Breastfeeding: AGuide for HealthcareProvidersCoffee Bourne UTSN
Your Words Carry Weight!• Patients who are deciding to breastfeed are open to suggestion about breastfeeding• Nurses are often the first people to talk to the patient about breastfeeding after the baby is born. Your encouragement could change the course of the baby’s life.
Changes in the Hospital• Due to the emphasis on breastfeeding in the new healthcare law, many hospitals are making changes to their policy and procedure.• Patients will be required to sign a consent to have formula given to their baby that outlines the risks involved• Emphasis on rate of exclusive breastfeeding by corporate entities running hospitals• Doctors will have to write an order for formula and show a medical reason the child needs supplementation• Desire to breastfeed will be documented in the mother’s medical record• Babies will be placed skin to skin with mother after delivery when possible as a priority• Breastfeeding assessments will be done after each shift
Supplementation• This may seem like a quick and simple fix for a fussy baby but it creates other problems.• Exposure to cow’s milk poses a risk of developing allergies, eczema, and asthma.• Flow rates differ between a mother’s nipple and a bottle. Often, when a baby drinks from a bottle, it does not understand that it needs to suck hard when it goes back to the breast.• Breastfeeding involves use of an undulating tongue action whereas a bottle will squeeze milk into baby’s mouth when bitten.
Sometimes it is hard to think of what to say when patients have questions about breastfeeding. Here are some common questions and good responses to promote breastfeeding.
Can you give my baby a bottle in the nursery? Myfriend said he’ll sleep through the night if he drinksformula. I am too tired and I need sleep.• Formula is much harder for baby to digest and absorb so it sits in his stomach longer. Your baby needs to eat more often when he is developing.• If I give baby a bottle it may cause nipple confusion. He may not want the breast because the nipple is softer and the milk does not flow as fast as the bottle.• Baby sleeps better when mom is nearby. It is a good idea for you to get used to his schedule before you go home in case you have any questions.• It is a good idea to try and sleep while baby is sleeping.• Why don’t I take the baby to the nursery and I will come in every three hours so you can feed him and then get back to sleep?
I won’t make milk, my mom didn’t make milkand our family just doesn’t make any milk.• Low milk supply does not run in families.• It is extremely rare that a mother is unable to produce enough milk to meet her infant’s needs.• Why don’t we wait and see? You can try breastfeeding in the hospital and if it works out you can continue at home. If not, you can always use formula.• The more you breastfeed, the more you will make.
Can you get some formula for my baby?I am not making any milk and she ishungry.• Why do you think you aren’t making milk? (Dispel false notions)• For the first 72 hours, your body makes a very rich form of breast milk called colostrum. A few drops of it can satiate baby’s appetite.• It may not look like there is a lot of milk coming out but baby’s stomach is only the size of a thimble (grape, teaspoon, shooter marble) right now.• Teach how to hand express• Soft breasts with colostrum make it easier for baby to learn how to breastfeed. This time is crucial.• Your milk is a process of supply and demand. The first few weeks are crucial in developing demand. If you give baby formula, you might not make enough milk to exclusively breastfeed later.
My nipples hurt. My baby cries allof the time and just wants to eat. Igive up. shouldn’t be painful, let’s look at the latch and• Breastfeeding see what we can do to make it more comfortable for you both.• Babies can’t tell you what they need so they cry for many different reasons. Try changing and burping baby. Often, they just need to be held.• Growth spurts happen around 7-10 days of age, 6 weeks, and 3 months. Your baby will want to eat constantly for a day or two. This is normal, your body will accommodate. You will get through it!
Baby is Crying: Help for Nurses• Get baby skin to skin with mom or dad• Let the baby suck on a finger or pacifier• Let the baby taste breast milk- it calms them• Provide motion- rocking, patting, bouncing• Swaddle baby• Check baby’s temperature• Stay calm and help calm the parents• Reduce stimulation (the TV, lights, etc.)• Burp baby. Bicycling baby’s legs can help him release gas.
References for Moms• Mom’s Place• La Leche League• WIC• Mother’s Milk Bank• Local Lactation Consultants• NIH Website
You have the power to make significant changes. Make yourself a breastfeeding expert and promote the health of tomorrow’s children.
References The American academy of pediatrics section on breastfeeding: Breastfeeding and the use of human milk. (2005). Pediatrics, 496-506. American College of Obstetricians and Gynecologists and Committees on Health Care for underserved women and obstetric practice (Breastfeeding: Maternal and Infant Aspects No. Clinical review). (2007). Retrieved from http://www.acog.org/departments/underserved/clinicalRe viewv12ils.pdf Breastfeeding. (2006). World Health Organization. Retrieved from http://whqlibdoc.who.int/publications/2006/924159084X_ eng.pdf HHS blueprint for action on breastfeeding. (2000). U.S. Department of Health and Human Services, 1-31. Lowdermilk, D. L., Perry, S. E., & Cashion, K. (2009). Maternity Nursing (8th ed.). Maryland Heights, MO : Mosby.