1.  Avoid routine admission care (eye ointment, Vitamin K injection, etc)
until after the first feed.

2.  Advantages of BF immediately after birth which include:
        skin to skin contact
        opportunity for the infant to pattern with the mother
        effective latch on skills
        organized suckling patterns
        longer continuation of BF (Righard, 1990)

3.  First Feeding is the "Introduction to the Breast Session"
        goal is for infant to become acquainted to the breast
        postioning is less critical (avoid traumatic latch-on)
        Intimate time for the family - avoid noxious stimuli
        Infants usually receive <5cc of colostrum
        If the couplet is separated or not assosted to BF within the first to
hours following birth, record should document why

4.  What can L & D Nurses do to improve care to BF fmailies
        balance convenience and efficiency with humanistic care and the importance
of establishing healthy family interactions
        focus on whose needs are being served
        Reduce technological barriers, enhance skin to skin contact and touching

5.  Intrapartum Red Flags-who is at risk for BF difficulties?
        Inadequate social support
        Elective induction of labor (usually a long tiring process)
        Long dfficult labor
        Analgesia or anesthesia in labor
        Separation of Mother and Baby
        Delay in the initial feeding beyond two hours
        Afternoon and evening births


All of these tricks really do work in establishing a good breastfeeding
pattern and identifying who is at risk.  I can't take all of the credit for
these tips though.  The credit goes to Debi Bocar who has taught these tips
to me and a lot of oters throughout the Midwest.

Maurenne Griese, RNC, BSN, CCE, CBE
Birth and Breastfeeding Resources  http://www.childbirth.org/bbfr
Manhattan, KS  USA
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