A nurse is reinforcing discharge instructions about breastfeeding with a client. Which of the following statements should the nurse make?

(a) "Wear an underwire bra between feedings."
Wearing an underwire bra between feedings can compress breast tissue and impede milk flow, increasing the risk of mastitis. This recommendation is incorrect and could contribute to the development of mastitis rather than preventing it.

(b) "You should use a breast pump if you plan to return to work."
Regularly expressing breast milk with a breast pump, especially if planning to return to work, helps maintain milk supply and prevents engorgement, which can lead to mastitis. This recommendation encourages appropriate breastfeeding practices to prevent mastitis.

(c) "Wash your nipples with soap and water daily."
While maintaining good breast hygiene is important, excessive washing with soap and water can strip the nipples of natural oils and increase the risk of dryness and cracking, which may predispose to mastitis. This recommendation is not the most effective strategy for preventing mastitis.

(d) "Cover your breasts immediately after feedings."
Covering the breasts immediately after feedings may trap moisture and promote bacterial growth, increasing the risk of mastitis. It is important to allow the breasts to air dry after feedings to prevent moisture buildup and promote healing of any cracked nipples. This recommendation is not appropriate for preventing mastitis.

(A) "You should recognize that your baby sucking on his hands is a hunger cue."
Recognizing hunger cues is crucial for successful breastfeeding. Early hunger cues like sucking on hands, rooting, and lip-smacking indicate that the baby is ready to feed. Responding to these cues can help establish a good breastfeeding routine and ensure the baby gets adequate nutrition before becoming too distressed to feed effectively.

(B) "You should feed your baby for 10 minutes on each breast."
Feeding duration can vary significantly among babies. Some may need longer than 10 minutes on each breast, while others might feed more efficiently in a shorter time. Instead of a strict time limit, it's important to encourage the mother to allow the baby to feed until they show signs of being full, such as pulling away from the breast or falling asleep.

(C) "You should feed your baby six times a day."
Newborns typically need to feed more frequently than six times a day. Most newborns breastfeed 8-12 times in 24 hours. Limiting feeds to six times a day may not provide sufficient nutrition and can affect the baby’s growth and milk supply.

(D) "You should wake your baby at least every 6 hours at night for feedings."
Newborns, especially in the first few weeks, often need to be fed more frequently than every 6 hours, including at night. Typically, it’s recommended to wake a baby to feed if they sleep for more than 4 hours at a time in the early weeks to ensure adequate intake and to help establish the mother’s milk supply.