Position and Attach

Stimulating the Hormonal Reflexes

Breast massage assists the release of oxytocin.  Several methods are possible:-

  • The fist may be gently rolled over the breast
  • The flat of the hand (or fingers) may be used to press or stroke gently
  • There should be no rubbing or pulling of the skin
  • The technique should feel pleasant to the mother
  • Rolling the nipple gently between thumb and forefinger stimulates prolactin release.

How to Express by Hand

  • Find the right spot, make a ‘C’ shape with thumb and fingers
  • Squeeze gently, get a rhythm going
  • Small drops then squirts

As flow subsides:

  • Rotate around the breast as if moving around a clock face.
  • When flow decreases move to other breast and alternate between both breasts.

Breastfeeding Observation Checklist

Signs that Breastfeeding is Going Well:-

Before attachment:

  • Mother’s position:  Mother relaxed and comfortable, breast hanging or lying naturally, easy access to nipple/areola, hair/clothing do not restrict mother’s view, back supported, shoulders directly over hips.
  • Baby’s position:  Baby’s head and body in line – nose, navel and knee all facing same direction, baby held close to mother’s body (baby’s whole body supported), baby’s nose opposite nipple, baby’s head free to tilt back – (no fingers, no hand or crook of arm restricting baby’s head)
  • Attaching to breast: Baby reaches or roots for the breast, Mother waits for baby to open mouth wide, Baby opens mouth wide, Mother brings baby swiftly towards breast with head tilted back, baby approaches breast – chin first with wide open mouth.

During the Feed:

  • Observations: Baby’s chin touches the breast, baby’s mouth wide open, baby’s cheeks soft and rounded, baby’s lower lip turned outwards, top lip just over nipple, lower lip as far away around the breast as possible, breasts allowed to hang naturally during the feed, signs of milk (e.g. leaking), no pain or discomfort unless already damaged.
  • Baby’s behaviour: Baby stays attached to the breast, baby calm and alert at the breast, slow, deep sucking bursts with pauses, no noise other than swallowing, rhythmic swallowing seen.

At the end of the feed:

  • Baby releases the breast spontaneously, breasts appear soft, nipple is same shape as before feed, skin of nipple/areola appears healthy

This is a video clip from Bump to Breastfeeding DVD - to view the complete DVD and learn more about the work of Best Beginnings follow this link - www.bestbeginnings.org.uk

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