7.1  Counselling the mother on newborn feeding

It is always advisable to provide counselling about newborn feeding during the antenatal period and continue reinforcing it during the postnatal period. This teaching should focus on establishing and maintaining optimum breastfeeding. The criteria for achieving this are summarised in Box 7.1.

Box 7.1  Optimum breastfeeding criteria

  • Initiation of breastfeeding within one hour after birth (early breastfeeding).
  • Nothing is given to the baby other than breast milk for the first six months (exclusive breastfeeding).
  • Colostrum is not thrown away. It is rich in protein and antibodies and is useful to the newborn; you should tell the mother to feed it to her newborn, because it is the first ‘immunization’ that her baby will get.
  • The mother is sitting in a good position while breastfeeding.
  • The baby has good attachment to the breast while breastfeeding.
  • There is effective suckling.

When you arrive for a postnatal visit, ask the mother to put the baby to the breast to check for good positioning and good attachment (we describe how you do this below). If the baby was fed recently, wait for at least an hour before putting him or her back to the breast. This will allow you to observe how the baby is breastfeeding and identify if there are any breastfeeding problems, which you can help the mother to overcome. Before you leave the house, ensure the mother understands how to breastfeed her baby optimally.

Learning Outcomes for Study Session 7

7.1.1  Four signs of good positioning