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    Basic Breastfeeding Assessment

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    Neeta Bhide
    This document provides guidance on how to perform a basic breastfeeding assessment. It outlines the key steps which include observing positioning, the latch-on, and milk transfer. Correct and incorrect latch positioning are illustrated. Next steps are suggested if issues are identified.

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    Basic Breastfeeding Assessment

    Uploaded by

    Neeta Bhide
    133 views15 pages
    This document provides guidance on how to perform a basic breastfeeding assessment. It outlines the key steps which include observing positioning, the latch-on, and milk transfer. Correct and incorrect latch positioning are illustrated. Next steps are suggested if issues are identified.

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    © Attribution Non-Commercial (BY-NC)

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    This document provides guidance on how to perform a basic breastfeeding assessment. It outlines the key steps which include observing positioning, the latch-on, and milk transfer. Correct and incorrect latch positioning are illustrated. Next steps are suggested if issues are identified.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    133 views15 pages

    Basic Breastfeeding Assessment

    Uploaded by

    Neeta Bhide
    This document provides guidance on how to perform a basic breastfeeding assessment. It outlines the key steps which include observing positioning, the latch-on, and milk transfer. Correct and incorrect latch positioning are illustrated. Next steps are suggested if issues are identified.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 15

    Basic Breastfeeding Assessment

    Breastfeeding Residency Curriculum


    Prepared with information from the

    AAP/ACOG Breastfeeding Handbook for Physicians

    Breastfeeding Assessment
    Determine if there is a basic problem with breastfeeding by observing the mother breastfeeding the baby Tell the mother that you would like to observe how the baby is feeding Helpful approach for pediatricians not comfortable with examining breasts Makes the mother feel less self-conscious (you are assessing how the baby feeds, not how the mother feeds the baby)

    Step 1 - Positioning
    Watch how the mother positions the baby for feeding and look for:

    Maternal Comfort suggest different positions, pillows, or nursing stools if positioning looks uncomfortable
    How the infant is positioned the head, shoulders, and hips are in alignment and the infant faces the mothers body. The head should not be turned to the side Infant brought to the breast, not the breast to the infant Pushing on the back of the infants head This should be avoided. It may cause the infant to arch away from the breast

    Cradle Hold

    Cross-cradle Hold

    Photo Joan Meek, MD, FAAP

    Side-lying Hold

    Photo Roni M. Chastain, RN

    Football Hold

    Photo Lori Feldman-Winter, MD, MPH, FAAP

    Step 2 Latch-on
    Watch how the baby is latched to the breast and look for: Use of the C-hold to make a sandwich for the baby to latch on
    4 fingers underneath and thumb on top of the breast Mothers fingers should be parallel to the infants jaw and well behind the areola

    Acknowledgement of the rooting reflex


    Middle of infants lip stroked with nipple Infant opens his mouth wide Mother quickly draws the infant to her breast Infant takes in an adequate amount of the breast, not just nipple

    Step 2 Latch-on (contd)


    Areola grasp
    Infant grasps the entire nipple and as much of the areola as possible The nose and chin of the infant will touch the breast Lips will be flanged out

    Mothers comfort
    Gentle undulating motion No pain with each suck

    Proper release if infant does not release on his own


    Mother inserts finger gently in corner of infants mouth to release suction

    CORRECT

    Proper Latch

    INCORRECT

    Nipple protected by positioning far back in infants mouth Breast tissue inferior to nipple exposed to massaging action of tongue and lower jaw.
    Photos Jane Morton, MD, FAAP

    Signs of Incorrect Latch


    Immediate signs Infants cheeks indenting during suckling, clicking noises, lips curled inward Frequent movement of the infants head and lack of swallowing sounds Maternal pain and discomfort Later signs Trauma to mothers nipples and pain Poor infant weight gain Low milk supply

    Step 3 Milk Transfer


    Watch the baby as she sucks and swallows and milk is transferred. Look and listen for: Audible swallowing Sucking that begins with rapid bursts to stimulate milk let-down A rhythm of sucking, swallowing, and pauses following establishment of milk flow
    Becomes slower and more rhythmic Approximately 1 suckle/swallow per second

    Undulating action no stroking, friction, or in-and-out motion of the tongue Milk is extracted by a peristaltic action from the tip of the tongue to the base (not by negative pressure)

    Next Steps

    Watch Breastfeeding Management, Educational Tools for Physicians and Other Professionals by Jane Morton, MD, FAAP, for a live demonstration of how to observe and assess breastfeeding.
    http://newborns.stanford.edu/Breastfeeding/FifteenMinut eHelper.html See one, do one, teach one

    Follow-up

    Refer to the Residency Curriculum presentations,

    Management of Common Breastfeeding Problems and Management of Common Breastfeeding Situations, to


    understand the next steps if breastfeeding issues are identified during the breastfeeding assessment

    Reference

    Schanler RJ, Dooley S. Breastfeeding Handbook for Physicians. Elk Grove Village, IL: American Academy of Pediatrics, Washington, DC: American College of Obstetricians and Gynecologists; 2006.
    This resource may be purchased by visiting www.aap.org/bookstore.

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