pediatrics
Breastfeeding
Breastfeeding Technique
The mother should use whatever comfortable, relaxed position works best and should support her breast with her hand to ensure that it is centered in the infant’s mouth, minimizing any soreness. The center of the infant’s lower lip should be stimulated with the nipple so that rooting occurs and the mouth opens wide. The infant should be encouraged to take in as much of the breast and areola as possible, placing the lips 2.5 to 4 cm from the base of the nipple. The infant’s tongue then compresses the nipple against the hard palate. Initially, it takes at least 2 minutes for the let-down reflex to occur. Volume of milk increases as the infant grows and stimulation from suckling increases. Feeding duration is usually determined by the infant. Some mothers require a breast pump to increase or maintain milk production; in most mothers, a total of 90 minutes/day of breast pumping divided into 6 to 8 sessions produces enough milk for an infant who is not directly breastfed. The infant should nurse on one breast until the breast softens and suckling slows or stops. The mother can then break suction with a finger before removing the infant from one breast and offering the infant the other breast. In the first days after birth, infants may nurse on only one side; then the mother should alternate sides with each feeding. If the infant tends to fall asleep before adequately nursing, the mother can remove the infant when suckling slows, burp the infant, and move the infant to the other side. This switch keeps the infant awake for feedings and stimulates milk production in both breasts. 2500 g may need to feed even more frequently to prevent hypoglycemia. In the first few days, neonates may need to be wakened and stimulated; small infants and Preterm Infants should not be allowed to sleep long periods at night. Large full-term infants who are feeding well (as evidenced by stooling pattern) can sleep longer. Eventually, a schedule that allows infants to sleep as long as possible at night is usually best for the infant and family. Mothers who work outside the home can pump breast milk to maintain milk production while they are separated from their infants. Frequency varies but should approximate the infant’s feeding schedule. Pumped breast milk should be immediately refrigerated if it is to be used within 48 hours and immediately frozen if it is to be used after 48 hours. Refrigerated milk that is not used within 96 hours should be discarded because risk of bacterial contamination is high. Frozen milk should be thawed by placing it in warm water; microwaving is not recommended. 