Breastfeeding Techniques
It is important that the mother has been trained and physically and psychologically prepared during prenatal care. In delivery rooms, early initiation should be performed. Subsequently, breastfeeding technique will be taught and evaluated to ensure successful breastfeeding.
General Recommendations
1. Daily general bath. During the bath, palpate the breasts and check that they are soft, without nodules or lumps (milk accumulation).
2. Wash hands before breastfeeding the baby.
3. The baby should be clean and dry to be fed.
4. Keep the baby uncovered (free from covers) while breastfeeding to prevent them from falling asleep. This allows free and close contact with the mother. Avoid moving the baby abruptly to prevent risk of vomiting.
5. Adopt the most comfortable position, whether sitting or lying down with the back well supported.
6. The breast and nipple should not be washed before or after feeding the baby.
7. Express a small amount of milk and apply it to the nipple before and after breastfeeding the baby.
8. Moisture favors bacterial proliferation (infections) and formation of cracks, so after breastfeeding, air out the breasts as much as possible.
9. If during the first days of breastfeeding you experience cracks and pain in the nipples, do not stop breastfeeding. Treat them with breast milk and use the correct breastfeeding technique. Consult a community support group or health institution.
10. To maintain milk production and secretion, recommend the mother breastfeed on demand, stay calm, happy, and rest while the baby sleeps.
11. Position the baby so that their arms do not interfere between the mouth and the breast; the contact with the breast should be close.
12. While breastfeeding, the baby’s body should face the mother’s body without needing to extend or turn their head to eat.
13. Place the baby on the breast until they empty it, then switch to the other breast. For the next feeding, start with the last breast offered.
14. When breastfeeding is exclusive and on demand, the baby does not need water or juices. Breast milk supplies all nutritional and liquid needs.
15. Avoid any strenuous exercise during the first three months of breastfeeding.
Breastfeeding Positions
To breastfeed correctly, both the mother’s and baby’s positions must be considered.
Allow the mother to sit comfortably and relaxed. Use a stool or any object to keep her feet elevated and supported. Remember that in any position, the baby should approach the breast, not the mother lean toward the baby.
• Sitting or cradle position: Place pillows on the armrests of the chair and instruct the mother that the baby’s head should rest on the inside angle of her elbow, forming a straight line with the back and hips. Hold the baby with the arm and bring them close to the breast in a close hug. Keep the baby close to the body and in contact with the abdomen.
• On the arm: The baby is held on the mother’s forearm, and the body leans back while the head is supported by the hand on the same side. Pillows can be placed to help the mother support the baby’s weight.
• Semi-sitting: Position the bed in a semi-Fowler position, support the back with one or two pillows so that it stays straight and legs slightly bent. The baby will be on the mother’s chest. This position is used when there are abdominal wounds (cesarean section).
• Lying down: If the mother is lying on her side, use pillows to support the back, reducing tension that could affect breastfeeding. Also place pillows between the knees or blankets to elevate the baby’s body.
Important Baby Reflexes for Breastfeeding
The newborn has three reflexes that help with feeding:
• Rooting reflex: Helps the baby find the nipple. It is stimulated by touching the baby’s cheek with the nipple.
• Sucking reflex: When the lips are stimulated, the infant starts sucking movements. This reflex is necessary for proper feeding and is usually accompanied by the swallowing reflex. The infant sucks in a more or less regular pattern of starts and pauses. It is also present in premature babies.
• Swallowing reflex: The passage of milk to the stomach through voluntary and involuntary movements that automatically occur in a unique sequence of movements.
Breastfeeding Procedure
• Support the breast with the hand in a "C" shape, placing the thumb above and the other four fingers below the nipple behind the areola. If the baby’s lips touch the mother’s fingers, it prevents proper latch covering the nipple and part of the areola.
• Remind the mother to bring the baby to the breast, not the breast to the baby, preventing back pain and nipple traction.
• Stimulate the rooting reflex by bringing the nipple to the baby’s mouth corner, and when the baby opens the mouth wide, insert the nipple and areola. If resisted, gently pull down the baby’s chin to achieve proper suction.
• The baby’s lips should be fully open without folds or predisposition to cracks that hinder breastfeeding. If the position is incorrect, remove the baby from the breast and try again.
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