Feed at Least Eight Times in 24 Hours (Usually Nearer Twelve)

Breastfeeding Update The results of the latest Infant Feeding Survey key recommendations for have just been published preparing formula: either by not always using boiled water . Initial breastfeeding rates in 2005 were that had cooled for less than 78 per cent in England, 70 per cent in 30 minutes or not always Scotland, 67 per cent in Wales, and 63 adding the water to the bottle per cent in Northern Ireland Skin-to-skinbefore the powder. contact: . In 2005, 48 per cent of all mothers in the United Kingdom were breastfeeding at six weeks, while 25 per cent were still • should be immediate breastfeeding at six months . In 2005, 45 per cent of all mothers in • should be unhurried the United Kingdom were breastfeeding exclusively at one week, while 21 per cent were feeding exclusively at six • should be unlimited weeks. At four months the figure was 7 per cent while at six months the proportion of mothers who were breastfeeding exclusively was negligible . Three-quarters of all mothers had given their baby milk other than breast milk by the age of six weeks, this proportion rising to 92 per cent by six months. . Just under half of all mothers who had prepared powdered infant formula in the last seven days had not followed the Skin-to-skin This is skin-to-skin “Skin-to-skin contact at contact. birth increases Research shows that skin-to-skin contact the duration of at birth helps babies stay warm, helps exclusive babies stay calm, helps babies maintain with their newborn for at least thirty breastfeeding.” their blood sugar, helps mothers to fall in minutes, and that they themselves chose love with their babies and has significant to end the period of contact, rather than Mikiel-Kostyra K, Mazur J, positive effects on breastfeeding, both for staff suggesting it. Boltruszko I (2002). Effect of early early breastfeeding success and skin-to-skin contact after delivery on duration of breastfeeding: a breastfeeding duration. prospective cohort study. Acta Paediatr 91(12):1301-6 For a Baby Friendly assessment, mothers An audit of skin-to-skin contact in Powys should report that they had the opportunity will be starting shortly. to have uninterrupted skin-to-skin contact

How to get started Key points

 Concern about babies becoming cold  Although thirty minutes (or more) of -there is evidence to show that babies uninterrupted skin-to-skin contact may maintain their body temperature better if slightly delay the ‘completion’ of the care kept in skin contact with their mothers episode for the midwife (due to not being The baby can be dried and, if needed, a able to weigh, check and dress the baby blanket can be wrapped around mother immediately, it can save on postnatal care and baby together time by getting breastfeeding off to a great  Midwives need to carefully consider the start language they use - offering 'to clean This is a lovely post birth the baby up', for example, suggests that newborns are dirty cuddle. It’s not the same as  The midwife does not have to stay in skin-to-skin Skin-to-skin should be the DEFAULT the room throughout the period of skin  contact if both mother and baby are OPTION for all births and mothers should be well. Leaving the family alone in a quiet given the opportunity to ‘opt out’ rather than atmosphere can be a positive action, ‘opt in’ providing that the midwife is available to help with the first feed Just in… Latest breastfeeding statistics

The UK’s Department of Health recommends that all babies are exclusively breastfed for the first six months of their lives

The number of UK babies receiving the lifetime of health benefits this is known to confer is described as ‘negligible’

With postnatal visiting reduced, we all need to be aware of the need to take a full feeding history at each‘Red visit flags’ and into increasebreastfeeding support and if necessary involve a breastfeeding specialist where concerns areassessment identified. Newborn babies should:  Feed at least eight times in 24 hours (usually nearer twelve)  Wake for feeds  Have at least six properly wet nappies a day after day 3  Have at least two really pooey nappies a day  Be back to birthweight by two weeks

Mums should:  Not have sore nipples which are not getting better  Not report feeds which are extremely long and frequent  Be able to report that their nipples remain round after a feed

Where these concerns are identified midwives should observe an entire feed. Attachment of the baby at the breast is almost always the problem.