Infants born at term following an uneventful birth generally require no breastfeeding interventions aside from a supportive environment. However, even in populations of women who are well-motivated to breastfeed, fully one third of infants demonstrate sub-optimal breastfeeding behavior in the first week postpartum. Risk factors have been identified that predict which mother-infant pairs may require extra assistance to protect the option to fully breastfeed once conditions stabilize. Careful assessment of the dyad helps identify who will need the most help. Such assessment is necessary to protect the infant from excessive weight loss and, because the calibration of milk supply is a time-sensitive event, serves to protect the potential for a full milk supply. Midwives must be familiar with new research that recommends that, in the presence of risk factors, milk expression should begin in the first hour after birth, with expressed colostrum being delivered to the infant by spoon or cup.
Learning Objectives:
Objective 1: Learners will identify 4 major infant risk factors that may compromise the newborn's ability to breastfeed.
Objective 2:Learners will identify 4 major maternal risk factors that may impair the mother's early milk production or impede breastfeeding.
Objective 3: Learners will describe the latest research on calibration of milk production and the steps necessary to take when any early interruption of normal breastfeeding occurs.
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