1–2)
• [Infant red flag 2] (Include only if critical)
• [Parent red flag] (Include only if relevant)

Next appointment: [date/time and purpose] or [instruction to schedule within specific timeframe]

Current Status

• [Baby's age]
• [Today's weight and percent change from birth weight] (If not measured today, state "Weight not measured today" and note when/where it will be obtained)
• You reported [recent diaper count and stool pattern].
• You reported [parent symptoms affecting today's plan]. (Include only if they change today's plan)

Your Care Plan

Plan timeframe: For the next [timeframe], until [event/date].

Feeding

• Feed at least [number] times in 24 hours; do not go more than [hours] between feeds, day or night.
• [Essential positioning/latch instruction]. (Include only if essential to today's plan)
• During the feed, look for [signs of effective milk transfer].
• If latch is painful or shallow after [seconds], break suction and re-latch.
• Switch sides when [criterion] or after [minutes], whichever comes first. End when your baby shows [satiety cues].
• If your baby is too sleepy at a feeding time, try [waking strategies] for up to [minutes], then [next step].

Pumping/hand expression (Include only if baby is not transferring well, parent is supplementing, or supply protection is needed)

• Begin pumping/hand expression [start time].
• Pump/express [number] times per 24 hours for [minutes] per session. Do not exceed [hours] between sessions.
• Use [flange size] and gentle suction for comfort; avoid pain or nipple damage.
• [Tracking instruction] (Include only if requested)

Supplementation (Include only if using supplements now or if a contingency plan was agreed)

• Reason: [medical indication / parental choice].
• What to give: [expressed milk / donor milk / formula].
• How much: [volume range] per feed (based on baby's age).
• When/how: Give [after breastfeeding / at specific times] using [cup / syringe / bottle with paced technique].
• Pump or hand express each time your baby gets a supplement.
• Plan to reduce: [weaning plan with criteria]. Do not reduce below this plan without a weight or output check. Reassess on [date/time].

Breast or nipple care (Include only if pain, engorgement, redness, or mastitis risk was discussed)

• Do: [recommended actions, e.g., cool packs after feeds, analgesics as directed].
• Avoid: [contraindicated actions, e.g., aggressive massage, excessive heat].
• Call sooner if pain, redness, or fever worsen over [timeframe].

Milk storage (Include only if pumping or bottle-feeding expressed milk)

• Room temperature: up to 4 hours.
• Refrigerator: up to 4 days.
• Freezer: about 6 months.
• Label with date/time. Do not microwave. Thaw in the refrigerator or cool water.

Follow-up & When to Call

Your next appointments:

• Lactation follow-up: [scheduled date/time and purpose] or [instruction to call clinic to schedule within timeframe].
• Pediatric follow-up: [date/time and purpose].

Call us or your pediatrician today if your baby:

• Has fewer wet diapers than expected for age.
• Is too sleepy to feed or feeds poorly despite your efforts.
• Has worsening jaundice.
• Shows persistent poor feeding or vomiting.

Call us today if you:

• Have fever with worsening breast pain or redness.
• Are concerned about a breast abscess or rapidly increasing pain/swelling.

Go to urgent care or the ER now if:

• Your baby shows signs of severe dehydration (very few or no wet diapers, no tears, sunken soft spot), unusual sleepiness, breathing problems, or fever per your pediatrician's guidance.
• You have severe systemic illness or rapidly worsening breast symptoms.

Confirm your understanding: Before you leave, please tell us in your own words: (1) how often you will feed, (2) when you will supplement (if applicable), (3) when you will pump (if applicable), and (4) what would make you call us today.