Sensitive Midwifery - Issue 43 - July2019

Milky ways Another reason to delay newborn bathing There are many reasons not to bath a newborn immediately after birth, including improved temperature control, reduced risk of infection, and keeping stress hormones low. A new Cleveland Clinic study from Hillcrest Hospital in Ohio, USA has now also found that delaying a newborn’s bath benefits breastfeeding. Babies whose baths were delayed by at least 12 hours after birth saw an increase in in-hospital exclusive breastfeeding rates, from 59.8% before the intervention, to 68.2% after the intervention. Study author and nursing professional development specialist Heather DiCioccio noted that there are many reasons delayed bathing would benefit breastfeeding, including more time for skin-to-skin. Zeltner, B, ‘Breastfeeding rates rise if newborn’s bath delayed, Cleveland Clinic study finds’, 21 January 2019. Available: https://www. cleveland.com/metro/2019/01/breastfeeding-rates-rise-if-newborns- bath-delayed-cleveland-clinic-study-finds.html Better birth, better breastfeeding With medicalised birth (which includes interventions like intravenous fluid administration, routine separation of Mom and Baby after delivery, and advice to breastfeed according to a schedule), painful, swollen, breasts are often thought of as ‘normal’. In days gone by, mothers were mostly advised to limit their fluid intake and bind their breasts for postnatal breast pain from engorgement. Nowadays, they are seldom given advice that is of any more constructive help, even if binding isn’t advocated! The normal postpartum fullness of the breasts may be exacerbated by or confused with oedema associated with excessive intravenous fluids during medicalised labour, birth and the immediate postnatal period. While breast oedema and pain will gradually resolve as these excessive fluids drain from the body, the effect on breastfeeding can be very negative, and prevention through enshrining natural birth is really the best option. Kujawa-Myles, S, et al, ‘Maternal intravenous fluids and postpartum breast changes: a pilot observational study’, International Breastfeeding Journal, 2 June 2015, 10 (18). Available: https://www. ncbi.nlm.nih.gov/pmc/articles/PMC4480510/ Ditch the dummy for breastfeeding In 2008 in Brazil, 41.3% of infants up to six months of age were exclusively breastfed (EBF). Over the previous decade, EBF rates had increased by 15.2%, whereas pacifier use had decreased by approximately 17%. A new study has found that the reduction of pacifier use contributed towards approximately one-third of the increase observed in EBF prevalence, suggesting that discouraging dummies may be an effective intervention to promote EBF. Buccini, G, et al, ‘Exclusive breastfeeding changes in Brazil attributable to pacifier use’, PLoS One, 2018; 13(12): e0208261. Available: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC6300199/ Breast assurance 27 eSensitive Midwifery Magazine Issue 43