Common Questions and Answers  

Which hormone is primarily responsible for bonding?

-The hormone that is responsible for bonding is Oxytocin “The hormone of love.”

Why should a mother try to indicate breast feeding within 1 hr after birth?

-The oxytocin high immediately after birth last from 20 min- 1hr, so it is very important to have immediate skin to skin contact and initiation of breastfeeding.

What is the process of latching on?

-The first step is to make sure the mother has correct positioning of the babies head, and body. The baby should face the mother and not have the lower body twisted away from the mothers chest. The perfect position would be unswaddled, skin to skin, and covered comfortably with a blanket.

-The second step is to express a small amount of milk on to the nipple and then place the nipple around the baby’s mouth. While caressing the nipple to the corners of the baby’s mouth hold the breast in a compressed manor so the shape of the nipple looks similar to the shape of the b infant’s mouth. The mothers thumb should be adjacent to the infant’s nose about two inches away and the remaining fingers below the breast making a C-shape.

-The third step is as the bringing the baby close to the breast. The nose should be level with the breast. Do not bring the baby to the nipple because this will cause the nipple to be centered in the baby’s mouth. The latch should be done asymmetrically, to allow the nipple to point up towards the back of the mouth.

-The fourth step is as the mothers milk begins to let down , swallowing should be heard. Be aware of noises because this could mean that there is an improper latch. Any suckling or sucking noises are a sign of improper latch.

-The final step to the process of latching is making sure that the baby’s lips are flanged not pursed, and when the lower lip is pulled down the tongue is visible.

How do breastfeeding mothers detach from her baby if the latches incorrectly?

-Place a clean finger in the corner of the baby’s mouth and softly detach the baby from the incorrect latch. It is better to keep trying for the correct latch then to proceed the feeding with an incorrect latch.

What are the signs of a good latch?/Poor latch?

Signs of a proper latch:

-No Pain

-More of the areola is taken in with lower lip than top lip

-Chin touches breast, nose does not

-Lips are flanged

-Ear wiggles with suckle

Signs of an incorrect latch:

-Pain

-Clicking or sucking noises

-Cheeks sucked inward

-Baby easily coming off breast

-Little or no swallowing at breast

-Lips are tucked instead of flanged

-Mothers nipple flattened or creased after feeding

- Inadequate wet diapers

What are infant hunger cues? Which common hunger cue is a late sign of hunger?

Infant Hunger Cues (from early cues to late)

-Heads moves towards voice mouth opens

-Lips smack, tongue reaches

-Fists clench and move to mouth

-Exaggerated motions

-Fussing behavior

-Brow furrow

*Crying is a late sign of hunger

What are the four most common positions for breastfeeding?

-Cross Cradle Position

-Clutch Hold Position

-Conventional Cradle Hold

-Side Lying-Advanced Hold

Descriptions of each one of the four breastfeeding positions

Cross Cradle Position:

-In this position the mother has good control of the baby and her breast. The baby lies across the mother’s tummy. The mothers hand and arm on the same side body of the breast were the feeding is happening will support the breast during the feeding. While the other hand and arm is used to support the infant during the feeding.

Before the feeding:

-Place a receiving blanket across the baby’s upper arm if it is in the way of the feeding. Hole the baby so that the legs and arms wrap around the side of the mothers body. Wrap the lower arm around the bottom of the breast before starting the feed. Hold the baby so that the nose is level with the nipple rather that the mouth before starting the feeding process.

Your arm and hand positioning:

-Hold the baby with the opposite arm form which you are breast feeding with. Support the back of the infant with the hand that is holding the infant. The heel of the hands is used to support the head and shoulders. The mothers thump should be placed behind her ear and let your fingers supports the infants jaw bone.

Getting baby on the breast:

-Move the baby to your towards your nipple so that the nipple touches the lips of the infant. Proceed to move the baby away so that the mouth opens wide. Once that mouth is open as wide as a yawn, move the baby to the breast. The baby’s bottom lip should be aimed away from the nipple as far as possible. When the baby’s mouth opens widely place as much alveolar in the mouth as possible. The mothers hand should be placed on the infants shoulders so that the head is tilted slightly back as it is brought to the breast.

Clutch Hold-Beginners Hold

-This hold is also known as “Football Hold’. This is an excellent position for new mother or mothers that delivered C-section, women with larger breast, and for infants that have a hard time latching on. In this position the mother need to pay close attention to that centering the nipple in the baby’s mouth.

Before Feeding:

-To start this position place a pillow at your side, and position the baby’s bottom on the back of the chair the mother is sitting in. Place the feet in a flexed position so that the infant’s feet do not push off the back of the chair. Before you start make sure that the baby’s mouth is well under the breast. To ensure this correct nipple position place the mothers nipple at the bridge of the baby’s nose.

Hand position:

-The mother needs to support the infants back with arm, and the mothers hand supports the baby’s neck and shoulders. The mother should place her thumb behind the baby’s ear to support the jaw.

Conventional Cradle Hold-Advanced Hold

-The conventional cradle hold is one of the most popular hold for breast feeding mothers. The position allows the baby to lay across the mother’s stomach on its side with the feeding mother supports the baby with her forearm.

-The mother should support the breast with the hand on the opposite side the baby is not nursing on, making sure that the thumb and fingers are away from the areola.

-The arm on the same side the infant is nursing on is used to support the infants back, shoulders, and neck. This positioning of this arm will allow the mother to hold the infant close while feeding.

Side Lying-Advanced Hold

-The side laying position is very beneficial for feeding baby while resting or after a c-section. But this can be hard sometimes for new moms to try to do it by themselves in the beginning. In this position the mother lies on her side facing the infant and the infant lays on it’s a side facing the mother. It will help make the mother more comfortable if there are lots of pillow to support the mother’s knees, back, and head. The help support the baby a small pillow or rolled up towel behind the baby’s back can help. It is very important the infant is brought in close to the mother. Place support pillow for neck and back.  Position the infant completely on its side so that its mouth is level with the mother’s nipple. The baby’s nose chin, tummy, and nose should all be touching the mother.  The upper hand of the mother is used to support the breast to insure proper latch.  The lower arm of the mother may be curled around the infant back or tucked under her head.  A small rolled blanket may help the mother to keep the baby on its side.

-Which of the four positions is good for a woman who has just delivered a C-section delivery?The Side laying-Advanced Position is great for women who have had C-section deliveries.  This position allows the new mother the feed infant while relaxing in a resting position.

How can a new woman have a positive experience I the hospital while breastfeeding?

-Find out if the hospital is Baby-Friendly, and has adopted the Ten Steps to Successful breastfeeding program by WHO/UNICEF.

-Breastfeeding needs to be initiated as soon as possible after birth. A latch to the mother within the first 30 minutes is very beneficial.

-Encourage the deliver of the newborn infant to be place on the mothers abdominal immediately after birth, if the baby is healthy and the umbilical cord is long enough.

-The baby needs to be kept with the mother at all times.

-Delay all infant intervention before the infant has latched and breast feed. Such as eye drops, vitamin K, that includes no artificial nipples, or formula supplements or pacifiers.

-Take advantage of the lactation consultant on staff at that time.

-The baby needs to room with the Mom so that feeding can be on demand and the mother can direct the care of the infant.

-Take advantage of the hospital breastfeeding instruction.

-Use the hospital breast-pump equipment, or manually express milk, if there is any need to supplement. Supplement the baby with breast milk.

-If the baby’s needs to be supplement then try not to use an artificial nipple. Use an SNS, spoon, dropper, syringe, or Foley cup to minimize the nipple confusion for the infant.

-Trust your instincts when glucose testing in the hospital. Ask questions so you personally can decide weather this test is a procedure to support your infant or this test is routine. Practice informed consent and understand informed refusal.

Why should a infant not use an artificial nipple or supplement?

-Using an artificial nipple can cause confusion in the baby and sometime frustration. The infant can become frustrated because the nipples work differently and the latch to each is different. Sometime infants will refuse the mothers nipple because the use of an artificial nipple. The best way to prevent this confusion is to establish breastfeeding well before using a artificial nipple.

What are the risks of using pacifiers for breastfeeding infants?

-Pacifiers are linked to decrease in breastfeeding and can cause milk reduction. If the milk supply is low then the baby will gain less weight. It is best not to make a pacifier use as a habit.

Why is support crucial for breastfeeding at home?

-The support is very important for mother’s breastfeeding infants. Socializing with other mothers who encourage breastfeeding and support each other is beneficial to mothers. Socializing with similar mothers in group meeting is excellent with La Leche Meetings.

Author, Jessica Hedrick

More Breastfeeding 101 Q and A to come....