Pumping/Hand Expression Teaching Note

Date/Time: [Date and time of teaching session]

Clinician/Credentials: [Clinician name and credentials]

Setting: [inpatient / outpatient clinic / home / telehealth / other: ______]

Learners Present: [Names and roles of learners present]

Interpreter: [language and modality / No interpreter used/required]

Reason for Teaching: [Stated reason for teaching]

Indication and Context

[Clinical indication for lactation skill-teaching] (Clearly state why teaching was provided, such as infant feeding difficulty, separation, supplementation plan, engorgement relief, return to work, or exclusive pumping plan. Document only what is known; do not list unknowns.)

[Patient's stated feeding goal in their own words] (Use quotation marks if a direct statement is available. Do not infer goals from general statements. Omit if no goal was stated.)

[Brief relevant context affecting the teaching plan] (Include only elements that change the approach: postpartum day or lactation stage, pertinent infant factors, pertinent maternal factors, current feeding and expression pattern. Omit if context does not inform teaching decisions.)

Teaching Provided

(Document only the modalities actually taught during this encounter. Omit any modality not addressed.)

Hand Expression: (Only include if taught during this encounter.)

[Technique elements reviewed and observations from practice] (Summarize key techniques covered, collection method if addressed, and observations during practice including ease of expression and adjustments made. Note return demonstration: yes/no/partial, and teach-back results: what the patient articulated about steps and goals. If patient declined or could not complete practice, document the barrier and what was accomplished.)

Pumping: (Only include if taught during this encounter.)

[Setup, equipment, and session structure reviewed] (Include pump type if stated, assembly, and session workflow covered.)

[Flange assessment] (Document flange/shield type and size used, L/R if different. Describe observed fit during active suction: nipple movement, areolar draw-in, pain or blanching. Do not document "correct fit" unless visually assessed during pumping.)

[Pump settings and output] (Record device suction level(s) used and whether at maximum comfortable. Include session output and L/R differences if measured.)

[Verification] (Note return demonstration: yes/no/partial, and teach-back results: what the patient articulated about setup, fit, settings, and equipment care. If patient declined or could not complete practice, document the barrier and what was accomplished.)

Plan

(Align recommendations with the clinical goal. If context is incomplete, provide a conservative default and note the plan will be refined.)

Expression schedule: [# sessions per 24 hours] for [establish supply / maintain supply / symptom relief]; maximum overnight interval [hours] if indicated; typical session duration [minutes] if guidance provided

Milk handling and storage: (Only include if milk is being saved.) [Guidance reviewed: labeling, storage location, thawing/warming, transport as applicable]

Pump cleaning: (Only include if pump is used.) [Cleaning steps reviewed] (Note if daily sanitizing emphasized for premature or immunocompromised infant.)

Troubleshooting and safety: [Tailored troubleshooting for anticipated issues] Urgent return precautions reviewed: [precautions discussed in plain language, such as fever with breast redness, rapidly worsening pain, signs of abscess, inability to express with worsening engorgement]

Response and Follow-up

Patient response: [Engagement, fatigue, readiness to practice]

Comprehension verification: [What the patient articulated or demonstrated; observed competence level]

Barriers and supports: [Identified barriers such as anxiety, pump access, time constraints, need for partner assistance] [Identified supports and resources]

Agreed next steps: [Specific actions the patient will take]

Materials/supplies provided: [Titles or categories] (Omit if none provided.)

Referrals: [Service and reason] (Omit if none placed.)

Follow-up: [Timing and modality] (If no follow-up scheduled, document that patient was instructed to contact appropriate service as needed.)