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    <meta name="author" content="Denise Fisher" />
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    <title>Breastfeeding the Baby</title>
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      <h1 id="top">5.0 Breastfeeding the Baby</h1>
      <div><p> There is no knowledge or skill more important for you to possess and pass on to mothers than how to position their babies for comfortable latching and efficient milk transfer. If positioning and latching isn't correct then breastfeeding isn't working at all. When a mother is confident her baby is breastfeeding well there's very little else she needs to know to be successful. </p><p> Mothers who have the confidence to breastfeed their babies find it an empowering experience. Teaching by 'hands-off' methods will enhance the mother's confidence when her baby achieves good latch. </p><p> The best time to commence feeding an infant is when he first exhibits cues that he is ready to feed. When early cues are ignored the infant's behaviour will progressively become more agitated until he is crying, making latching more difficult. If the feed is further delayed the infant may tire quickly and feed poorly once feeding is finally offered. </p><p class="listTitle">Early feeding cues</p><ul><li>mouthing and non-nutritive sucking - the infant moves his mouth in a searching or sucking manner</li><li>subtle body movements, wriggling</li><li>rooting when face touched</li><li>hand-to-mouth movements, with or without sucking on hand</li></ul>(<span style="font-style: italic;">Note</span>: the infant may progress through these signals very quickly - immediate attention to these signals will meet the baby's needs and initiate a more effective breastfeed)<br /></div>
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        <img width="295" height="469" src="images/early_feeding_cue_cropped.jpg" alt="Newborn displaying early feeding cue." />
        <p>Newborn displaying early feeding cue. <br />&copy; D.Fisher, IBCLC</p>
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              <h3>Workbook Activity 5.1</h3>
              <p>Complete Activity 5.1 in your workbook.</p>
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            <td class="body"><h3>Answering baby's cues</h3>
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	{ c : 'The mother can be immediately responsive to her baby\'s cues when she wears her baby on her chest or carries him in a sling/pouch. <br/>What about the baby who is laid to sleep in a bed or cot? What other suggestions could you give a mother about being alert to her baby\'s feeding cues?<br/>', r : '<ul><li>Move the baby\'s cot into the main room of the house where the mother is spending her time.</li><li>Sleep the baby in the pram (stroller) and move it from room to room as the mother continues her activites.</li><li>Use a \'baby monitor\' if the baby is sleeping in another room...........(Is it safe to sleep a baby in a room which is so far away that it can only be heard with a baby monitor?)</li><li>At night, safely bed-share or ensure the baby\'s cot is in the same room as the mother.</li></ul><br/>' }
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      <div class="section" id="It_s_a_team_effort_"><h2>It's a team effort!</h2>
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      <p>
		The team consists of the mother and the baby.  Supporters of the team include the baby's father, the mother's other relatives and friends, and her health care providers. 
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      <p>
		The mother's role is to position the baby to facilitate his breastfeeding reflexes; the baby's role is to be free to respond to the stimulation of those reflexes. If not interfered with the baby's reflexes will cause him to latch perfectly to the mother's breast and suckle effectively. The role of the health professional is to guide the mother to position the baby so that the baby's reflexes are stimulated - not to either do it for the mother and baby, nor to tell the mother how she should latch the baby.
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    <div class="section" id="Preparing_to_guide_the_mother"><h3>Preparing to guide the mother</h3>
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        <p> Expensive teaching aids aren't necessary to demonstrate good positioning and latch. Common positioning and latching problems can be avoided by using these simple strategies. </p>
        <ul>
          <li>Demonstrate positioning using a doll. This is an effective visual aid.</li>
          <li>Ask the mother to try to swallow when her head is turned to one side, or when her head is tilted forward. This demonstrates how difficult it would be for baby to swallow if he had to turn his head or flex his neck to latch.</li>
          <li>Ask the mother suck on her own thumb. Firstly have her put her thumb midway into her mouth and suck, then move the thumb back to the junction of the soft and hard palate and suck. Ask her to compare the effort required to keep the thumb in her mouth in both positions and the different tongue action necessary in each position. This may help the mother to understand the importance of facilitating a deep latch where her nipple will move to the back of the baby's mouth to prevent undue pressure on the nipple.</li>
          <li>Show the mother a photograph of a baby who is well latched to the breast to demonstrate how wide and deep the latch should be.</li>
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          <p> How do you assist a mother to position and latch her baby? How often do you achieve this being totally 'hands off'? Note the number of times the mother latches her baby well herself after your 'hands off' instructions, and the number of times you give hands-on assistance. Think about why you are needing to do it for her, or giving her significant assistance. Reflect on ways to reduce the number of times hands-on assistance is necessary. </p>
          <p> How would you feel about benchmarking your results against those of several of your colleagues? Get a small group together that you feel 'safe' with and keep your individual statistics for a month, then compare them. Explanations for unsuccessful cases can be discussed together. </p>
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      <div class="section" id="What_should_I_remember_"><h2>What should I remember?</h2>
    <table class="callout"><thead><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_01.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background: repeat-x url(design/callout_02.png);"><img src="design/callout_02.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_03.png" width="10" height="10" alt="" /></td></tr></thead><tfoot><tr class="decoRow"><td class="topleft" style="width: 10px"><img src="design/callout_07.png" width="10" height="10" alt="" /></td><td class="topcenter" style="background-image: url(design/callout_08.png);"><img src="design/callout_08.png" width="59" height="10" alt="" /></td><td class="topright" style="width: 10px"><img src="design/callout_09.png" width="10" height="10" alt="" /></td></tr></tfoot><tbody><tr><td class="middleleft" style="background: repeat-y url(design/callout_04.png);"><img src="design/callout_04.png" width="10" height="80" alt="" /></td><td class="body"><img src="design/remember.png" class="icon" alt="" /><h3></h3>
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          <li>Ways to teach and pass on knowledge without touching</li>
          <li>Variations of early feeding cues</li>
          <li>A baby who is crying in hunger is detrimental to breastfeeding</li>
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      <h1>Breastfeeding Essentials</h1>
      <ol>
        <li>1.0 <a href="topic_1-0.html">Why Breastfeeding is Important</a><ol><li>1.1 <a href="topic_1-1.html">Biochemistry</a></li><li>1.2 <a href="topic_1-2.html">Immunology</a></li><li>1.3 <a href="topic_1-3.html">Relative risks</a></li></ol></li>
        <li>2.0 <a href="topic_2-0.html">Communication Skills</a><ol><li>2.1 <a href="topic_2-1.html">Non-verbal</a></li><li>2.2 <a href="topic_2-2.html">Listening skills</a></li><li>2.3 <a href="topic_2-3.html">Building confidence</a></li><li>2.4 <a href="topic_2-4.html">An example</a></li></ol></li>
        <li>3.0 <a href="topic_3-0.html">Pregnancy Care</a><ol><li>3.1 <a href="topic_3-1.html">The feeding decision</a></li><li>3.2 <a href="topic_3-2.html">The barriers</a></li><li>3.3 <a href="topic_3-3.html">Physical preparation</a></li></ol></li>
        <li>4.0 <a href="topic_4-0.html">The Birth Experience</a><ol><li>4.1 <a href="topic_4-1.html">The first hours</a></li><li>4.2 <a href="topic_4-2.html">Labor interventions</a></li><li>4.3 <a href="topic_4-3.html">Postnatal interventions</a></li></ol></li>
        <li class="current">5.0 <img src="design/bullet_arrow_right.png" alt="*" title="You are here" /><a href="topic_5-0.html">Breastfeeding the Baby</a><ol><li>5.1 <a href="topic_5-1.html">Positioning Principles</a></li><li>5.2 <a href="topic_5-2.html">Breastmilk transfer</a></li><li>5.3 <a href="topic_5-3.html">Assessing breastfeeding</a></li></ol></li>
        <li>6.0 <a href="topic_6-0.html">A time to learn</a><ol><li>6.1 <a href="topic_6-1.html">Practical skills</a></li><li>6.2 <a href="topic_6-2.html">Breastfeeding messages</a></li><li>6.3 <a href="topic_6-3.html">Normal growth</a></li><li>6.4 <a href="topic_6-4.html">Sleep</a></li><li>6.5 <a href="topic_6-5.html">Psychological support</a></li><li>6.6 <a href="topic_6-6.html">Discharge planning</a></li></ol></li>
        <li>7.0 <a href="topic_7-0.html">Infant Challenges</a><ol><li>7.1 <a href="topic_7-1.html">Late preterm infant; Non-latching</a></li><li>7.2 <a href="topic_7-2.html">Hypoglycemia; Jaundice</a></li><li>7.3 <a href="topic_7-3.html">Supplementation</a></li><li>7.4 <a href="topic_7-4.html">Crying baby</a></li><li>7.5 <a href="topic_7-5.html">Inadequate weight gain</a><ol><li>7.5.1 <a href="topic_7-5-1.html">Feeding-line device at the breast</a></li><li>7.5.2 <a href="topic_7-5-2.html">Cup feeding</a></li><li>7.5.3 <a href="topic_7-5-3.html">Finger Feeding</a></li><li>7.5.4 <a href="topic_7-5-4.html">Bottle feeding</a></li></ol></li></ol></li>
        <li>8.0 <a href="topic_8-0.html">Maternal Challenges</a><ol><li>8.1 <a href="topic_8-1.html">Engorgement</a></li><li>8.2 <a href="topic_8-2.html">Nipple Pain</a></li><li>8.3 <a href="topic_8-3.html">Breast Problems</a></li><li>8.4 <a href="topic_8-4.html">Insufficient breastmilk</a></li><li>8.5 <a href="topic_8-5.html">Medical, Surgical Issues</a></li></ol></li>
        <li>9.0 <a href="topic_9-0.html">Promotion, Protection and Support</a><ol><li>9.1 <a href="topic_9-1.html">The International Code of Marketing of Breastmilk Substitutes</a></li><li>9.2 <a href="topic_9-2.html">The Baby Friendly Initiative</a></li><li>9.3 <a href="topic_9-3.html">Young Child Feeding</a></li><li>9.4 <a href="topic_9-4.html">Local initiatives</a></li><li>9.5 <a href="topic_9-5.html">Infant feeding in emergencies</a></li></ol></li>
        <li>10.0 <a href="topic_10-0.html">Closing session</a><hr /></li>
        <li class="appendix"> <a href="references.html">List of references</a></li>
        <li class="appendix"> <a href="contents.html">Course contents</a></li>
        <li class="appendix"> <a href="full.html">Print version</a></li>
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