Observations based upon multiple telephone contacts with new breastfeeding mothers.

Common themes and phenomena were identified by a lactation consultant providing an average number of nine follow-up phone contacts per mother during an average of 12 1/2 weeks postpartum. Over 600 mother-infant couples received lactation support services in the past 6 years. Eighty-six percent of the mothers receiving this telephone support breastfed for at least 1 month, 46% breastfed at least 3 months, and 23% breastfed for at least 5 months. Co-sleeping was encouraged in the first week postpartum, as was nursing one breast per feed. Normal breastfeeding was identified when the mothers nursed comfortably (save for first-minute latch-on pain), when they reported having fun with their babies, when their babies woke spontaneously to feed and to look around, when their babies urinated sufficiently and either had bowel movements or passed flatus, and when their babies were observed to smile. Anticipatory guidance about areolar engorgement, growth sports, and continuing to nurse despite maternal illness reduced bottle use in the first few weeks. The majority of women had no problems establishing breastfeeding with daily telephone contact for the first 5-7 days postpartum, one to three calls per week for the next few weeks, and gradually diminishing calls thereafter. Telephone calls were initiated by the LC, as only 12-16% of mothers called for help, even though they all received the LC's home telephone number.