Southwestern Indiana Regional Perinatal Advisory Board - Professional Resources: Breast Feeding

Breast Feeding

Basics of Breastfeeding
Prenatal and post-partum patients have a lot of questions about breastfeeding for which they depend on their physician to address. The following are two brief question-answer tools that can be utilized to address patient questions.

PRENATAL FAQs

Why breastfeed?

Breastfed infants have a lower risk of getting otitis media, diarrhea, other gastrointestinal infections, urinary tract infections, diabetes, allergies, and obesity among other things from infancy to young adulthood. Benefits for the breastfeeding mother include a shorter recovery time after having the baby, and the reduced risk of ovarian and endometrial cancer, premenopausal breast cancer, and osteoporosis.

Who should not breastfeed?

A baby with Galactasemia; mothers with active and untreated TB, who are HIV positive, receiving radioactive isotopes, antimetabolites or chemotherapy agents, have herpes simplex lesions on the breast, and mothers abusing drugs.

How often?

Mothers should breastfeed 8-12 times per day in a 24 hour period

How long?

Mothers should breastfeed as long as the infant stays attached and is suckling. Offer both sides at each feeding but the infant may only nurse from one side.

Supplements and Pacifiers?

These should be discouraged unless medically necessary since they both interfere with latching and milk production.

Research-based sources

http://www.aafp.org
http://www.familydoctor.org/handouts/019.html
http://www.pediatrics.org/cgi/content/full/115/2/496
http://www.nmanet.org/National_Programs_Breast_Feeding.htm
Newman, J. & Pitman, T.(2000) The Ultimate Breastfeeding Book of Answers, NY, Three Rivers Press

POSTPARTUM FAQs

How often?

8-12 times per day in a 24 hour period

How do I tell if my baby is getting enough?

A breastfed baby should have at least one wet diaper on day 1, two wet diapers on day 2, three wet diapers on day 3, and at least 6 soaking wet diapers on day 6-7. Watching the stools is actually more important than counting the wet diapers. The initial meconium stools will change to lighter colored stools by day 3-4 and by day 4-5 they should turn yellow and be runny and seedy. A baby who continues to have meconium stools on day 4 or who goes 24 hours without any stools needs to be seen by the hospital’s Lactation Consultant and have her observe a feeding.

How long?

The mother should nurse as long as her infant stays attached and is suckling. She should offer both sides at each feeding but her infant may not take the second side.

High bilirubin levels

This could be a signal that the baby is not getting enough breastmilk. Refer them to a Lactation Consultant.

Sore nipples

Mother should not have sore nipples and needs to be referred to a Lactation Consultant if this occurs.

When should a breastfed infant be seen after discharge?

Between days 3-5 and then again at week 2-3 (AAP Policy statement on breastfeeding)

Prescribing drugs

Many drugs are not contraindicated and when a drug is contraindicated, usually it can be replaced by a similar acting drug that is not contraindicated. Go to http://neonatal.ama.ttuhsc.edu/lact/ for updated pharmacy information.

Supplements and Pacifiers

These should be discouraged unless medically necessary since they both interfere with latching and milk production.

Research-based sources

Breastfeeding Resources on the Web:

The Academy of Breastfeeding Medicine – www.bfmed.org

The AAP – http://www.pediatrics.org/cgi/content/full/115/2/496

Breastfeeding handouts by Dr. Jack Newman – www.breastfeedingonline.com

La Leche League International – http://www.lalecheleague.org

American Academy of Family Physicians – http://www.aafp.org

National Medical Association – http://www.nmanet.org/National_Programs_Breast_Feeding.htm

FamilyDoctor.org – www.familydoctor.org/handouts/019.html