1. Preparing for OB Clinicals: Teaching Breastfeeding 101

2. Teaching Breastfeeding
Helping a patient breastfeed is time consuming. Therefore the staff nurses will rely on you to help out
Know the basics of breast-feeding so you can assist both the patient and the nurse

3. Breastfeeding Basics Have the patient empty her bladder
Have her wash her hands. Wash your hands too!
Ensure patient privacy. Close the door or pull the curtain
Consider medicating beforehand. Breastfeeding releases natural oxytocin which causes uterine cramping
Use several pillows for support and comfort
Demonstrate the various breastfeeding positions
Assist with positioning and latching
Allow the infant to nurse until satisfied
Assess breastfeeding technique using the LATCH tool

4. Assessing Breastfeeding Success: L.A.T.C.H. Score
Audible Swallowing
Type of Nipple
Comfort
Hold
Successful Breastfeeding Score = at least 8/10

5. Breastfeeding Basics Encourage feeding every 2-3 hours or on demand
Let the baby decide how long to nurse
Encourage infant burping after each breast is emptied
Consider a Lactation Consultant referral if necessary
Remember the 4 Ps of successful breastfeeding:
Positioning
Patience
Practice
Persistence

6. Breastfeeding Positions

7. Breastfeeding Positions
1. Cradle Hold This is a commonly used position that is comfortable for most mothers. Hold the baby with his head on the forearm and his/her whole body facing the mother.
2. Cross Cradle or Transitional Hold This is good for premature babies or babies who are having problems latching on. Hold the baby along the opposite arm from the breast being used. Support baby's head with the palm of mother’s hand at the base of his/her neck.
3. Clutch or "Football" Hold This is good for mothers with large breasts or inverted nipples. Mother holds the baby at her side, lying on his/her back, with his/her head at the level of the nipple. Mother supports baby's head with the palm of her hand at the base of his/her head.
4. Side-Lying Position This allows mother to rest or sleep while baby nurses. Good for mothers who had a Cesarean birth. She lies on her side with her baby facing her. She pulls the baby close and guides his/her mouth to her nipple.

8. Proper Latching
Tickle the baby’s lower lip with the nipple to encourage him to open wide
Point the nipple to the roof of the baby’s m mouth and when open wide, pull him
onto the breast, chin and lower jaw first
Watch the lower lip and aim it as far from the base of the nipple as possible,
so the baby’s tongue draws the areola into into his/her mouth

9. A Wide-Open Latch is Essential!

10. Signs of a Correct Latch vs. an Incorrect Latch
Baby’s lips are around the nipple AND the areola, not just the nipple.
The top lip will be closer to the nipple, and some areola shows above top lip.
More areola is taken in with the lower lip than the top lip.
Baby’s chin is close against breast.
Baby’s lips are “flanged,” not tucked in.
You hear baby swallow after every one or two sucks. Some babies swallow too quietly to hear, so listen for a slight pause in baby’s breathing which shows he or she is swallowing.
You see a “wiggle” at the junction of baby’s temples and ears.
Baby has enough wet and dirty diapers (beginning on the 3rd or 4th day after birth, there should be at least five to six wet disposable diapers (six to eight cloth diapers) and at least three to four bowel movements the size of a U.S. quarter or larger.
Incorrect:
Mother feels pain.
Mother hears clicking or sucking noises.
The baby comes off easily from the breast.
The baby swallows little or not at all at the breast.
Baby’s lips are tucked in instead of turned out (flanged).
Mother’s nipple is flattened or creased after feeding.
Baby does not have enough wet or dirty diapers.

11. Feeding Breastmilk to an Infant
You may be in the Special Care Nursery or NICU and the nurse asks you to feed an infant expressed breastmilk
ALWAYS, ALWAYS check the label on the milk with the infant’s ID band and ensure they match
This will ensure that the correct breastmilk is being given to the correct baby. Don’t assume the nurse gave you the right breastmilk
If breastmilk is given to the wrong baby, this is a sentinel event. Please be careful!

12. Breastfeeding Video
Watch this 6-minute video for 10 tips on how to teach breastfeeding to your patients