1. Beal, Judy DNSc, PNP, RN
  2. Heaman, Maureen PhD, RN

Article Content

Radzyminski, S. (2005).Journal of Obstetric, Gynecologic, and Neonatal Nursing, 34(3), 335-341.


The purpose of this study was to determine whether neurobehavioral responses in the newborn are predictive of breastfeeding behaviors in the first day of life. Data were analyzed from a larger study of the effect of epidural analgesia on newborn breastfeeding behaviors, in which half the mothers delivered by natural childbirth, while half delivered under epidural analgesia. Fifty-six mother-infant dyads were assessed at 1 and 24 hours after birth for breastfeeding behaviors (measures of rooting, sucking, swallowing, infant activity state, and mother's awareness of letdown), followed by an assessment of the infant's neurobehavioral status using the Neurologic and Adaptive Capacity Score (NACS) (Amiel-Tison et al., 1982).


A large proportion of mothers who begin breastfeeding will stop within the first few weeks. To promote longer duration of breastfeeding, nurses need to ensure successful initiation of breastfeeding. This study suggests that the newborn's ability to successfully latch on to the breast is significantly related to passive tone, primary reflexes, and adaptive capacity. As Radzyminski noted, "Awake, alert newborns tend to feed better" (p. 339). Another recent study also found a positive correlation between infant neurobehavioral status and breastfeeding effectiveness (Chang & Heaman, 2005), suggesting that nurses should give consideration to routinely assessing the newborn's central nervous system functioning after birth. These assessments may help predict which newborns require additional assistance to initiate breastfeeding or need additional time to successfully feed.


Comment by Maureen Heaman




Amiel-Tison, C., Barrier, G., Shnider, S. M., Levinson, G., Hughes, S. C., & Stefani, S. J. (1982). A new neurologic and adaptive capacity scoring system for evaluating obstetric medications in full-term newborns. Anesthesiology, 56, 340-350. [Context Link]


Chang, Z. M., & Heaman, M. I. (2005). Epidural analgesia during labor and delivery: Effects on the initiation and continuation of effective breastfeeding. Journal of Human Lactation, 21 (3), 305-314. [Context Link]