Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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Reference Manual<br />
Inverted Nipples<br />
Some women have flat or inverted nipples which may reduce their confidence in their ability to<br />
breastfeed <strong>and</strong> cause some babies frustration when they are starting to breastfeed. There is no<br />
reason why women with inverted nipples cannot breastfeed. Antenatal treatment may not<br />
always be helpful. Assisting women with inverted nipples is most important soon after birth,<br />
when the baby starts breastfeeding.<br />
Management of flat <strong>and</strong> inverted nipples<br />
• Build the mother's confidence.<br />
o Explain that it may be difficult at the beginning, but with patience <strong>and</strong> persistence she<br />
can succeed. Explain that her breasts will improve <strong>and</strong> become softer in the week or<br />
two after delivery. Her baby's suckling will help to pull her nipples out.<br />
o Explain that a baby suckles from the breast not from the nipple.<br />
o Her baby needs to take a large mouthful of breast. Explain also that as her baby<br />
breastfeeds, he/she will pull the breast <strong>and</strong> nipple out.<br />
• Encourage her to give plenty of skin-to-skin contact <strong>and</strong> to let her baby explore her<br />
breasts. Let him/her try to attach to the breast on his/her own, whenever he/she is<br />
interested. Some babies learn best by themselves.<br />
• Help her to position her baby.<br />
o If a baby does not attach well by himself/herself, help the mother to position the baby<br />
so that he/she can attach better. Give her this help early, in the first day, before her<br />
breast milk “comes in” <strong>and</strong> her breasts are full.<br />
o Help her to try different positions to hold her baby. Sometimes putting a baby to the<br />
breast in a different position makes it easier for him/her to attach. For example, some<br />
mothers find that the underarm position is helpful (see Figure 11.1).<br />
• Help her to make her nipple st<strong>and</strong> out more before a feed. Sometimes making the nipple<br />
st<strong>and</strong> out before a feed helps a baby to attach. Stimulating her nipple may be all that a<br />
mother needs to do. Or she can use a h<strong>and</strong> breast pump or a syringe to pull her nipple<br />
out (see Figure 11.2).<br />
• Express her milk <strong>and</strong> feed it to her baby with a cup. Expressing milk helps to keep<br />
breasts soft so that it is easier for the baby to attach to the breast, <strong>and</strong> it helps to keep<br />
up the supply of breast milk.<br />
• She should not use a bottle because that makes it more difficult for her baby to take her<br />
breast.<br />
• Express a little milk directly into her baby's mouth; some mothers find that this is helpful.<br />
The baby gets some milk straight away so he/she is less frustrated, <strong>and</strong> he/she may be<br />
more willing to try to suckle.<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course<br />
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