Relationship aspect of breastfeeding

Question 1

John Bowlby’s attachment theory

Answer 1

An infant’s ability to cope with stress is directly related to maternal behaviour. Consistent responsive care and interaction is essential to build a strong relationship that will enhance an infants ongoing development. High cortisol levels are thought to result in a state of hyper arousal and dissociation
Pollard (2017)

Question 2

Responsive feeding

Answer 2

Habron et al (2013) described it as a reciprocal relationship between an infant and their caregiver that is characterised by the child communicating feelings of hunger and safety through verbal and non verbal cues, followed by an immediate response from caregivers

Question 3

What does responsive feeding acknowledge about breastfeeding?

Answer 3

Breastfeeding doesn’t just provide nutrition but can be used to comfort an infant and alleviate full breasts
The synchronous relationship between mother an infant and that BF will enhance growth, development and emotional attachment
Pollard (2017)

Question 4

Signs an infant is ready to feed

Answer 4

• Sucking movements
• Sucking noises
• Licking lips
• Head movements from side
  to side
• Rapid eye movements
• Restlessness
  Pollard (2017)

Question 5

What can interfere with this relationship?

Answer 5

Dummies, seperation and a sleepy or sick infant

Pollard (2017)

Question 6

What concerns are there in the early days?

Answer 6

The length between feeds and the mum may need to wake the infant and encourage feeding to establish or maintain lactation to avoid build up of FIL
It is also important to avoid breasts becoming too full as this may lead to engorgemtn or mastitis
Pollard (2017)

Question 7

How many times should a baby feed in 24 hours?

Answer 7

8

Baby may also cluster feed

Question 8

Responsive bottle feeding

Answer 8

Is important for continuity in who bottle feeds baby, particularly in the early days to build a close, loving reciprocal relationship
There is limited research - it is possible to overfeed a formula fed baby.
Pace the feed so the baby isn’t encourage to take more than required and recognise when baby has had enough
(Pollard 2017)

Question 9

What is non responsive feeding associated with?

Answer 9

Childhood obesity but more research is needed

Question 10

Benefits of responsive feeding

Answer 10

- Maintenance of an adequate 
  milk supply 
- Less infant weight loss in the 
  immediate postpartum 
  period 
- Increased duration of 
  breastfeeding 
- Prevention of engorgement, blocked ducts and mastitis
- Comforted and calm infant 
- Promotion of a close loving 
  relationship 
Pollard (2017)

Question 11

Skin to skin in the first hour

Answer 11

It is strongly recommended as helps encourage breastfeeding. In this first hour after birth, oxytocin levels are high which not only encourages the let down reflex but facilitates instinctive BF behaviour
Pollard (2017)

Question 12

What is skin to skin?

Answer 12

Where baby is laid on the bare chest of the mum and covered by a blanket. It can help calm or comfort a baby and boost the mother’s milk supply
Unicef (2019)

Question 13

Benefits of skin to skin after birth

Answer 13

- calms and relaxes mum and 
  baby
- regulates baby's heart rate 
  and breathing 
- regulated temperature 
  stimulates digestion and an 
  interest in feeding 
- colonisation of the baby's 
  skin with the mother's 
  friendly bacteria, thus 
  providing protection against 
  infection 
- stimulates oxytocin 
Unicef (2019)

Question 14

Skin to skin on NNU

Answer 14

Known as kangaroo care
- improves O2 stats 
- reduces cortisol particularly 
  following painful procedures 
- encourages pre feeding 
  behaviour 
- assists with growth 
  may reduce hospital stay
Always ensure airways are clear