Newborn Breastfeeding

The Newborn Breastfeeding Check Up typically takes place in your home when your baby is 3 to 5 days old.  

For those who are breastfeeding well, it is reassuring to get that confirmation prior to the usual first pediatric visit at 2 weeks.  For those few who are experiencing difficulties, it is invaluable to get help early on so that needed adjustments can be made to protect the baby's and mother's health and to ensure the best possible milk supply.   

Please call us at 713 884 6204 if you have any questions or would like to schedule an appointment. 

For further info on the AAP Statement on Breastfeeding and how we specifically help, please read below:

The complete Policy Statement by the American Academy of Pediatrics, Section on Breastfeeding* was originally posted on December 1, 1997 and was updated and posted in PEDIATRICS, Vol. 115 No. 2 February 2005, pp. 496-506 (doi:10.1542/peds.2004-2491). 

It reads as follows:
"All breastfeeding newborn infants should be seen by a pediatrician or other knowledgeable and experienced health care professional at 3 to 5 days of age as recommended by the AAP. This visit should include infant weight; physical examination, especially for jaundice and hydration; maternal history of breast problems  (painful feedings, engorgement); infant elimination patterns (expect 3–5 urines and 3–4 stools per day by 3–5 days of age; 4–6 urines and 3–6 stools per day by 5–7 days of age); and a formal, observed evaluation of breastfeeding, including position, latch, and milk transfer. 

Weight loss in the infant of greater than 7% from birth weight indicates possible breastfeeding problems and requires more intensive evaluation of breastfeeding and possible intervention to correct problems and improve milk production and transfer. "

 As of this writing, many insurance companies do not routinely cover a pediatric visit for a 3 to 5 day old infant unless there is a problem.  For many infants their first pediatric visit outside of the hospital/birthing center will be when they are 2 weeks old.  Unfortunately, by that time too many infants have been supplemented with formula because of a real or perceived lack of breast milk and as a result, their mom’s milk supply is diminishing.  On the other hand, some may not have regained birth weight and probably needed supplementation but did not receive it, and as a result, their mom’s milk supply and the baby's health may have been compromised.

We want to stress here that not ALL newborns require intervention to successfully breastfeed BUT for those who do, this early screening is vital.

We, at TLC, really like the proactive approach presented  by the AAP and for this reason we have designed The Newborn Breastfeeding Check Up.  During this visit we thoroughly address all of the AAP's recommendations for the baby with only one exception:  because we are not pediatricians, we can not do a complete physical exam (checking stomach, ears, nose, etc); however, we will do a physical assessment as relates to breastfeeding, assessing baby’s tone and overall appearance, especially noting jaundice and hydration, and doing a complete exam of the infant’s mouth.  This includes checking the palate, the tongue and it’s mobility, and the infant’s suck.  Last but not least, we check how much milk is being transferred in a feeding by doing a pre and post breastfeeding weight.  A written report is then sent to the pediatrician with our findings and recommendations for his/her consideration.  

For the mother, we address all the points recommended for her care by the AAP, paying particular attention to details in her medical history that may alert us to potential breastfeeding management concerns (previous difficulties with supply, surgeries, medications, family allergies, etc). We ensure that breastfeeding is comfortable and where needed, correct positioning and latch, giving the mother ample time to practice while we are there.  We answer her questions (and her family's questions!) and give her appropriate anticipatory guidance that will help her to meet her breastfeeding goals.  Finally, if adjustments need to be made, we devise a care plan for the family's specific needs which includes follow up (phone/text/email/home visits) until the concerns are resolved.  When needed, we also communicate with the mother's health care provider.   

* For more info on the AAP's recommendations for newborns including who should and who should not breastfeed, guidelines for breastfeeding in the first few days, how long babies should be breastfed, and special recommendations for high risk infants and the use of donor breast milk, please click here.

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