Physicians who counsel nursing mothers should be conversant with the literature on this subject before they recommend any reading to their patients. The physician should discuss the physiology of lactation with the mother. It is often helpful if the mother talks to a woman who has nursed successfully and observes the process. Preparing the nipple before delivery is unnecessary, and manual expression of the breast prepartum, which may lead to mastitis or early labor, is not advisable. At delivery, if the mother has had little medication and a normal delivery and the newborn is alert and active, breastfeeding may start immediately for a few minutes until the newborn is satiated.
Colostrum also stimulates the passage of meconium.
The newborn, regardless of whether or not nursed in the delivery room, can be taken to the mother for nursing within the first 4 h of birth. The mother should assume a comfortable, relaxed position, such as lying almost flat and turning from one side to the other to offer each breast. The newborn should face the mother, ventral surface to ventral surface. The mother should support her breast with thumb and index finger above and three fingers below the nipple to ensure that it is centered in the newborn's mouth, minimizing any soreness. The center of the newborn's lower lip should be stimulated with the nipple so that rooting will occur and the mouth will open wide and grasp the nipple and areola.