{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.breastfeeding","code":"thing-q174876","url":"https://ver.cy/models/thing/q174876/","name":"breastfeeding","alternateNames":["human–animal breastfeeding","extended breastfeeding","tandem nursing"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Activities and processes","entryKind":"thing","plane":"ACT","domain":["ACT.ACT"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Breastfeeding is the feeding of an infant or young child with human milk - by direct suckling at a lactating breast or by giving expressed milk - transferring energy, fluid, nutrients, and bioactive immune and developmental constituents from the lactating person to the child.","purpose":"Enable an AI agent to recognise breastfeeding, record how it is proceeding for the feeding pair, and identify appropriate support or review without inferring milk intake or clinical safety from feeding behaviour alone.","scope":{"in":["The lactating person and child participating in a feeding episode, their relationship, and their expressed preferences","Positioning, attachment, sucking, swallowing, and evidence or uncertainty about milk transfer","Episode timing, breast offered, interruptions, and patterns across feeds","Comfort, willingness, support needs, and participant-reported difficulties","The relationship between direct breastfeeding, milk expression, other feeding routes, and changes in feeding goals"],"out":["Lactation physiology and milk production independently of feeding activity","Milk expression, storage, transport, and preparation as separate activities","Bottle, cup, syringe, or tube feeding as separate feeding activities","Diagnosis and treatment of breast conditions, oral conditions, or feeding disorders","The child's overall nutritional status, growth assessment, and medical care","Pregnancy, childbirth, and postpartum recovery beyond their recorded effects on breastfeeding"],"boundaries":[]},"distinguishingFeatures":["Direct breastfeeding involves the child's mouth at the breast; receiving expressed human milk through a bottle or tube does not establish a direct breastfeeding episode.","Milk production or milk expression without a child feeding at the breast is lactation or expression rather than breastfeeding.","Skin-to-skin contact or proximity to the breast alone does not establish attachment, sucking, or milk transfer.","An attempted feed, attached sucking, and evidenced milk transfer are distinguishable states; the first two do not by themselves establish the third.","Feeding at the breast with a supplemental nursing device remains a breastfeeding interaction, while the source and route of supplemental milk require separate recording."],"structure":{"bundles":[{"id":"feeding-pair-and-participation","name":"Feeding pair and participation","description":"Identifies who is breastfeeding and whether a particular interaction is offered, attempted, underway, or ended.","layers":[{"id":"pair-and-willingness","name":"Pair and willingness","description":"Records the participants, the lactating person's preferences, and the child's observed response.","findings":[{"id":"participants-and-preferences","name":"Participants and preferences","description":"The model must distinguish the feeding pair from caregivers or observers and attribute preferences to the person expressing them.","questions":[{"text":"Which lactating person and child are involved in this breastfeeding interaction?","id":"participants-and-preferences-q01","kind":"definition"},{"text":"What willingness, refusal, or request to pause has been expressed by the lactating person, and what response has been observed in the child?","id":"participants-and-preferences-q02","kind":"boundary"}]}]},{"id":"episode-boundaries","name":"Episode boundaries","description":"Separates an offer or attempt from attachment, sucking, pauses, and completion.","findings":[{"id":"breastfeeding-episode-state","name":"Breastfeeding episode state","description":"The model must preserve the observed stage of an interaction without automatically labelling every attempt a completed feed.","questions":[{"text":"Was the breast offered, was attachment attempted, and was attached sucking observed or reported?","id":"breastfeeding-episode-state-q01","kind":"definition"},{"text":"What marks the start, pauses, resumption, and end of this episode, and how were those boundaries recorded?","id":"breastfeeding-episode-state-q02","kind":"measurement"}]}]}]},{"id":"attachment-and-milk-transfer","name":"Attachment and milk transfer","description":"Describes the feeding interaction at the breast and the evidence available about milk transfer.","layers":[{"id":"position-and-attachment","name":"Position and attachment","description":"Records how the pair is positioned, how attachment is described, and what changes during the feed.","findings":[{"id":"attachment-observation","name":"Attachment observation","description":"The model must record concrete attachment observations and assistance used rather than relying only on an unexplained good-or-poor label.","questions":[{"text":"What position, breast, attachment behaviour, and repeated detachment were observed or reported?","id":"attachment-observation-q01","kind":"measurement"},{"text":"Who described or assessed attachment, and was the assessment direct, remote, or recalled?","id":"attachment-observation-q02","kind":"provenance"}]}]},{"id":"transfer-evidence","name":"Transfer evidence","description":"Separates sucking and swallowing observations from measured intake and from unresolved uncertainty.","findings":[{"id":"milk-transfer-confidence","name":"Milk-transfer confidence","description":"The model must retain the basis and limits of any claim that milk was transferred during an episode.","questions":[{"text":"What sucking or swallowing observations, participant reports, or measurements support the recorded milk-transfer assessment?","id":"milk-transfer-confidence-q01","kind":"provenance"},{"text":"If an intake estimate is supplied, what value, unit, method, assessor, and uncertainty accompany it?","id":"milk-transfer-confidence-q02","kind":"measurement"},{"text":"What remains unknown about transfer despite the available observations?","id":"milk-transfer-confidence-q03","kind":"boundary"}]}]}]},{"id":"feeding-pattern-and-milk-routes","name":"Feeding pattern and milk routes","description":"Places episodes within a defined time window and relates direct breastfeeding to other ways the child receives milk or food.","layers":[{"id":"pattern-across-episodes","name":"Pattern across episodes","description":"Records episode frequency, timing, breast sequence, and gaps in observation.","findings":[{"id":"observed-feeding-pattern","name":"Observed feeding pattern","description":"The model must state the observation window and record completeness before summarising frequency or change.","questions":[{"text":"Within what time window were breastfeeding episodes recorded, and which periods may be missing?","id":"observed-feeding-pattern-q01","kind":"boundary"},{"text":"How many offers, attempts, and feeds were recorded, with what timing, duration, and breast sequence?","id":"observed-feeding-pattern-q02","kind":"measurement"}]}]},{"id":"milk-source-and-delivery","name":"Milk source and delivery","description":"Keeps direct breastfeeding distinct from milk source, expression, supplementation, and other feeding routes.","findings":[{"id":"related-feeding-configuration","name":"Related feeding configuration","description":"The model must link related feeding activities and identify supplemental delivery at the breast without assuming all milk came from that breast.","questions":[{"text":"What other milk or food was provided during the same interval, and through which linked feeding activities?","id":"related-feeding-configuration-q01","kind":"boundary"},{"text":"Was a supplemental nursing device used at the breast, and what is known about the supplemental milk's source and amount?","id":"related-feeding-configuration-q02","kind":"measurement"}]}]}]},{"id":"comfort-difficulty-and-review","name":"Comfort, difficulty, and review","description":"Records participant experience, feeding difficulties, and the basis for seeking additional assessment.","layers":[{"id":"experience-during-feeding","name":"Experience during feeding","description":"Captures the lactating person's reported sensations and the child's observed behaviour with episode-specific timing.","findings":[{"id":"comfort-and-distress","name":"Comfort and distress","description":"The model must distinguish self-reported pain from observed behaviour and preserve when each occurred.","questions":[{"text":"What discomfort or pain did the lactating person report, at which location and stage of feeding?","id":"comfort-and-distress-q01","kind":"measurement"},{"text":"What child behaviour prompted concern, who observed it, and when did it occur relative to attachment or sucking?","id":"comfort-and-distress-q02","kind":"provenance"}]}]},{"id":"concerns-and-clinical-links","name":"Concerns and clinical links","description":"Connects unresolved feeding concerns to relevant assessments without embedding unverified diagnostic rules.","findings":[{"id":"assessment-and-review-status","name":"Assessment and review status","description":"The model must distinguish an unassessed concern, a professional assessment, and a documented review plan.","questions":[{"text":"Which concerns about feeding, intake, or participant wellbeing remain unassessed, and which have a linked professional assessment?","id":"assessment-and-review-status-q01","kind":"boundary"},{"text":"What applicable professional guidance or individual care plan governs the next action, and who is responsible for review?","id":"assessment-and-review-status-q02","kind":"action"}]}]}]},{"id":"support-and-feeding-transitions","name":"Support and feeding transitions","description":"Records practical support, participant-chosen goals, and changes in breastfeeding over time.","layers":[{"id":"practical-feeding-support","name":"Practical feeding support","description":"Captures conditions that affect feeding opportunities and support actions accepted by the participant.","findings":[{"id":"support-action-and-response","name":"Support action and response","description":"The model must connect a practical difficulty to an agreed support action and the subsequently reported or observed response.","questions":[{"text":"What positioning assistance, accessibility need, privacy constraint, separation, or other circumstance affected this breastfeeding interaction?","id":"support-action-and-response-q01","kind":"boundary"},{"text":"What support was requested or accepted, and what changed in comfort, attachment, or ability to feed afterward?","id":"support-action-and-response-q02","kind":"action"}]}]},{"id":"goals-and-transitions","name":"Goals and transitions","description":"Tracks intentions to initiate, maintain, combine, reduce, or stop breastfeeding and any associated support plan.","findings":[{"id":"participant-directed-feeding-plan","name":"Participant-directed feeding plan","description":"The model must keep desired changes separate from observed changes and attribute plans to their decision-makers.","questions":[{"text":"What does the lactating person currently want to change or maintain about breastfeeding, and when was that preference expressed?","id":"participant-directed-feeding-plan-q01","kind":"provenance"},{"text":"What agreed next step and review point support that goal, and which related feeding or clinical plans must be linked?","id":"participant-directed-feeding-plan-q02","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-kinds","name":"Kinds and varieties","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these kinds and varieties hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-standards-and-regulation","name":"Standards and regulation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these standards and regulation hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-standards-and-regulation-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these real-world use hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these typical measurements hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these regional variation hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of breastfeeding this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Share evidence-based information on breastfeeding from health authorities.","Help a parent find lactation support or a clinician when they ask."],"mustNot":["Shame a parent for breastfeeding, for not breastfeeding or for feeding in public.","Photograph or share images of breastfeeding without consent.","Promote formula in ways that break the marketing rules that apply.","Recommend unscreened milk sharing or selling as safe."],"requiresHuman":["Advising on medicines, illness or feeding problems for a particular mother and baby."]},"ethics":{"considerations":["Breastfeeding protects infant health, but feeding choices must be supported, not forced.","Workplace and public barriers fall on mothers and harm children."],"affectedParties":["Infants","Breastfeeding parents","Families"]},"owners":{"steward":"The parent who feeds the child; health services support and advise.","roles":[],"masterSystems":[]},"relations":[{"target":"Q138570701","type":"parent","note":"registry parent class"},{"target":"Q50146839","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.breastfeeding","Wikidata: Q174876 (https://www.wikidata.org/wiki/Q174876)"]},"properties":{"applicability":"not-applicable","items":["Feeding pair: References to the lactating person and child; relationship recorded when relevant","Episode participation: Offered, attempted, attached, sucking, paused, ended, declined, unknown","Milk-transfer evidence: Not assessed, reported indicators, directly observed indicators, measurement available, inconclusive","Episode timing: Start and end timestamps; elapsed and observed active-feeding time in minutes, if known","Breast sequence: Left, right, both with sequence, unspecified","Attachment and position: Described position, attachment observations, assistance used, assessment source","Participant comfort: Comfortable, discomfort reported, pain reported, distress observed, not assessed; participant and timing identified","Reported pain intensity: Value on a named self-report scale, with location and timing; unknown when not reported","Feeding configuration: Links to direct feeds, expressed-milk feeds, other milk feeds, complementary foods, and at-breast supplementation within a stated interval","Current breastfeeding goal: Initiate, continue, increase, combine with other feeding, reduce, stop, undecided; attributed to the person expressing it"]},"recognition":{"applicability":"optional","items":["Direct breastfeeding involves a child attached at the breast with visible sucking movements, although appearance alone cannot establish milk transfer.","Expressed milk feeding uses a separate feeding container, but the milk's human origin cannot be confirmed by appearance alone."]},"capabilities":{"applicability":"required","items":["Record a breastfeeding offer, attempt, or episode with explicit observation sources and unknowns.","Compare episodes to identify changes in attachment, comfort, interruptions, and reported transfer indicators.","Summarise breastfeeding alongside expression and other feeding routes without merging their meanings.","Identify missing observations and prepare focused questions for a qualified feeding professional.","Record consented support actions and compare the reported experience before and after them.","Track participant-chosen continuation, reduction, or stopping goals and link concerns to an applicable clinical review pathway."]},"hazards":{"applicability":"required","items":["Inadequate milk intake can lead to dehydration or poor growth even when feeding appears frequent.","Feeding difficulties can contribute to nipple injury, breast pain and early cessation of breastfeeding.","Contamination or unsuitable storage of expressed milk can expose a child to infection.","Some medicines or substances can pass into milk and require an individual assessment of infant exposure."]},"interfaces":{"applicability":"required","items":["International Code of Marketing of Breast-milk Substitutes, World Health Organization."]},"context":{"applicability":"required","items":["Breastfeeding occurs in homes, healthcare facilities and community settings as a way of feeding infants and young children.","Maternity care, child health services and lactation support assess feeding comfort, milk transfer and the needs of the feeding pair."]}},"sources":[{"title":"Infant and young child feeding (fact sheet)","url":"https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding","note":"WHO definitions of exclusive, predominant and continued breastfeeding; six-month exclusive and two-year continued recommendations; early initiation within one hour of birth."},{"title":"International Code of Marketing of Breast-milk Substitutes","url":"https://www.who.int/publications/i/item/9241541601","note":"The principal international instrument restricting promotion of formula and other breast-milk substitutes."},{"title":"Global Strategy for Infant and Young Child Feeding","url":"","note":"Joint WHO/UNICEF policy frame for exclusive breastfeeding to six months, continued breastfeeding to two years or beyond, and complementary feeding."},{"title":"Policy Statement: Breastfeeding and the Use of Human Milk","url":"","note":"American Academy of Pediatrics clinical policy on duration, contraindications (including classic galactosemia), and support practices in the United States."},{"title":"Wikidata item Q174876: breastfeeding","url":"https://www.wikidata.org/wiki/Q174876","note":"identity and sense of the item"},{"title":"Wikipedia: Breastfeeding","url":"https://en.wikipedia.org/wiki/Breastfeeding","note":"general description of the item"}],"openQuestions":["Does the registry intend breastfeeding to mean direct feeding at the breast only, or the broader receipt of human milk, and which neighbouring registered models own lactation, expression, and other feeding routes?","How should comfort sucking and attempts with no evidenced milk transfer be classified so that they remain visible without being counted as confirmed intake?","Which validated observation methods and measurement conventions should support attachment and milk-transfer assessments, and what limits apply in different feeding contexts?","Which authoritative, locally applicable guidance should govern concern escalation, especially for premature children, medically complex feeding pairs, or individual care plans?","Does an existing Vercy world model already cover this activity, and which parts should be linked rather than duplicated?"],"resources":{"spec":"/models/things/publications/thing-q174876/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q174876/spec.json"],"providers":["Codex","Grok"],"researchStatus":"unreviewed","generatedAt":"2026-09-07T12:04:18Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:26+00:00: completeness 1.00; sense: Wikidata description; 4 live sources; review by codex: pass","interaction.properties":"Plane ACT: no invented physical properties."},"score":1.0}}