A nurse is reinforcing teaching about preventing mastitis with a client who is breastfeeding. Which of the following instructions should the nurse include?

(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.

(A) "I will nurse my baby for 5 to 10 minutes on each breast.":
While nursing for 5 to 10 minutes on each breast might work for some babies, it's generally recommended to allow the baby to nurse as long as they are actively sucking and swallowing. The length of time can vary depending on the baby's needs and the mother's milk supply.

(B) "I will make sure that just the nipple is in my baby's mouth.":
This is incorrect because proper latch-on involves the baby having not just the nipple but also a large portion of the areola in their mouth. This ensures effective milk transfer and helps prevent nipple soreness and damage.

(C) "I will apply vitamin E oil to my nipples after each feeding.":
Applying vitamin E oil or any other substance to the nipples is not typically recommended without the advice of a healthcare provider. Some substances can cause irritation or allergic reactions. Instead, if there is nipple soreness, lanolin or expressed breast milk can be used, but it's best to follow guidelines given by a healthcare provider.

(D) "I will lay my baby on a pillow at the level of my breast.":
Using a pillow to support the baby at the level of the breast can help ensure proper positioning and latch during breastfeeding. This position can make breastfeeding more comfortable for both the mother and the baby, promoting effective feeding and reducing the risk of nipple pain.