The nurse is working with a new mother who delivered yesterday. The mother has chosen to breastfeed her infant. Which demonstration of skill is the best indicator that the patient understands breastfeeding?
1. She puts the infant to breast when he is asleep to help wake him up.
2. She takes off her gown to achieve skin-to-skin contact.
3. She holds the infant so that he turns his head to access the nipple.
4. The infant is crying when he is brought to the breast.
2
Rationale 1: Breastfeeding is more successful if the infant is in the alert-awake state when put to breast. Putting a newborn to breast is not likely to wake him up to feed.
Rationale 2: Skin-to-skin contact creates tactile sensations that increase the sucking of newborns.
Rationale 3: The infant should be held in a "tummy-to-tummy" position so that the head does not have to turn to find the nipple and access the breast.
Rationale 4: Crying is a late cue of hunger. Newborns should be put to breast when they begin rooting, lip-smacking, or tongue-thrusting behaviors.
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