2. Purpose:
To promote the philosophy in maternal infant
care, which advocates breastfeeding and supports the normal
physiological functions, involved in the establishment of this
maternal infant process. To assist families choosing to
breastfeed with initiating and developing a successful and
satisfying experience.
3. Policy:
•New Life Center associates will base breastfeeding instruction on the
Academy of Breastfeeding Medicine Clinical Protocols, and the
International Lactation Consultant Association Clinical Guidelines
for the Establishment of Exclusive Breastfeeding as the primary
resources in order for mothers to receive consistent information (refer
to Appendices A and B).
•Initiate breastfeeding orders for all breastfeeding infants.
4. Procedure:
1. All NLC nursing associates will have knowledge in the current basic management
of lactation. Written protocols are located in the Lactation Office of the NLC.
2. Infants will be put to the breast as soon as possible following delivery (within 30
minutes to two hours after birth) unless contraindicated by the mother/baby
condition, or patient preference.
3. Breastfeeding mothers will receive a purple folder with Breastfeeding information
and a Breastfeeding Log. Instructions will be given to the patient regarding usage
of these.
4. Infants will be fed on demand (at least 8 or more times in 24 hours). Twenty-four
(24) hour rooming-in will be encouraged.
5. Breastfeeding and breast care instructions will be offered to all mothers on a
routine basis by NLC nursing associates. If possible, the mother and infant will be
seen and assessed by the Lactation Consultant during patient’s stay.
5. 6. No supplementary water or formula is to be given unless specifically ordered by
the physician or requested by the parent. If supplements are ordered, the infant
will be given the feeding method of the mother’s preference (refer to the ABM
Clinical Guidelines Protocol # 3 in Appendix A).
• The reason for giving a supplement will be documented in the nurse’s notes.
• The importance of exclusive breastfeeding will be addressed. A mother who
requests an artificial feeding will be given information regarding possible
impact on successful breastfeeding.
7. Mothers may breastfeed while taking prescribed customary postpartum
medications unless otherwise ordered by infant’s physician.
• For questions on medications and breastfeeding, refer to the reference book
“Medications and Mother’s Milk” (Hale, 2008).
• If the medication is categorized as a 3 or above in this book, the physician is
consulted regarding the appropriateness of the medication while
breastfeeding.
• If the mother/baby has/have a positive toxicology screen, refer to P/P
6600.0211: Breastfeeding and Substance Abusing Mother.
6. 8. Feedings will be assessed and evaluated by a NLC licensed nurse associate every
shift for comfortable positioning and active nutritive suckling at the breast. If
breastfeeding problems are assessed, the Lactation Consultant and/or NLC Nurse
will work with the patient/infant to facilitate effective breastfeeding.
9. If mother/infant separation occurs:
• Mothers will be instructed in proper breast care and on how to initiate
and/or maintain lactation.
• Mother’s milk expressed during the period of separation will be collected
and made available to the infant as soon after expression as is feasible.
Instruction on the use of a breast pump may be performed if necessary.
• If the breastmilk cannot be offered to the infant, it will be safely stored for
use at a later time (refer to P/P # 6600.0604 - Breastmilk Storage).
• Separated infants will receive their own mothers expressed breastmilk unless
alternate feeding orders have been written by the infant’s physician.
7. 10. Mothers are encouraged to nurse from one side well with infant self detaching and
contented, burp infant, and then offer the other breast if indicated. If unable to
nurse on both breasts, instruct mother to offer the next feeding using the unused
breast first.
11. No pacifiers are offered to breastfed infants in the NLC. Refer to Breastfeeding
orders.
12. Breastfeeding interactions with mother and infant are documented in the mother’s
and infant’s charts under the narrative.
13. The primary nurse will complete the Breastfeeding Checklist prior to discharge (see
Appendix C) and place it on the chart infant’s chart under education partition.
8. 14. A Breastfeeding Telephone Consult Sheet (Appendix E) is initiated by
the primary nurse, and is placed on the patient’s chart until discharge.
When the chart is broken down, this is placed on the Lactation
Consultant’s Desk for follow up.
15. At discharge, each Breastfeeding mother will receive the
Breastfeeding Discharge Instructions Sheets (refer to Appendix
D), and the Lactation Consultant’s contact card. At discharge, all
mothers are encouraged to follow up if necessary regarding
breastfeeding challenges by telephone or visit. A phone call (follow
up) by the LC or a Nurse will be attempted within a week of the
patient’s discharge.
