Helping with a Breastfeed-Step 5Helping with a Breastfeed-Step 5

Objectives

Getting breastfeeding correct from the beginning is crucial to long-term breastfeeding success!

Getting breastfeeding correct from the beginning is crucial to long-term breastfeeding success!

Infant Feeding CuesInfant Feeding CuesAll infants exhibit feeding cues which mothers can be taught to recognize.

Early feeding cues are subtle and include

Bringing hands to mouth or cheek and trying to suck on them

Rooting

Lip smacking, mouthing, tongue protrusion

CryingCrying

Crying is a late feeding cue.

When crying is seen, earlier feeding cues have been missed.

It is much more difficult to feed an infant who is crying.

Recognizing Correct Latch-OnRecognizing Correct Latch-On

Correct latch involves three aspects:

1. Baby’s body positionVentral surface of infant to ventral surface of mother

Baby’s lower arm around mother’s trunk or hugging the breast

Baby’s head should not be turned away from the breast, but looking at the breast.

Never push the baby toward the breast.

Correct Latch-On IICorrect Latch-On II

Correct Latch-On IIICorrect Latch-On III

Suckling Behavior at the BreastSuckling Behavior at the Breast

Average newborn swallow is 0.6 ml at the breast.

Stomach size is very small. Parents and health care providers should have realistic expectations regarding the volume the newborn stomach can hold at each feed.

With time, the amount of milk per suck increases.

Changes in suck-swallow ratios relate to availability of milk via flow

SucklingSucklingThe nipple should not move in and out of the baby’s mouth during suckling.

The mother of an infant with poor suck may be advised to hand express or pump for extra stimulation to increase milk production.

Potential Problems Associated with Incorrect Latch-On

Potential Problems Associated with Incorrect Latch-On

Babies not suckling well at discharge are less likely to continue breastfeeding long-term.

Engorgement and poor milk supply may result from inadequate breast emptying due to incorrect latch-on.

Nipple damage may result from incorrect latch-on.

Potential Problems IIPotential Problems IILengthy feedings caused by poor milk transfer may leave mother with sense of inadequacy and failure and/or a desire to discontinue breastfeeding.

An association has been found between the use of analgesia/anesthesia and delay of effective sucking.

Birth Routines Associated with Correct Latch-On

Birth Routines Associated with Correct Latch-OnUninterrupted skin-to-skin after birth

Breastfeeding within the first hour of life

Rooming-in 24 hours a day with minimal separation during stay

Knowledgeable observation of feedings with guidance for correct positioning and latch-on

Frequent nursing “on cue”