Breast feeding (indicators of effective breastfeeding)

The following signs indicate that the baby is successfully feeding:

• audible and visible swallowing (1)
  • swallows may be less audible until milk comes in day 3-4 (2)
    
    
• baby's cheeks are round (not hollowed or sucked in) (3)
  
  
• initial rapid sucking pattern which changes to slower sucks with pauses and soft swallowing
  
  
• the infant is calm, the arms and hands are relaxed
  
  
• the mouth is moist
  
  
• regular soaked nappies
  • on days 1-2 - 1-2 or more
  • on days 3-4 - 3 or more, heavier
  • day 7+ - 6 or more, heavy
    
    
• baby feeds for 5 -30 minutes at most feeds
  
  
• at the end of the feed the baby lets go spontaneously or does so when the breast is gently lifted
  
  
• the baby is content after most feeds (1,2)

Indicators of effective breastfeeding in the woman are:

• softening of their breast during the feed
• breast and nipples are comfortable
• nipple shape is the same as when feed began or slightly elongated
• feeling relaxed and sleepy (1,2)

Reference:

• 1. National Collaborating Centre for Primary Care (NCCPC) 2006. Postnatal care. Routine postnatal care of women and their babies
• 2. Oxford Radcliffe NHS Trust 2008. Breastfeeding assessment form. UNICEF UK Baby Friendly Initiative
• 3. World Health Organisation (WHO) 2000. Mastitis. Causes and management