Colostrum, present at birth, is rich in protein and immunoglobulin A and acts as the newborn's first immunization.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A nurse is counseling a non-breastfeeding postpartum client about lactation suppression. Which instructions should the nurse provide?
Answer: A. For a mother who is not breastfeeding, lactation suppression is achieved by avoiding nipple stimulation: wear a snug, supportive bra continuously, apply cold/ice packs and use mild analgesics for engorgement discomfort, and avoid warmth, breast massage, pumping, or expressing milk because these stimulate further milk production. Bromocriptine is no longer used for routine suppression because of safety concerns.
Question 2 of 5
A breastfeeding mother who is Rh-negative gave birth to an Rh-positive infant. The nurse explains that Rho(D) immune globulin (RhoGAM) will be given. Which statement by the nurse is accurate?
Answer: A. An Rh-negative mother with an Rh-positive infant and a negative indirect Coombs (antibody screen) should receive Rho(D) immune globulin within 72 hours of birth to prevent maternal sensitization in future pregnancies. RhoGAM is safe during breastfeeding, is given intramuscularly, and does not treat the current infant's blood; it protects future pregnancies.
Question 3 of 5
A nurse is teaching a postpartum client about resuming activity and contraception before discharge. Which client statement indicates a need for further teaching?
Answer: A. Exclusive breastfeeding is not a reliable form of contraception, and ovulation can occur before the first postpartum menstrual period, so a client who believes she cannot become pregnant while breastfeeding needs further teaching. Correct statements include waiting for provider clearance (usually about the postpartum visit) before resuming intercourse and strenuous exercise, using contraception as advised, and reporting heavy bleeding or fever.
Question 4 of 5
A client with mastitis asks whether she should stop breastfeeding from the affected breast. What is the nurse's best response?
Answer: A. Clients with mastitis should continue breastfeeding or pumping frequently, including from the affected breast, to keep milk flowing and prevent stasis and abscess formation. The milk is safe for the infant. Abrupt weaning worsens engorgement and the infection.
Question 5 of 5
A client wants to quit smoking. The most effective nursing approach is to:
Answer: B. Assess readiness, set a quit date, offer support and pharmacologic aids (nicotine replacement, etc.), and follow up. Brief, supportive, individualized counseling beats simply telling them to stop.
Keep the streak going with more questions like these, each with a full rationale.
What is breastfeeding support?
Effective latch and frequent feeding drive milk supply on a supply-and-demand basis. Nurses promote correct positioning, latch, and feeding cues.
Key points to remember
- Colostrum, present at birth, is rich in protein and immunoglobulin A and acts as the newborn's first immunization.
- A correct latch covers the nipple plus a large portion of the areola, with lips flanged outward; this prevents sore nipples.
- Newborns should feed 8 to 12 times in 24 hours, about every 2 to 3 hours, on demand.
- Milk supply works on supply and demand; more frequent emptying increases production.
- Six or more wet diapers and 3 or more stools per day after day 4 confirm adequate intake.
Nursing priorities
- Initiate breastfeeding within the first hour of life when the newborn is most alert.
- Teach and verify a deep latch and varied positions (cradle, football, side-lying) to relieve nipple soreness.
- Instruct the mother to break suction with a finger before removing the baby from the breast.
- Encourage feeding on cue (rooting, hand-to-mouth, lip smacking) rather than waiting for crying.
- Recommend exclusive breastfeeding and refer to a lactation consultant for persistent difficulty.
Patient teaching
- Feed on demand, watching for early hunger cues instead of waiting for crying.
- Air-dry nipples and apply expressed milk; lanolin can soothe soreness.
- Avoid pacifiers and formula supplementation in the first weeks to protect supply unless medically indicated.
- Most medications and a moderate diet are compatible; check before taking new drugs, alcohol, or herbal supplements.
Red flags: report now
- Fewer than 6 wet diapers daily, ongoing weight loss beyond 7 to 10 percent, or lethargy signals inadequate intake.
- Fever, a hard red wedge-shaped breast area, and flu-like symptoms indicate mastitis requiring treatment.
- Never advise stopping breastfeeding for mastitis; continued emptying of the breast is part of treatment.
References
Clinical references for this topic
