Clinical aspects of lactation. Promoting breastfeeding success

Human milk is universally recognized as the preferred nutrition for infants. Exclusive breastfeeding is ideal for approximately 6 months of life, and continued breastfeeding complemented by solid foods is recommended throughout the baby's first year, and longer if desired. This article offers counseling strategies to help physicians promote successful breastfeeding, beginning with effective prenatal education and a screening breast exam to detect lactation risk factors. Optimal initiation of breastfeeding is reviewed, including supportive hospital practices, correct breastfeeding technique, and the regulation of milk production. The early follow-up of the breastfeeding infant and criteria for assessing the successful initiation of breastfeeding are discussed. Practical strategies are offered for preventing and managing common lactation difficulties, such as postpartum breast engorgement, sore nipples, mastitis, maternal employment, and impaired let-down.