Professional Documents
Culture Documents
North Carolina:
www.ncbfc.org
www.sph.unc.edu/breastfeeding
www.breastfeeding4health.com
Our Goal in Supporting Breastfeeding:
Healthy Mom, Healthy Newborn
• Evidence Base for Action
• Clinical Practice and Skills
• Achieving Change among All Staff
What to we wish to achieve?
• Homeostasis, and
• Avoidance of:
– Hypothermia
– Hypoglycemia
– Significant weight loss
– Hyperbilirubinemia
• Eventually, Growth and Development
When mom and baby achieve good EBF
feeding skills during the hospital stay,
we have succeeded
Correct sucking technique at discharge
100% Incorrect sucking technique at discharge
Percentage
50%
0%
EBF in hospital 1 month 2 months 3 months 4 months
Any breastfeeding
From: Righard L and Alade O. (1992) Sucking technique and its effect on success of breastfeeding Birth 19(4):185-189.
How do we achieve this?
• Frequent, effective breastfeeding
• Assessment - and support - through Observation
• Skills and Outcomes
1. Establishing Rapport
2. Comfort
3. Position
4. Latch
5. Effective Milk Transfer
6. Cue recognition
7. Hand expression
8. Frequency
Skills 1/2/3:
Rapport, Maternal Comfort, Positions
• Seek permission to observe and support
• Maternal Comfort
– suggest different positions
– use pillows or nursing stools only if positioning looks
uncomfortable or issues arise
• Position
– infant head, shoulders, and hips are in alignment
– infant faces the mother’s body. BELLY TO BELLY
– Infant brought to the breast, not the breast to the infant
– Avoid pushing the back of the infant’s head; the infant may
arch away from the breast
Cradle Hold and
Cross-Cradle Hold
INC OR R E C T
• Nipple protected by positioning far
back in infant’s mouth
• Breast tissue inferior to nipple
exposed to massaging action of
tongue and lower jaw.
20%
Incidence
15.2%
11.8%
10%
0.0%
0%
0-2 3-4 5-6 7-8 9-11
Frequency of breastfeeding/24 hours
From: Yamauchi Y and Yamanouchi I. Breast-feeding frequency during the first 24 hours after birth in
full-term neonates. Pediatrics, 1990, 86(2):171-175.
Next: Getting ready to “See one, do
In your team: one, teach one!”
• Consider which staff will be with the dyad at the time
when breastfeeding support is needed:
– Who is most likely to be with the mother at the time of the first
feeding?
– Who is most likely to be asked for support?
– List all the staff will need these skills
• Discuss the current level of each of these skills among
the staff
– 1) Rapport 2) Comfort 3) Position 4) Latch 5) Milk
Transfer 6) Cue recognition 7) Hand expression 8) Frequency
– Consider: What additional training is needed to ensure that all
staff in contact with the mother/baby dyad at these times can
carry out this basic support? Do we have staff skilled to do this
training? How soon can this be accomplished?
Reference