Revisions to the Ten Step document have been released for the United States and are currently being completed for the remaining global community. You will find the link to the full document below. This post will focus on the early initiation of breastfeeding.
Recommendation 2 states, “All mothers should be supported to initiate breastfeeding as soon as possible after birth, within the first hour after delivery,” and is supported by high-quality evidence. ¹ (See Annex 2 for details.)
"Compared to infants who initiate breastfeeding within 1 hour of birth, those who initiate breastfeeding at 2-23 hours after birth, or those who initiate breastfeeding after the first day after birth, are more likely to die in the first 28 days after birth. Breastfeeding within the first hour after birth may improve survival to 3 months and to 6 months, compared to those who initiate breastfeeding later (low-quality evidence)." ¹
In working with new breastfeeding families over the past two years as an RN, IBCLC, too many mothers have shared how they experienced early initiation of breastfeeding... "the nurse did it for me", "she (the nurse) just grabbed my breast without even asking", or "they just pushed the baby onto my breast and left the room". These are stories which mothers report as traumatic and completely unhelpful in their breastfeeding journey. Ideally, all staff working with the new infant and mother should be able to assist the initiation of the latch and milk transfer WITHOUT EVER TOUCHING either mother or infant. Is that something you are able to do? If not, it’s a great clinical skill to develop.
The next post will help you to learn this hands-off approach. I’d encourage you to practice it and get really skilled at not “forcing” the initial latch.
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC
Professional Development Educator
1. Protecting, promoting and supporting Breastfeeding in Facilities providing maternity and newborn services. (2017). World Health Organization https://www.who.int/nutrition/publications/guidelines/breastfeeding-facilities-maternity-newborn/en/
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Last Updated: September 2018