CORRECT BREASTFEEDING TECHNIQUES BABY
Category: Child Health
Abstract : correct breastfeeding positions and techniques Before the common
breastfeeding positions and techniques are reviewed, an understanding of the
importance of timing in initiating breastfeeding is essential. Studies show that
a woman's likelihood of continuing breastfeeding beyond the first month is
related to the initiation of breastfeeding immediately after
delivery. Oxytocin le
correct breastfeeding positions and techniques
Before the common
breastfeeding positions and techniques are reviewed, an understanding of the
importance of timing in initiating breastfeeding is essential. Studies show that
a woman's likelihood of continuing breastfeeding beyond the first month is
related to the initiation of breastfeeding immediately after
delivery.
Oxytocin levels at 15, 30, and 45 minutes after delivery are
elevated significantly, coinciding with the expulsion of the placenta. Studies
have linked maternal bonding and oxytocin levels. Therefore, encouraging the
mother to have contact with her infant at a time when suckling is paired with
high oxytocin levels and better letdown seems appropriate. In addition, the
infant is alert soon after delivery and has not entered the deep sleep period
that ensues approximately 6-12 hours after birth. Finally, personnel are more
available to assist the mother in initiating breastfeeding during this immediate
postpartum period.
Successful latch-on of the infant during this period
enhances a mother's confidence that she can breastfeed. If a mother received
narcotic analgesics during delivery, the infant may be sleepy and less able to
breastfeed; if so, the mother may need to wait until the infant is in a more
alert state. The use of relaxation techniques during labor and other forms of
anesthesia, such as epidural anesthesia, allows the infant to be delivered in a
more fully awake state. This early breastfeeding session typically helps instill
confidence in the mother. Any early problems can be identified, and the mother
can be offered assistance to facilitate the lactation
process.
Breastfeeding environment
The mother and infant should be
allowed to breastfeed in a relaxed and supportive environment. Personnel should
be readily available to facilitate the process. Constant interruptions and a
deluge of visitors may disrupt the early breastfeeding experience. The father's
assistance and support are strongly associated with the success of
breastfeeding. In a study of 224 mothers who were interviewed regarding their
feeding choice, the father was a key factor in the initiation of breastfeeding.
When the father supported breastfeeding, more than 75% of the mothers chose to
breastfeed; in contrast, when the father did not support breastfeeding, only 2%
of the mothers chose to breastfeed.
Often, the father can assist the
mother with the positioning of the infant, particularly if she is recovering
from a cesarean delivery. Thus, the father's approval and involvement in the
breastfeeding process is helpful in creating a supportive environment.
Grandparents who support breastfeeding also facilitate the process; however, if
they do not breastfeed, their attitude can adversely affect the breastfeeding
mother. Therefore, the mother who is breastfeeding and learning to know her
newborn should be surrounded by a supportive caring team of health care
providers and family members.
Positioning the infant
Positioning the
infant is one of the most fundamental components to successful breastfeeding. If
no maternal or neonatal contraindications (eg, low Apgar scores, known
tracheoesophageal fistula, heavily medicated mother) are present immediately
after birth, the mother should be helped into a comfortable position. This
position may be lying on her side on the hospital bed or sitting in a
comfortable chair. The most common position involves cradling the infant next to
the breast from which he or she will feed, with his or her head propped up by
the mother's arm. The infant should be placed with his or her stomach flat
against the mother's upper abdomen, in the same plane. Another holding position
is the football hold, in which the infant is cradled in the mother's arm with
his or her head in the mother's hand and the feet oriented toward the mother's
elbow. Mothers recovering from cesarean delivery may prefer this position
because less pressure is placed on her abdomen. The mother then presents her
breast to the infant, and the suckling process is initiated.
Presenting
the breast to the suckling infant
Two basic hand positions that the mother
typically uses are the palmar grasp or C-hold and the scissor grasp. With the
palmar grasp, the mother places her thumb above the areola, and she places her
remaining fingers under the breast to form a "C" or "V." The scissor grasp
involves the placement of her thumb and index finger above the areola with the
remaining 3 fingers below. The mother should ensure that the nipple is not
tipped upward when she presents it to the infant because improper latch-on and
nipple abrasion may result. In addition, the grasp should not impede the
infant's ability to place a sufficient amount of the areola into his or her
mouth, which is necessary for adequate latch-on and suckling.
Achieving
latch-on
Infants instinctually open their mouths wide when the nipple touches
their upper or lower lip. The tongue extends under the nipple, and the nipple is
drawn into the mouth, initiating the suckling reflex. The mother's nipple and
areolar should be maneuvered to the infant's open mouth instead of pushing the
infant's head toward the breast. Although this maneuver may appear simple, it
may seem impossible to a first-time mother. Care should be taken to assist the
mother not only with the positioning of her infant relative to her breast but
also with understanding the importance of putting the nipple and areola into the
infant's mouth when it is open. The suck-swallow pattern should be evaluated
while the infant is breastfeeding. Proper latch-on is evident by the infant's
suckling and then swallowing. One can hear an infant's feeding rhythm, which
produces a characteristic sound. During the early postpartum period, the mother
typically reports that she feels her uterus contracting while her infant is
breastfeeding.
Feedback from the mother during the breastfeeding process
Simply asking a mother if breastfeeding is going well is not enough. Many women
report that everything is fine, but when further questioned about nipple pain,
hearing the infant suckle, or the frequency of breastfeeding, problems often
surface. The best way to know if breastfeeding is going well is to observe the
mother-infant dyad. This observation allows the staff to assist the mother with
immediate feedback and corrective measures when necessary. The observation
checklist that Lawrence and Lawrence proposed in 1999 is adapted
below.
Key observation checkpoints of the breastfeeding mother-infant
dyad
• Observe the position of the mother, her body language, and her level
of tension. Offer pillows to support the mother's arm or the infant. Help
reposition the mother if necessary.
• Observe the position of the infant. The
mother and infant should be positioned ventral surface to ventral surface (ie,
stomach to stomach). The infant's lower arm, if not swaddled, should be around
the mother's thorax. The infant cannot swallow if he or she has to turn to face
the breast because the infant's grasp of the areola is poor in this position.
The infant's head should be in crook of the mother's arm and moved toward the
breast by the mother's arm movement.
• Observe the position of the mother's
hand on the breast and ensure that it is not impeding proper grasping by the
infant.
• Observe the position of the infant's lips on the areola. Typically,
the lips should be 1-1.5 inches (2.5-3.8 cm) beyond the base of the nipple.
•
Observe the lower lip. If folded in, suckling does not occur. The lips should be
flanged.
• Observe the presentation of breast to the infant and the mother's
assisting the infant to latch-on.
• Observe the response of the infant to
lower lip stimulus. The infant should open his or her mouth wide to allow the
insertion of the nipple and areola.
• Observe the motion of the masseter
muscle during suckling, and listen for sounds of swallowing.
• Observe the
mother's comfort level, and ensure that she is not having breast
pain.
One should reinforce a mother's own physiologic cues during
breastfeeding. A mother's letdown is the interplay of her physiologic response
to suckling and her emotional state. Prolactin, the hormone responsible for
letdown, is inhibited by stress (mediated by dopamine, norepinephrine, and
epinephrine). The mother's relaxation ensures adequate letdown and the continued
adequacy of breastfeeding.
Putting the infant to breast 8-12 times a day
during the first 4-5 days after birth ensures the creation of an adequate milk
supply, which the infant's use later regulates. A mother who responds to her
infant's cry with letdown and who breastfeeds her infant on demand (ie,
unrestricted breastfeeding) is more successful with continued lactation than the
mother who breastfeeds according to the clock. The recommendation for mothers to
use systematic or controlled timed feedings to help regulate the baby's cycles
is fraught with misinformation. A mother should be empowered to follow the
internal schedule that is appropriate for her and her baby.
Hit: 334 times
Related Articles in Child Health :
|
Advertise with Health Information Encyclopedia