Dear Nurse,

If I am a healthy full-term baby, please don't give me any water bottles, formula, or pacifiers.

I eat "on cue" or every 1 - 3 hours, whichever comes first, daytime and nighttime.

I may be allowed to sleep one 4 - 5 hour period at night if I have already had 8 feedings that day.

My mom allows bunching (frequent feedings) whenever I want.

My mom feeds me from both breasts at each feeding for as long as I want. If my latch-on and positioning are correct, my mom won't become sore.

My mom understands that I need to eat 8 - 12 times in 24 hours.

Please don't separate me from my mom for long periods of time unless it is medically necessary. I have been with my mom a long time and want to stay with her.


___________________________________________________ Mother's Signature

___________________________________________________ Baby's Name



Breastfeedingonline adheres to the
WHO International Code of Marketing of Breast Milk Substitutes
& the WHO/UNICEF Baby Friendly Hospital Initiative