Well Established

Pre- and postfeed weights have been established as the best way to determine adequacy of breast milk intake. However, assess-ments such as listening for swallows are done to evaluate breast-feeding. Newly Expressed This study indicates that, in the first few days of life, audible swallows are not a reliable or valid measure of breast milk intake. Background Maternal and infant specialists agree that breastfeeding should be supported from the moment of birth on.1-3 Agreement on how to assess the status of breastfeeding and determine the need for intervention, however, remains unset-tled.4-6 The ultimate questions are, “Is breastfeeding going well? ” and “Is the infant getting adequate milk? ” Determining adequacy of milk intake in the first days after birth is chal-lenging due to multiple maternal and neonatal variables and because common assessments such as weight gain, frequency of voids and stools, and breast softening postfeed are nonspe-cific in the early postpartum period.7,8 The first days after birth are critical for successful initiation of breastfeeding and are when nurses and lactation consultants (IBCLCs) have ready access to mother-infant dyads to facilitate effective feeds and promote breastfeeding continuation. Several breastfeeding assessment tools have been devel