Dear Friends:
I totally agree with Ruth Fiedler's lovely post about letting the dyad
work out the breastfeeding from the beginning, given a warm safe and private
environment.
Here is a protocol of sorts that I have developed for the postpartum
ward:
An easy way to help a mother:
1) Ask permission to enter her room after identifying self.
2) Once in, notice baby and praise or offer congratulations
3) Wash hands
4) Ask mom how the birth was
5) Ask if we can get the baby into the conversation about bf
6) Describe s2s and how this gets baby into conversation
7) Ask mother to get into a position where she would go to sleep
8) Give her enough time and encouragement to do this. “Really, show me
how you would sleep.”
9) Pull drapes, turn off lights, turn off TV, close door to room.
10) Have partner undress baby down to diaper (If no partner, ask
permission from mother to first touch, then undress baby.)
11) Partner place baby on mother’s bare chest if mother is reclining, and
next to her, with baby's face next to nipple/areola if mother is side-lying.
12) Both are comfortable.
13) Baby usually rests after some slight stirring.
14) Continue conversation about birth or breastfeeding or history or other
children or who baby looks like: as long as conversation is sincere and you
are truly interested. LC to be sitting next to mother's bed.
15) If, after 20 minutes, baby is still deeply asleep, teach mom to hand
express. Collect EBM in spoon and give to baby. Or collect in TB syringe,
label and save for later.
16) Leave them tucked in together.
17) Come back later if possible.
18) The other path is that baby moves to breast and attaches itself and
starts suckling. This takes MUCH longer than anybody wants. Baby may tell story
on the way to the breast. S2s nourishes baby and reduces caloric
expenditure; explain this to the mother.
19) Marvel at new miracle if B is nursing. If baby has a cluster of feeds,
reinforce this pattern’s normalcy. Remind mother that her job now is to be a
placenta, and let the baby wean off the continual feeding and constant
heartbeat gradually.
20) Suzanne Colson calls this biologic nurturing. She says it can occur if
dyad is clothed. It can, I am sure. But breastfeeding will be learned more
easily if there is no clothing in the way.
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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