DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
Table 1: Breastfeeding assessment
Score |
Category at 10 min |
Action |
A |
|
|
B |
|
|
C |
|
|
D
|
|
|
E |
|
|
F |
|
|
Signs of effective breastfeeding
- Effective latch
- latches within few seconds of trying, with wide open
- mouth
- no nipple pain after 10–20 sec
- chin pressed against breast
- head tipped back slightly, nose lightly touching breast
- some areola seen above top lip, but not below bottom lip
- rounded cheeks (not sucked in)
- remains attached throughout feed
- nipple looks rounded (not pinched) at end of feed
- Rhythmic sucking and swallowing
- rapid sucks (≥2 sucks/sec) at first, slowing to regular bursts of rhythmic sucking
- deep jaw drops (1 suck/sec) before brief pause for most of feed
- Eyes open at start of feed
- Remains calm and relaxed as feed progresses
- Baby removes self from breast when no longer wants milk, and looks relaxed and sleepy
BOTTLEFEEDING
Table 2: Bottle feeding assessment chart for babies receiving special/transitional care
Score |
Category at 10–20 min |
Action |
A |
|
|
B |
|
|
C |
|
|
D |
|
|
E |
|
|
Supportive interventions to prepare for bottle feeding:
- Skin-to-skin contact
- Positive touch
- Mouth care with EBM
- Non-nutritive sucking
- Held in a feeding position during NGT feeds
Early feeding readiness cues:
- Stirring
- Mouth opening
- Turning head/rooting
- Stretching
- Hands to mouth
Avoidance behaviours during bottle feed:
- Finger splay
- Back arching
- Grimace/startled look
- Disengages
- Cry
- Change in saturations and heart rate
- Drooling
- Loss of tone
- Colour change to face, lips, nose/finger tips
Co-ordinated sucking/swallowing and breathing
- Able to maintain consistent latch around teat and minimal milk loss observed
- Maintains pattern of 3–5 suck-swallows followed by a breath, with occasional long pause
- Returns to sucking in a pattern of short series of suck-swallow bursts and brief pauses for breathing
Supportive interventions during bottle feed
- Responsive feeding following feeding readiness signs and offering external pacing as led by baby
- Elevated side-lying feeding position
- Slow flow teat