COUNSELING THE BREASTFEEDING MOTHER
Category: Child Health
Abstract : Counseling the Breastfeeding Mother In the time before managed care and
"drive-through" deliveries, the vast majority of newborns remained in the
hospital for several days after birth and were typically examined by their
physician when they were aged 2 weeks. In theory, this longer hospitalization
allowed ample time to ensure that the baby was receiving adequate nutrition and
had demo
Counseling the Breastfeeding Mother
In the time before managed care and
"drive-through" deliveries, the vast majority of newborns remained in the
hospital for several days after birth and were typically examined by their
physician when they were aged 2 weeks.
In theory, this longer hospitalization
allowed ample time to ensure that the baby was receiving adequate nutrition and
had demonstrated the ability to appropriately latch on and suckle at the breast
once the mother's milk became available. In addition, the longer stays gave the
staff more opportunities to reassure the mother, answer her questions, and
provide her with support and encouragement.
However, rates of
breastfeeding in the United States declined during the periods of prolonged
postpartum recuperation, with the lowest rates occurring in the 1950s. Reports
of breastfeeding infants who were failing to thrive decreased, but at the same
time fewer infants were being breastfed. Women who continued to breastfeed
received supportive breastfeeding care from a variety of sources, including
their social network. With the recent reemergence of breast milk as the ideal
source of infant nutrition, more women are choosing to breastfeed.
Women
were once supported by others with personal knowledge about breastfeeding;
however, this has been replaced with generations of women and men who are
experts about formula feeding. Lack of community knowledge about breastfeeding
and shorter hospital stays have led to more breastfeeding failures. Because
women and their infants are now being discharged earlier, it is essential that
the tradition of the first follow-up at age 2 weeks be replaced with earlier
more carefully planned assessments of the breastfeeding mother-infant dyad. Such
early follow-up makes lactation success more likely and leads to a healthier
infant.
Careful follow-up depends on the health care provider's knowledge
of the mechanics of breastfeeding, the evaluation of successful lactation, and
the interventions required if difficulties develop.
This article reviews
the mechanics of breastfeeding, correct breastfeeding techniques, and sufficient
versus insufficient milk supplies. A discussion of early follow-up of the
breastfeeding mother-infant dyad and the warning signs of difficulties in that
dyad are also included. Emphasis is placed on assessing the breastfeeding
neonate and determining when neonatal jaundice is pathologic. Finally, common
breastfeeding problems are discussed, with emphasis on their early recognition
and management.
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