2. Your Words Carry Weight!
• Patients who are deciding to breastfeed are open to
suggestion about breastfeeding
• Nurses are often the first people to talk to the patient about
breastfeeding after the baby is born. Your encouragement
could change the course of the baby’s life.
3. Changes in the Hospital
• Due to the emphasis on breastfeeding in the new healthcare
law, many hospitals are making changes to their policy and
procedure.
• Patients will be required to sign a consent to have formula
given to their baby that outlines the risks involved
• Emphasis on rate of exclusive breastfeeding by corporate
entities running hospitals
• Doctors will have to write an order for formula and show a
medical reason the child needs supplementation
• Desire to breastfeed will be documented in the mother’s
medical record
• Babies will be placed skin to skin with mother after delivery
when possible as a priority
• Breastfeeding assessments will be done after each shift
4. Supplementation
• This may seem like a quick and simple fix for a fussy baby but
it creates other problems.
• Exposure to cow’s milk poses a risk of developing
allergies, eczema, and asthma.
• Flow rates differ between a mother’s nipple and a bottle.
Often, when a baby drinks from a bottle, it does not
understand that it needs to suck hard when it goes back to the
breast.
• Breastfeeding involves use of an undulating tongue action
whereas a bottle will squeeze milk into baby’s mouth when
bitten.
5. Sometimes it is hard to think of what to say when patients have
questions about breastfeeding. Here are some common
questions and good responses to promote breastfeeding.
6. Can you give my baby a bottle in the nursery? My
friend said he’ll sleep through the night if he drinks
formula. I am too tired and I need sleep.
• Formula is much harder for baby to digest and absorb so it sits
in his stomach longer. Your baby needs to eat more often
when he is developing.
• If I give baby a bottle it may cause nipple confusion. He may
not want the breast because the nipple is softer and the milk
does not flow as fast as the bottle.
• Baby sleeps better when mom is nearby. It is a good idea for
you to get used to his schedule before you go home in case
you have any questions.
• It is a good idea to try and sleep while baby is sleeping.
• Why don’t I take the baby to the nursery and I will come in
every three hours so you can feed him and then get back to
sleep?
7. I won’t make milk, my mom didn’t make milk
and our family just doesn’t make any milk.
• Low milk supply does not run in families.
• It is extremely rare that a mother is unable to produce enough milk
to meet her infant’s needs.
• Why don’t we wait and see? You can try breastfeeding in the
hospital and if it works out you can continue at home. If not, you
can always use formula.
• The more you breastfeed, the more you will make.
8. Can you get some formula for my baby?
I am not making any milk and she is
hungry.
• Why do you think you aren’t making milk? (Dispel false notions)
• For the first 72 hours, your body makes a very rich form of breast
milk called colostrum. A few drops of it can satiate baby’s appetite.
• It may not look like there is a lot of milk coming out but baby’s
stomach is only the size of a thimble (grape, teaspoon, shooter
marble) right now.
• Teach how to hand express
• Soft breasts with colostrum make it easier for baby to learn how to
breastfeed. This time is crucial.
• Your milk is a process of supply and demand. The first few weeks
are crucial in developing demand. If you give baby formula, you
might not make enough milk to exclusively breastfeed later.
9. My nipples hurt. My baby cries all
of the time and just wants to eat. I
give up. shouldn’t be painful, let’s look at the latch and
• Breastfeeding
see what we can do to make it more comfortable for you both.
• Babies can’t tell you what they need so they cry for many
different reasons. Try changing and burping baby. Often, they
just need to be held.
• Growth spurts happen around 7-10 days of age, 6 weeks, and
3 months. Your baby will want to eat constantly for a day or
two. This is normal, your body will accommodate. You will
get through it!
10. Baby is Crying: Help for Nurses
• Get baby skin to skin with mom or dad
• Let the baby suck on a finger or pacifier
• Let the baby taste breast milk- it calms them
• Provide motion- rocking, patting, bouncing
• Swaddle baby
• Check baby’s temperature
• Stay calm and help calm the parents
• Reduce stimulation (the TV, lights, etc.)
• Burp baby. Bicycling baby’s legs can help him release gas.
11. References for Moms
• Mom’s Place
• La Leche League
• WIC
• Mother’s Milk Bank
• Local Lactation Consultants
• NIH Website
12. You have the power to make significant changes. Make yourself a
breastfeeding expert and promote the health of tomorrow’s
children.
13. References
The American academy of pediatrics section on breastfeeding:
Breastfeeding and the use of human milk. (2005).
Pediatrics, 496-506.
American College of Obstetricians and Gynecologists and Committees
on Health Care for underserved women and obstetric
practice (Breastfeeding: Maternal and Infant Aspects No.
Clinical review). (2007). Retrieved from
http://www.acog.org/departments/underserved/clinicalRe
viewv12ils.pdf
Breastfeeding. (2006). World Health Organization. Retrieved from
http://whqlibdoc.who.int/publications/2006/924159084X_
eng.pdf
HHS blueprint for action on breastfeeding. (2000). U.S. Department
of Health and Human Services, 1-31.
Lowdermilk, D. L., Perry, S. E., & Cashion, K. (2009). Maternity
Nursing (8th ed.). Maryland Heights, MO : Mosby.
