Breast feeding (timing of first feed)

Timing of the commencement of the first feed has not been clearly evaluated.

• UK Baby Friendly Initiative Step 4 recommends that mothers should initiate breastfeeding soon after the birth (1)
  
  
• a Cochrane review has shown that timing may be important since most healthy full term infants
  • would spontaneously grasp the nipple and begin to suckle by approximately 55 minutes post birth (but for the first 30 minutes after the birth they may only lick the nipple)
  • became sleepy after the first two hours post birth and becomes difficult to arouse (2)
    
    
• infant feeding survey done in UK has revealed that 72% of women who wished to breastfeed, commenced the first feed within one hour of giving birth
  
  
• advantages like enhanced relationship between mother and baby and maintenance of the baby's temperature is associated with earlier feeding (1)
  
  
• researches have shown that babies who are breastfed soon after birth are more likely to breast feed for a longer period (3)

Skin to skin contact between the baby and the mother should be encouraged as soon as possible after delivery in an unhurried environment regardless of their intended feeding method (3)

• a Cochrane review on effects of early skin-to-skin contact on breastfeeding exclusivity and duration reported that
  • skin-to-skin contact (SSC) immediately postbirth resulted in more successful breastfeeding than in babies who were held swaddled in blankets (but it did not result in a longer duration)
  • early SSC had little effect on breastfeeding exclusivity or duration when compared to control infants who were held swaddled by their mothers and given the opportunity to breastfeed soon after birth than in studies where control infants were separated from their mothers for 12 to 24 hours immediately postbirth (1)
    
    
• in cases where skin to skin contact is interrupted for clinical reason, it should commence as soon as the mother and the baby are able to do so
  
  
• a delay in few hours will result in less successful breastfeeding
  
  
• in a baby who did not feed well shortly after birth, regular and prolonged skin to skin contact in the early days may be useful (2).

Reference:

• 1. National Collaborating Centre for Primary Care (NCCPC) 2006. Postnatal care. Routine postnatal care of women and their babies
• 2. Moore ER, Anderson GC, Bergman N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2007;(3):CD003519
• 3. NHS Sheffield 2009. Section 1: Breastfeeding