The mother of a premature infant born at 32 weeks' gestation expresses the desire to breastfeed her child. An appropriate suggestion by the nurse would be:

Question

1. "Mothers who cannot directly breastfeed should talk with and stroke their infants during gavage feedings, as this can help facilitate milk letdown."

2. "The letdown reflex is best initiated by having the baby suck at the breast."

3. "Pumping should be done no more than three times daily, making sure to empty each breast completely."

4. "You should begin pumping by six hours postpartum to ensure adequate milk production."

Answer 1

4

Rationale:

1. Just because a newborn is premature does not preclude the mother from breastfeeding. The mother can breastfeed unless some other issue is present.
2. Pumping the breast can facilitate milk letdown.
3. Breast pumping should be done at least five or more times per day to ensure an adequate supply of milk.
4. It is best for the mother to initiate the letdown reflex by stimulating the breast prior to feeding so that the infant will not have to suck as hard, which can burn unnecessary calories. The sooner the mother can begin breast pumping postpartum, the more likely she is to produce an adequate milk supply.