Breastfeeding. Pam Price, IBCLC Coastal Pediatric Associates When Latching

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1 When Latching Bring baby's bottom into your body with the underside (the side of your baby finger) of your forearm, keeping his tummy, and chest snuggled close to you. Align infant s nose to mom s nipple. This will bring him towards your breast with the nipple pointing to the roof of his mouth Mother's hand under the side of baby's face, palm of hand under infant s shoulder and facing up Head supported but NOT pushed in against breast Head tilted back slightly Baby's body and legs wrapped in around mother Allow nipple to touch just above top lip, gently stroke the nipple under infant s nose, across the area above the top lip. (not up and down as that would make the baby tuck downward and not open wider). Use your whole arm to bring the baby onto the breast, when mouth wide Chin and lower jaw touch breast first Watch lower lip, aim it as far from base of nipple as possible, so tongue draws lots of breast into mouth Move baby's body and head together - keep baby uncurled Once latched, top lip will be close to nipple, Some areola may show above lip. Keep baby s chin close against breast. 1

2 (Mother s view when latching baby) In these pictures the hand is exaggerated. Holding infant around the neck or head would be forceful. Instead, support the head and neck from under the side. Snuggling the infant s chest and body close to mom gives the baby lots of centered support and makes baby easy to control. When Latching Need mouth wide before baby moved onto breast. To teach baby to open wide/gape : Move baby toward breast, touch top lip against nipple Move mouth away SLIGHTLY Touch top lip against nipple again, move away again Repeat until baby opens wide and has tongue forward Or, run nipple along the baby's upper lip, from one corner to the other, lightly, until baby opens wide 2

3 (Mother s view of nursing baby) Recommendations for the Mother Mother s posture Sit with straight, well-supported back Trunk facing forwards, lap flat Support breast and firm inner breast tissue by raising breast slightly with fingers placed flat on chest wall and thumb pointing up (if helpful, also use sling of tensor bandage around breast) Baby s position before feed begins On pillow can be helpful Nipple points to the baby's upper lip or nostril Baby s body placed not quite tummy to tummy, but so that baby comes up to breast from below and baby s upper eye makes eye contact with mother s. Entice baby to gape Baby s head and shoulders supported so head extends slightly as baby moved to breast Touch baby s top lip to nipple and move baby away slightly and repeat until baby opens wide with tongue forward Move baby quickly on to breast Head tilted back slightly, pushing in across shoulders so chin and lower jaw make first contact (not nose) while mouth still wide open Keep baby uncurled (means tongue nearer breast) Lower lip is aimed as far from nipple as possible so baby s tongue draws in maximum amount of breast tissue 3

4 Cautions for Mother Mother needs to avoid Pushing her breast across her body Chasing the baby with her breast Flapping the breast up and down Holding breast with scissor grip Not supporting breast Twisting her body towards the baby instead of slightly away Aiming nipple to center of baby s mouth Pulling baby s chin down to open mouth Flexing baby s head as is brought to breast Moving breast into baby s mouth instead of bringing baby to breast Moving baby onto breast without a proper gape Not moving baby onto breast quickly enough at height of gape Having baby s nose touch breast first and not the chin Holding breast away for baby s nose (not necessary if the baby is well latched on, as the nose will be away from the breast anyway) 4

5 Paced Bottle Feeding Method one: Hold infant upright and well supported Bottle should be horizontal allowing the nipple of the bottle to only be half or less filled with milk Allow infant to feed until satisfied or infant becomes fussy. Try to burp the baby Offer more from the bottle after the baby has burped. The baby may need to burp several times or only at the end of the feeding, with a paced feeding infant s do not swallow as much air and do not gulp as heavily and are better able to gage the speed and volume of their feeding. Method two: With the baby slightly upright cradled in your arms, slide the bottle nipple into the baby s mouth Count 3-5 sucks then slip the nipple out of the baby s mouth to the tip of his lips Count 3 seconds then slide the bottle back into the baby s mouth. Continue doing this pace until the infant puckers his mouth and tries to stop the bottle from going back into his mouth. Try to burp the baby Offer more from the bottle after the baby has burped. The baby may need to burp several times or only at the end of the feeding, with a paced feeding infant s do not swallow as much air and do not gulp as heavily and are better able to gage the speed and volume of their feeding. 5

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