information sheet - breastfeeding checklist by Grainne Flannelly

Green Column Suggests Effective Breastfeeding

Amber Column Suggests Breastfeeding Challenge

Breastfeeding Observation and Assessment Tool â&#x20AC;&#x201C; for use from day 5 approx. What to observe / ask about

Appearance and frequency of Baby has 3-6 wet heavy nappies over 24 hrs (pale yellow or clear urine) Baby has damp nappies, less frequent wet nappies bab e and di na ie and 3-8 stools (yellow, seedy, runny to loose) daily Baby has scant, hard or difficulty passing stools Bab c l ale ne and Baby may have evidence of normal physiological jaundice Bab ja ndice i ening n im ing tone? Baby is alert, Baby has good tone Baby is lethargic; not waking up to feed; has poor tone Weight of baby (following Bab eigh l i f bi h eigh Bab eigh l i f bi h eigh initial post birth weight loss)? Baby has returned to birth weight by day 14 Birth weight not regained by Day 14 Number of breastfeeds in the Baby breastfeeds on demand, or is fed responsively according to early Baby has fewer than 8 breastfeeds in the last 24 hour period last 24 hours? feeding cues, with at least 8-12 feeds in each 24 hour period Bab beha i d ing Baby is generally relaxed and calm Baby is unsettled during breastfeeds, or refuses to breastfeed breastfeeds? Bab ucking pattern during Baby initially sucks rapidly then changes to slower sucks with pauses and Baby does not change sucking pattern during breastfeeds breastfeeds? audible regular soft swallowing (may be less audible until milk comes in) Baby makes noises when feeding, (e.g. clicking) How baby breastfeeds? Baby feeds actively from first breast until satisfied Baby is unsatisfied despite regular breastfeeds Is baby offered second breast? Baby is offered second breast Mother restricts the baby to one breast per feed Baby feeds from second breast or not, according to appetite How baby ends breastfeeds? Baby releases breast spontaneously, or does so when breast is gently Baby does not release breast spontaneously, mother removes baby lifted from breast Bab beha i af e Baby is content after most feeds Baby is unsettled after breastfeeding breastfeeds? Shape of m he nipples after M he nipples are rounded similar to when the breastfeed began or M he nipples are misshapen or pinched at the end of breastfeeds breastfeeds? the nipples may be slightly elongated M he e n he ni le M he nipples and breasts are comfortable M he nipples are sore or damaged, breasts are uncomfortable and breasts? Ob e a i n f m he M he nipples are intact and breasts are comfortable with no redness, Mother may have symptoms of thrush (e.g. pink, shiny, flaky nipple, nipples and breasts? lumps or tenderness burning pain in breast after breastfeeds), breasts may be engorged or have signs of mastitis (e.g. hot sore breast area, feeling unwell) M he s wellbeing? Mother appears relaxed, comfortable and healthy with good eye contact Mother appears unwell, tense, uncomfortable with little/no eye with baby contact with baby Use of maternal nipple shields, Mother does not use nipple shields Mother uses nipple shields bottle feeds, formula? Baby breastfeeds exclusively with no bottle feeds or infant formula milk Baby offered bottle feeds or infant formula milk Breastfeeding challenge or concern with positioning/latch Refer to Lactation Consultant, bleep 347/023 Breastfeeding Clinic, Thursdays 9:30-12:30pm, 65/66 Mount St. Classroom Slow weight gain/growth or concern with nutrition/intake Refer to Dietitian, bleep 124 or ext. 3314, Monday to Friday See also to www.mychild.ie - breastfeeding

V1.1: Adapted from the Guideline on the Observation of a Breastfeed and Use of the Breastfeeding Observation and Assessment Tool (BOAT) Resource, HSE, 2018, by the Dept of Clinical Nutrition and Dietetics, National Maternity Hospital, Holles St., Dublin 2. Date: March 2020 Review date: March 2022 Document number: Page 1 of 2

Notes …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………