Evaluating Initial Breastfeedings
Feedings
- Watch baby for light sleep cues: eye movement under closed lids, finger sucking, noises, movement
- Wake infant every 2 ½ -3 hours during the day; every 3-4 hours at night for the first two weeks- baby may be sleepy initially so encourage arousal by changing diaper, washing face, tickling feet, rubbing back
- 8-12 feedings per day lasting 15-20 minutes per breast initiate good milk production, reduce jaundice and prevent low blood sugar
Proper Positioning
- Mother should be comfortable in arm chair with knees higher than hips using a foot stool
- Baby supported on pillows with body tummy to tummy at breast level
- Alternate positions to reduce stress on same area
Proper Latch
- Stroke/tickle baby’s lips with nipple or finger to stimulate rooting reflex and open mouth
- When mouth is open wide quickly pull baby onto areola and nipple with a rapid arm movement
- Baby’s nose and chin should touch breast
- Do NOT use finger to make an air passage which pulls nipple out of infant’s mouth
- Lips should be flanged with Pac-man like mouth
Effective sucking
- Mother should feel nipple tugging-no pain
- Round full cheeks with rhythmic jaw movement and swallowing
- Rhythmic sucking with brief pauses
Let Down
- Mother may feel sleepy, thirsty, and may have uterine cramping
- May feel tingling sensation or notice milk dripping from other breast
- After milk supply is well established in 3-5 days will notice breasts are softer after nursing
How to Know if Baby is Getting Enough to Eat
- Baby should feed 15-20 minutes per breast at each feeding
- Should hear baby swallowing
- Baby is satisfied after feeding for 1-3 hours
- Inside of mouth is moist
Output
- During colostrum stage baby will have 1-2 wet diapers of pale yellow urine
- After 48-72 hours when milk transitions, baby will have 6-8 soggy pale yellow wet diapers
- Stools will change from black to green to seedy yellow mustard color
- May have 3-8 stools per day varying in size to accumulate to be palm size amount in a 24 hr. period
Weight gain
- Initially infant may lose up 7 to 10 percent of birth weight the first few days
- Should be back to original birth weight by two week check up
