Table 6-1Infant feeding information and advice

Time band 1: First 24 hours
Women should be offered information and reassurance on:
  • colostrum – which will meet the needs of the baby in the first few days after birth [D(GPP)]
  • timing of the initial breastfeed and the protective effect of colostrums. This advice should be culturally sensitive [C]
  • The nurturing benefits of putting the baby to the breast in addition to the nutritional benefits of breastfeeding. [D(GPP)]
Time band 2: 2–7 days
A woman should be offered information and reassurance on:
Feeding patterns:
  • that her baby may have a variable feeding pattern, at least over the first few days, as the baby takes small amounts of colostrum and then takes increasingly larger feeds as the milk supply comes in [D(GPP)]
  • that when the milk supply is established, a baby will generally feed every 2–3 hours, but this will vary between babies and, if her baby is healthy, the baby’s individual pattern should be respected. [A]
Position and attachment:
  • that being pain free during the feed is an indicator of good position and attachment [D]
Other indicators of good attachment include: Signs of successful milk transfer:
The baby has: The woman:
  • feels no breast or nipple pain [D]
  • experiences her breast softening [D]
  • may experience uterine discomfort [D]
  • observes no compression of the nipple at the end of the feed [D]
  • feels relaxed and sleepy [D]
Engorgement – full breasts are common on day 3 but engorged breasts (hard, hot, inflamed) are a sign of inadequate milk drainage requiring treatment [D]
Safety – milk, either formula or expressed breast milk, should not be heated in a microwave as there is a danger of scalding (Advise Family/Partner as appropriate). [C]
Benefits of breastfeeding – that babies who are exclusively breastfed for 6 months will accrue the greatest health benefits and disease prevention. [B]
Local breastfeeding support groups – how to access and what services and support they provide. [A]
Women should be advised to report to their healthcare professional:
Urgently; the signs and symptoms of mastitis including flu like symptoms, red, tender and painful breasts. [A]

From: 6, Infant Feeding

Cover of Postnatal Care
Postnatal Care: Routine Postnatal Care of Women and Their Babies [Internet].
NICE Clinical Guidelines, No. 37.
National Collaborating Centre for Primary Care (UK).
Copyright © 2006, National Collaborating Centre for Primary Care.

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