Breast-feeding is the safest and least expensive way to provide complete infant nourishment. Components of successful and satisfying breast-feeding include proper breast care, normal milk flow, and a comfortably positioned woman and infant.

Breast-feeding is contraindicated for a woman with a severe chronic condition, such as active tuberculosis, human immunodeficiency virus infection, or hepatitis.

Nursing or support bra

Pillow

Protective cover, such as cloth diaper or small towel

Explain the procedure to the mother and provide privacy.

Encourage the mother to drink a beverage before and during or after breast-feeding. This ensures adequate fluid intake, which helps to maintain milk production.

Encourage the mother to attend to personal needs and to change the infant’s wet or soiled diaper before breast-feeding begins to avoid interruptions during feeding time.

Wash your hands and instruct the mother to wash hers.

Help the mother find a comfortable position, for example, the cradle or side-lying position, to promote the let-down reflex. (See Breast-feeding positions.) Have her expose one breast and rest the nape of the infant’s neck in the crook of her arm, supporting his back with her forearm.

Urge the mother to relax during breast-feeding because relaxation also promotes the let-down reflex. Inform her that she may feel a tingling sensation when let-down occurs and that milk may drip or spray from her breasts. Tell her the reflex may also be initiated by hearing the infant’s cry.

Guiding the mother’s free hand, have her place her thumb on top of the exposed breast’s areola and her first two fingers beneath it, forming a “C” with her hand. Turn the infant so that he faces the breast.

Tell the mother to stroke the infant’s cheek located nearest her exposed breast or the infant’s mouth with the nipple. This stimulates the rooting instinct. Emphasize that she shouldn’t touch the infant’s other cheek because he may turn his head toward the touch and away from the breast.

When the infant opens his mouth and roots for the nipple, instruct the mother to insert the nipple and as much of the

areola as possible into his mouth. This helps him to exert sufficient pressure with his lips, gums, and cheek muscles on the milk sinuses below the areola.

Check for occlusion of the infant’s nostrils by the mother’s breast. If this happens, reposition the infant to give him room to breathe.

Suggest that the mother begin nursing the infant for 15 minutes on each breast.

To alternate breasts, instruct the mother to slip a finger into the side of the infant’s mouth to break the seal and move him to the other breast.

To burp the infant, show the mother how to hold the infant in an upright forward-tilting position with one hand supporting his chest and chin. Tell her to gently pat or rub the infant’s back to expel ingested air. Help her place a protective cover, such as a cloth diaper, under the infant’s chin. (See Sitting up for burping.)