children s health issues
Breastfeeding
Breastfeeding Procedure
To begin breastfeeding, the mother settles into a comfortable, relaxed position, either seated or lying almost flat. The mother should be able to comfortably turn from one side to the other to offer each breast. The baby faces the mother. The mother supports her breast with her thumb and index finger on top and other fingers below and brushes her nipple against the middle of the baby's lower lip, which stimulates the baby's mouth to open (the Three Common Reflexes of Newborns ) and grasp the breast. As the mother eases the nipple and areola into the baby's mouth, she makes sure the nipple is centered, which helps keep the nipple from becoming sore. Before removing the baby from the breast, the mother breaks the suction by inserting her finger into the baby's mouth and gently pressing the baby's chin down. Sore nipples result from poor positioning and are easier to prevent than to cure. The mother settles into a comfortable, relaxed position. She may sit or lie almost flat, and she may hold the baby in several different positions. A mother should find the position that works best for her and her baby. She may wish to alternate among different positions. A common position is holding the baby on the lap so that the baby is facing the mother, stomach to stomach. The mother supports the baby's neck and head with her left arm when the baby is feeding on the left breast and with her right arm when the baby is feeding on the right breast. The baby is brought to the level of the breast, not the breast to the baby. Support for the mother and the baby is important. Pillows can be placed behind the mother's back or under her arm. Placing her feet on a footstool or coffee table may help keep her from leaning over the baby. Leaning over may strain her back and result in a poor latch. A pillow or folded blanket may be placed under the baby for added support. Initially, the baby should feed for several minutes at each breast. The resulting reflex in the mother called the let-down reflex triggers milk production. The production of milk depends on sufficient suckling time, so feeding times should be long enough for milk production to be fully established. During the first few weeks, the baby should be encouraged to nurse on both breasts with each feeding. However, some babies fall asleep while feeding at the first breast. Burping the infant and switching to the other breast helps keep the infant awake. The breast used last should be used first for the next feeding. For a first baby, full milk production is usually established in 72 to 96 hours. For subsequent babies, milk production is established earlier. No more than 6 hours should elapse between feeding sessions during the first few days in order to stimulate breast milk production. Feeding should be on demand (the baby's, that is) rather than by the clock. Similarly, the length of each breastfeeding session should be adjusted to meet the baby's needs. Babies should be nursed on demand, which is typically 8 to 12 times in a 24-hour period, but this guideline varies widely. Mothers who work may breastfeed while at home and have the baby drink pumped breast milk from a bottle during the hours they are away. Pumped breast milk should be immediately refrigerated if it is to be used within 2 days and should be immediately frozen if it is to be used after 2 days. Refrigerated milk that is not used within 4 days should be thrown away because the risk of contamination by bacteria is high. Frozen milk should be thawed by placing it in warm water. Breast milk should not be heated in a microwave. 