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The authors tested indicators of effective breastfeeding to identify those that provide reliable estimates of human milk intake. Human milk intake of 82 full-term infants was measured by test weights before and after feeding and compared with commonly used breastfeeding indicators: rooting, length of time before latch-on, latch-on, suckle, observable swallowing, and audible swallowing. Two models were tested: model 1, describing indicators at 96 hours postpartum, and model 2, describing indicators at > 96 hours postpartum. Median (interquartile) milliliters of mother’s milk consumed per feeding was 26 ml (range, 4-47) at 96 hours and 54 ml (range, 26-73) at > 96 hours. Significant predictors of human milk intake in model 1 were rooting and observable swallowing (R2 = 26%, P < .01). In model 2, audible swallowing alone estimated human milk intake (R2 = 29%, P < .001). Observed swallowing and rooting during the first 4 days (96 hours) following birth and audible swallowing after that time should be included in the breastfeeding assessment of full-term infants. [ABSTRACT FROM AUTHOR]

This case study describes an occurrence of gross edema in the breast and areolar tissue of a mother in the first 2 days postpartum that interfered with the early initiation of breastfeeding. The mother developed severe generalized fluid retention during labor and early postpartum. Her breasts were naturally large. The edema in her breasts made the areola and nipple tissue firm and nonpliable. The mother successfully latched her newborn onto her breast after being shown areolar compression (AC), a technique developed and named by the authors. AC reduces nipple and areola edema by using gentle positive pressure on the areola. The baby continued to successfully latch onto the breast after AC was used and taught to the mother. [ABSTRACT FROM AUTHOR]