Assessing breast milk adequacy and ways to increase milk production Nutrition

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Indicators of effective breastfeeding and breast milk adequacy are adequate infant hydration, adequate output and infant weight. Some infants take longer to regain their birth weight. Before deciding that exclusive breastfeeding is inadequate, the health care provider must consider other factors that may contribute to slow weight gain. Nearly all newborns lose weight for the first ۲ to ۴ days after birth, given the loss of meconium and diuresis. Newborns who are feeding well should not continue to lose weight after lactogenesis ۲ and who is nursing effectively should obtain enough milk to begin gaining weight by day ۴ or ۵ after birth, at a rate of approximately ۱۵ to ۳۰ g per day. If weight loss persists, milk production and transfer should be assessed. In maternal lactation insufficiency the weight change from before to after the feeding is less than ۴۵ g beyond the first few days after birth, this may be a reason for concern. During subsequent breastfeeding beyond the immediate postpartum period, whenever the mother perceives “insufficient milk," the introduction of supplementary fluids may cause negative feedback on milk production. Strategies to improve breast milk transfer and breast milk production include: •Encourage mother to: Respond to early feeding cues, breastfeed as often as the infant is showing feeding cues, and at least ۸ times in ۲۴ hours, Not wait until breasts are feeling hard, engorged, or overfull and ensure that the infant is positioned well and latched effectively (Elicit a mother's breast milk ejection reflex, have adequate breast milk transfer and help stimulate and/or maintain adequate breast milk production). • Ensure that the mother knows how to: Hand express, Nurse Longer, Double-Nursing and Uses breast compression and switch nursing.