Mothers who receive emotional encouragement and informational support about the positive benefits to their health and the health of their child throughout their pregnancy are more likely to breastfeed after delivery and continue to breastfeed for at least 1 year following delivery. Support and advice are available during prenatal visits and from family and friends but involvement in breastfeeding classes or breastfeeding support group meetings can be very beneficial. Mothers often decide whether to breastfeed very early in their pregnancy. This is not a decision that is made at the end of the pregnancy. Healthcare providers play an essential role in this process. Information and support must be provided as soon as the mother to be is aware she is pregnant. Spousal support and workplace support are also essential.
From the moment of delivery contact between mother and the new infant must be supported if breastfeeding success is to be enhanced. This includes skin-to-skin contact between mother and infant immediately after birth and frequently thereafter. This contact has many physical and emotional benefits for both mother and child. Breastfeeding should be initiated within the first hour after delivery and Vitamin K injection and the application of topical eye ointment should be delayed until after the first breastfeeding.
During the first 48 hours following delivery rooming in should be encouraged and supported. This allows maternal-infant contact. Skin-to-skin contact should also continue to be encouraged and supported. There should not be time restrictions to breastfeeding. Breastfeeding should be frequent. Mother and staff must wake the infant if needed to allow breastfeeding 6 to 8 times on the first day and 8 or more times on the second day. Breastfeeding technique should be observed and close attention given to latch problems. Formula, water, glucose water, bottles and pacifiers should be discouraged. During the first two days of life the infant’s weight and elimination patterns should be closely monitored.
Breastfeeding success is often linked to an infant’s readiness to nurse, breastfeeding positioning and the infant’s ability to obtain an effective latch. Parents must be aware of cues from their new infant that indicate a readiness to breastfeed. These include sucking on the hand, rooting and smacking of the lips. Mothers must be comfortable with and in their surroundings. Due to body exposure during breastfeeding mothers often feel uncomfortable, anxious or hesitant. Privacy and a well supported chest to chest position between mother and infant are essential. During breastfeeding the goal is for the infant to achieve a wide open mouth position with the tongue down and the entire nipple and some of the areola in the infant’s mouth. While the infant is nursing the mother should look for rhythmic sucking movements and listen for audible throat clicks which indicate her infant is swallowing. As milk production increases this audible swallowing will increase. Initial breastfeeding during the first few days may cause some discomfort. Care must be taken to prevent pain from breast engorgement, an improper latch or skin irritation. Overall, breastfeeding should be pain free.