Page 93 - MHF-FeedingMinds-final.indd

84 4.1 Milk Feeding
Example of a feeding session routine
Offer the first breast and allow the infant to feed 1.
for as long as he or she wishes, allowing the baby
to come off the breast when he or she has had
enough. Give the baby a cuddle, holding him or
her upright to wind. Next change the nappy and
then offer the second breast, allowing the baby
to feed for as long as he or she wishes and again
to come off this breast when he or she has had
enough or falls asleep.
By feeding correctly and on demand a good milk
supply should be ensured.
The frequency and length of breastfeeds will
vary from infant to infant and changes with age.
Some guidance is given in Table 4.1.1.
Positioning and Attachment
Positioning
The infant should be held close to the mother:
●● facing her and with the baby’s tummy towards her
●● with the baby’s back, shoulders and neck
supported
●● such that the baby can easily tilt his or her head
back and
●● the baby’s head is in line with his or her body so
that the neck is not twisted.
This can be achieved with the mother sitting or
lying. Some mothers like a pillow to support their
back and another on their lap to support the infant.
Following a caesarean section the underarm method
or ‘rugby ball hold’ may be more comfortable.
Table 4.1.1 Variability of frequency and length of breastfeeds
Age of baby Frequency of feeds
First 48 hours
From day 3 to 7 Infrequent and as few as 3 feeds in
first 24 hours
After 7 days
Increase in frequency on day 3 to
up to 12 feeds in 24 hours and then Still variable but each baby will begin
slowly decreasing in frequency
Variable between infants but most
feed about 6–8 times in 24 hours
Attaching onto the breast
The infant should be brought towards the breast
with his or her nose level with the mother’s
nipple, with the chin and lower lip reaching the
breast first.
2. As the infant comes close to the breast and
touches it, the mouth will gape open. This gape
can be encouraged by stroking the top lip.
3. The infant will usually tilt his or her head back
bringing the chin to the breast first. At the
height of the gape the infant’s mouth should be
brought onto the nipple and areola with as much
of the areola below the nipple being taken into
the mouth as possible.
4. There should be no rush to push the infant onto
the breast.
5. If the infant is correctly positioned it will not be
necessary to press the breast away from the
infant’s nose and the infant should be able to see
the mother’s face with his or her top eye.
6. When the infant has fed successfully he or she
will come off the breast spontaneously, leaving a
totally round, soft nipple.
Note: the photographs in the Department of
Health leaflet ‘Breastfeeding: Off to the best start’
illustrate good attachment (Department of Health
2007).
Indicators of good attachment
Good attachment is indicated if:
●● the infant’s mouth is wide open while feeding
●● the infant’s chin is touching the breast
Length of feeds
Variable
Very variable, both between babies and
from feed to feed
to develop an individual pattern over a
24-hour period