Breastfeeding Assessment (Tips for Doulas)

In anticipation of my laptop dying (it’s showing signs) I’m cleaning my desktop. I found this incredibly helpful document and I can’t see any source! I wish I could credit whomever created this so if you know where it’s from please let me know.

Breastfeeding Assessment
Make a quick observation of both mother and infant to determine any
conditions that may impact on the initiation of breastfeeding.
Mothers’ assessment
Look for:
Nipple shape: erect, Flat or inverted nipples make it more difficult for the baby to latch on.
Areola flexibility and elasticity – incompressible nipples and areola make it more difficult for the baby to latch on.
Surgical scars on the breast or areola – may indicate previous biopsy, augmentation or reduction surgery. Milk may back-up behind areas of severed ducts.
Shape of the breasts – Conical, hypoplastic or concave appearing breasts may have the potential to produce less milk. Breasts should have a rounded appearance
Size and symmetry of the breasts – Breasts that are very large or markedly different in size may signal the potential for reduced milk production.
Spacing of the breasts – A space larger than 3″ may indicate the potential for reduced milk production.
Engorgement- Extreme fullness makes latch-on difficult.
Nipples that are cracked, blistered, abraded or otherwise damaged – usually indicates a problem with positioning and latch-on.

Infants’ assessment
Look for:
Short frenulum or heart shaped tongue – may cause nipple soreness and low milk intake. Clipping the frenulum is recommended if the baby cannot maintain the tongue in a forward position over the lower gum ridge. Discuss this with the infant’s pediatrician.
Alertness and hunger cues – Capitalize on the baby’s cues to indicate feeding readiness.
Signs of jaundice – Elevated billirubin makes jaundiced babies are sleepy.

Stages of readiness for the first feeding

Relaxation 0 -15 minutes after birth
The baby is placed on the mother’s abdomen and he rests while
his body systems become accustomed to extra-uterine life.
Awakening 10 – 30 minutes after birth
The baby rouses and shows an interest in his surroundings.
Activity 15 – 30 minutes after birth
The baby starts to move arms and legs.
Crawling 20 – 40 minutes after birth
The baby makes movements that resemble crawling up the
mother’s abdomen.
Resting 25-45 minutes after birth
The baby rests for several minutes.

Locating the breast 30 – 45 minutes after birth
As the baby gets hungry for the first time, he is motivated to find the breast. He is attracted by the smell of the breast and the sight of the nipple and areola.
Suckling 40 – 60 minutes after birth
The baby latches on and feeds
Sleeping 60 – 75 minutes after birth
The baby goes into a deep sleep that may last for several hours.

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