Get Breastfeeding Assessment

Breastfeeding assessment form Date of assessment Baby s name Birth weight Date of birth Last recorded weight Gestation at birth on date What to observe/ask about Answer indicating effective feeding Answer suggestive of a problem Urine output At least 6 heavy wet nappies in 24 hours Appearance and frequency of stools Baby s colour alertness and tone 2 or more in 24 hours normal appearance i.e. at least 2 coin size yellow soft/runny Normal skin colour alert good tone Fewer than 6 wet nappies in 24 hours or nappies that do not feel heavy Fewer than 2 in 24 hours or abnormal appearance Weight following initial post-birth loss Number of feeds in last 24 hours Baby s behaviour during feeds Gaining weight At least 6 8 feeds in last 24 hours Generally calm and relaxed Sucking pattern during feed Initial rapid sucks changing to slower sucks with pauses and soft swallowing Baby feeds for 5 - 30 minutes at most feeds NB Not a reliable sign beyond 4 weeks Length of feed End of the feed Offer of second breast Shape of either nipple at end of feed Mother s report on her breasts and nipples Use of dummy / nipple shields / formula Baby lets go spontaneously or does so when breast is gently lifted Second breast offered. Baby feeds from second breast or not according to appetite Baby content after most feeds Same shape as when feed began or slightly elongated Breasts and nipples comfortable None used Jaundiced worsening or not improving baby lethargic not waking to feed poor tone Static weight or continued weight loss Fewer than 6 feeds in last 24 hours Baby comes on and off the breast frequently during the feed or refuses to breastfeed No change in sucking pattern or noisy feeding e.g. clicking Baby consistently feeds for less than 5 minutes or longer than 40 minutes Baby does not release the breast spontaneously mother removes baby Mother restricts baby to one breast per feed or insists on two breasts per feed Baby unsettled after feeding Misshapen or pinched at the end of feeds Nipples sore or damaged engorgement or mastitis Yes state which Ask why Difficulty with attachment Baby not growing If any boxes in right-hand column are ticked it is essential to observe a full breastfeed and develop an individualised plan of care including revisiting positioning and attachment and/or referring appropriately. Any additional concerns about the baby s well-being should be followed up as necessary UNICEF UK Baby Friendly Initiative 2008. Breastfeeding assessment form Date of assessment Baby s name Birth weight Date of birth Last recorded weight Gestation at birth on date What to observe/ask about Answer indicating effective feeding Answer suggestive of a problem Urine output At least 6 heavy wet nappies in 24 hours Appearance and frequency of stools Baby s colour alertness and tone 2 or more in 24 hours normal appearance i*e* at least 2 coin size yellow soft/runny Normal skin colour alert good tone Fewer than 6 wet nappies in 24 hours or nappies that do not feel heavy Fewer than 2 in 24 hours or abnormal appearance Weight following initial post-birth loss Number of feeds in last 24 hours Baby s behaviour during feeds Gaining weight At least 6 8 feeds in last 24 hours Generally calm and relaxed Sucking pattern during feed Initial rapid sucks changing to slower sucks with pauses and soft swallowing Baby feeds for 5 - 30 minutes at most feeds NB Not a reliable sign beyond 4 weeks Length of feed End of the feed Offer of second breast Shape of either nipple at end of feed Mother s report on her breasts and nipples Use of dummy / nipple shields / formula Baby lets go spontaneously or does so when breast is gently lifted Second breast offered* Baby feeds from second breast or not according to appetite Baby content after most feeds Same shape as when feed began or slightly elongated Breasts and nipples comfortable None used Jaundiced worsening or not improving baby lethargic not waking to feed poor tone Static weight or continued weight loss Fewer than 6 feeds in last 24 hours Baby comes on and off the breast frequently during the feed or refuses to breastfeed No change in sucking pattern or noisy feeding e*g* clicking Baby consistently feeds for less than 5 minutes or longer than 40 minutes Baby does not release the breast spontaneously mother removes baby Mother restricts baby to one breast per feed or insists on two breasts per feed Baby unsettled after feeding Misshapen or pinched at the end of feeds Nipples sore or damaged engorgement or mastitis Yes state which Ask why Difficulty with attachment Baby not growing If any boxes in right-hand column are ticked it is essential to observe a full breastfeed and develop an individualised plan of care including revisiting positioning and attachment and/or referring appropriately.