Sign of Good Attachment:
- Baby’s chin is close to the breast
- Baby’s tongue is under the lactiferous sinuses and nipple on the palate
- Baby’s mouth is wide open and lower lip turned outwards
- More areola is visible above the baby’s mouth than below it
- No pain while breastfeeding
- Baby’s cheek are full, not hollow
- Regular, Slow, deep sucks
Sign of Poor Attachment:
- Baby sucks only at the nipple
- Mouth is not wide open and much of the areola and thus lactiferous sinuses are outside the mouth
- Baby’s tongue is also inside the mouth and does not cup over the breast tissue.
- Chin is away from the breast.
- It is painful while breastfeeding.
Flat or Inverted Nipple:
Normally, the nipple corrects itself as the child suckles. But in few cases, the problem persists even after that, the following technique can be tried.
- Cut the nozzle end of a disposable syringe.
- Introduce the piston from the ragged cut end side.
- Ask the mother to apply the smooth side of the syringe on the nipple and gently pull out the piston and let her wait for a minute.
- Nipple would then protrude into the syringe. Ask the mother to slowly release the suction and put the baby to breast, at this time it helps the nipple to erect out and the baby is able to suckle in the proper position.
- After feeding, the nipple may retract back, but doing it each time before feeding over a period of few days will help to solve the problem.
Fullness and Engorgement of the Breast:
- Applying moist heat to the breast 3 to 5 minutes before a feed, followed by a gentle massage and stroking the breast towards the nipple.
- Expressing enough milk to soften the areola.
- Feeding frequently, every 2 – 2.5 hours or sooner at least for 15 – 20 minutes each side after milk let-down has occurred.
- Feeding the baby in a quiet relaxing phase.
- Paracetamol needed to relieve the pain in the breast.
Sore Nipple and Cracked Nipple:
- Feeding in a correct position.
- Washing the nipple once daily only with water.
- Exposure of nipple to air.
- Application of hindmilk drop on the nipple after each feed.
- If infants have oral thrush, 1% gentian violet should be applied to the nipple.
- Feeding in the correct position.
- Avoid wearing tight clothes.
- A warm compress or warm shower.
- Massage the breast using the firm movement of the thumb over the lump towards the nipple.
- Antibiotic therapy.
- Applications of warm packs.
Burping and Position after feeding:
Babies tend to take in a lot of air during feeding, this will lead to abdominal distension, colics, regurgitation, for that baby can be put on the left shoulder. The hand has to support with mothers left hand and then with right arm supporting the buttocks and pat gently on the baby’s back with the right hand. Slowly air will escape.
The prone position should be avoided as it found to be associated with higher incidence of sudden infant death syndrome.