Anemia of Prematurity - Portal Neonatal

Phenomenon of human imprinting
Lawrence and Lawrence discuss the phenomenon of human imprinting or stamping, which occurs
early in the postnatal period. Comfort sucking and the formation of a nipple preference are genetically
determined behaviors that affect imprinting to the mother's nipple. The baby's initial recognition of his
or her mother involves the distinctive features of the nipple. If an infant who is learning to breastfeed
receives supplementation via a bottle or a pacifier, the nipple-recognition signals are mixed. Although
some dispute the existence of nipple confusion, numerous documented cases support its existence.
Certainly, studies have shown that supplementation and the introduction of a foreign nipple, such as a
pacifier, are associated with decreased rates of continued breastfeeding.
CORRECT BREASTFEEDING TECHNIQUES Section 4 of 11
Before the common breastfeeding positions and techniques are reviewed, an understanding of the
importance of timing in initiating breastfeeding is essential. Studies show that a woman's likelihood of
continuing breastfeeding beyond the first month is related to the initiation of breastfeeding immediately
after delivery.
Oxytocin levels at 15, 30, and 45 minutes after delivery are elevated significantly, coinciding with the
expulsion of the placenta. Studies have linked maternal bonding and oxytocin levels. Therefore,
encouraging the mother to have contact with her infant at a time when suckling is paired with high
oxytocin levels and better letdown seems appropriate. In addition, the infant is alert soon after delivery
and has not entered the deep sleep period that ensues approximately 6-12 hours after birth. Finally,
personnel are more available to assist the mother in initiating breastfeeding during this immediate
postpartum period.
Successful latch-on of the infant during this period enhances a mother's confidence that she can
breastfeed. If a mother received narcotic analgesics during delivery, the infant may be sleepy and less
able to breastfeed; if so, the mother may need to wait until the infant is in a more alert state. The use of
relaxation techniques during labor and other forms of anesthesia, such as epidural anesthesia, allows
the infant to be delivered in a more fully awake state. This early breastfeeding session typically helps
instill confidence in the mother. Any early problems can be identified, and the mother can be offered
assistance to facilitate the lactation process.
Breastfeeding environment
The mother and infant should be allowed to breastfeed in a relaxed and supportive environment.
Personnel should be readily available to facilitate the process. Constant interruptions and a deluge of
visitors may disrupt the early breastfeeding experience. The father's assistance and support are
strongly associated with the success of breastfeeding. In a study of 224 mothers who were interviewed
regarding their feeding choice, the father was a key factor in the initiation of breastfeeding. When the
father supported breastfeeding, more than 75% of the mothers chose to breastfeed; in contrast, when
the father did not support breastfeeding, only 2% of the mothers chose to breastfeed.
Often, the father can assist the mother with the positioning of the infant, particularly if she is recovering
from a cesarean delivery. Thus, the father's approval and involvement in the breastfeeding process is
helpful in creating a supportive environment. Grandparents who support breastfeeding also facilitate
the process; however, if they do not breastfeed, their attitude can adversely affect the breastfeeding
mother. Therefore, the mother who is breastfeeding and learning to know her newborn should be
surrounded by a supportive caring team of health care providers and family members.