Baby-Friendly Questions and Answers

Q. What are the expert recommendations about exclusive breastfeeding and duration?

A. Expert recommendations are: Six months of exclusive breastfeeding, with solids introduced at about six months and breastfeeding continuing for two years or beyond.

Q. What are some of the benefits of breastfeeding?

A. Breast milk is a living tissue that provides numerous immunological benefits as well the appropriate species-specific food. Benefits of breastfeeding are optimal health and nutrition (less risk of many infections, including gastro-intestinal, middle ear, upper respiratory, meningitis, NEC; less risk of certain illnesses and chronic conditions, such as allergies, diabetes, and certain childhood cancers) and optimal cognitive development. Breastfeeding enhances maternal infant bonding and has numerous benefits to mothers including weight loss, decreased risk of postpartum bleeding, and decreased risk of breast cancer. Financial benefits: it’s free, and breastfed children require fewer antibiotics and other health care interventions. Parents also take less time off work to address the needs of their sick children.

Q. What are some key points about getting breastfeeding off to a good start?

A. Place baby skin-to-skin at delivery – when cuing behaviours begin assist with breastfeeding. Leave the mother and baby undisturbed throughout this initial feeding attempt. Encourage lots of skin-to-skin contact and frequent breastfeeding attempts. Support the mother to latch her baby well and to identify early feeding cues. Use positive language to empower mother and her baby.

Q. Why is skin-to skin care important?

A. Benefits of skin-to-skin care include thermoregulation, decreased newborn stress, enhanced homeostasis, decreased infant crying, stimulation of hormonal regulation of lactation, and increased maternal milk production.

Q. What percentage of mothers do you teach hand expression?

A. 100% of breastfeeding mothers. Hand expression includes expressing a few drops of colostrum to entice baby, to stimulate lactation in the first 24-48 hours when pumping may not be as efficient, or to empty breasts instead of using a pump.

Q. What are some medical indications for supplements?

A. For babies who are well enough to be with their mothers during postpartum, there are very few indications for supplements. The medical indications for supplementation are:

• infants with acute water loss, for example during phototherapy for jaundice, if increased breastfeeding cannot provide adequate hydration;
• infants whose clinical condition (hypoglycemic) indicates a need for additional calories which is not met by additional breastfeeding;
• infants whose mothers are severely ill (for example with psychosis, eclampsia, or shock);
• infants with inborn errors of metabolism (e.g. galactosaemia, phenylketonuria, maple syrup urine disease);
• infants whose mothers are taking medication which is contraindicated when breastfeeding (e.g. cytotoxic drugs, radioactive drugs, anti-thyroid drugs other than propylthiouracil);
• infants who have not regained birth weight at two to three weeks of age or who have insufficient weight gain, when increased effective breastfeeding cannot provide adequate intake.
  
  

Q. What do you suggest to mothers when their babies are fussy, especially at night?

A. Reassure mothers that it is common for babies to feed frequently at night. When the baby is ‘fussy’, keep baby skin-to-skin and feed frequently.

Q. What are some of the community resources available for breastfeeding mothers?

A. Resources in the community include La Leche League, mothers groups, and community health units that provide community health nurse visits and mothers groups. BC Women's also has outpatient breastfeeding clinics.

Q. What do you suggest to families to help their babies when they have painful procedures such as heel pricks?

A. Evidence indicates that babies cope best with painful procedures (and use up less energy) if they are comforted throughout the procedure. Breastfeeding during these procedures significantly helps the baby. Other possibilities include offering the parents finger to suck on.

Q. What do you tell parents about typical feeding patterns and how they change over the first few days?

A. Babies will often feed soon after birth if left undisturbed, skin-to-skin on the mother’s chest. During the first 24 hours, they are often quite sleepy. In the second 24 hours, we expect that babies will become much more wakeful and interested in feeding – at least eight times in 24 hours. They may have clusters of feeds when they feed very frequently over a short period of time and then sleep for a longer period. Their output increases from a minimum of one wet diaper during the first 24 hours, two during the second, and increases markedly over the next couple of days as the milk supply increases. Stooling also increases, and the stool colour changes.