ABSTRACT
This chapter focuses on the issues related to the infant with special needs and some other conditions or situations, such as poor weight gain, hypernatraemia and tongue-tie, which may also pose problems and challenges with breastfeeding. It makes an attempt to: identify those conditions or situations where breastfeeding may be temporarily challenged; provide evidence-based information for mothers to help them maintain lactation when their infant is unwell or if they are separated. Mothers should be encouraged to express breastmilk as soon as possible after birth to stimulate the production of prolactin in order to prime the lactocytes to establish milk production, as well as provide colostrum for the infant; ideally within the first two hours. Some mothers may have difficulty in establishing and maintaining lactation and, in addition to skin-to-skin contact and frequently expressing milk, they may need galactagogues such as domperidone or metoclopramine. Hypoxia can occur at any gestation, either because of an in-utero event or at birth.
