Breastfeeding

• Table Of Contents
• Feeding Your Baby
  • Breastfeeding vs. Bottle Feeding
  • Suggested Diet
• Bottle Feeding
• Breastfeeding
  • Start & End Breastfeeding
  • General Feeding Techniques
  • The Sleepy Baby
  • Storage of Breast Milk
• Common Breastfeeding Issues
  • Management of Sore Nipples
  • Other Breastfeeding Issues
• Diapering
  • Diaper Rash & Skin Care
  • Urination & Bowel Movements
• Is Something Wrong?
  • Normal Physical Characteristics
  • Signs & Symptoms of Illness
  • Taking a Temperature
  • When to Call
• Safety
  • Bulb Syringe Use
  • Car Seats
  • Shaken Baby Syndrome
• Other Care Issues
  • Bathing
  • Umbilical Cord Care
  • Circumcision
  • Sleep Patterns & Positioning
  • Newborn Screening Tests
• Recommended Immunization Schedule

How to Start and End Breastfeeding

Your decision to breastfeed is an important choice for the health and growth of your baby. The benefits of breastfeeding are too numerous to list. Just a few important benefits are: the high nutritional value, the resistance to infection, and the economic value.

Begin with a comfortable position, using a pillow to support and bring your baby up to your breast.

Hold your baby with his/her tummy to your tummy, and his/her nose toward your nipple so he/she does not have to turn to reach the breast.

• Support your breast in your hand with either the C-Hold or L-Hold; thumb on top and fingers away from the areola.
• Tickle the baby's lips with your nipple to get him/her to open his/her mouth wide like a yawn.
• Center your nipple in your baby's mouth and quickly draw baby close to your body. Make sure he/she has as much of the areola in his/her mouth as possible and the top lip is curled upward and bottom lip is curled downward.
• Hold your baby closely to help him/her remain in the proper position.
• Nurse your baby for 15-20 minutes on each breast. Burp your baby when you change breasts.
• To release the baby from your breast, gently insert your finger in the corner of his/her mouth to break the suction.
• Begin breastfeeding on the breast you last nursed. You can keep track of this by placing a safety pin on your bra strap.
• Your baby will have very good feedings and some "snacks" these first few days.
• Your newborn may nurse every 1 1/2 - 3 hours (8-12 times in 24 hours). Babies should not go longer than 4-5 hours without nursing.
• Your baby may nurse 5-20 minutes on each breast. It is important to keep your baby slightly alert while nursing, to make sure he takes in enough colostrum or breast milk.
• Feeding times will be irregular at first, but after the first few weeks your baby will usually nurse about every 2 1/2-3 hours.
• If your baby is sleepy, wake him/her up to nurse every 2-3 hours during the day, and at least every 4 hours at night.

You know your baby is getting enough if he:

1. Nurses 8-12 times a day
2. Is content after feeding
3. Has a minimum of 6 wet diapers, and 2-3 gold-colored, seedy stools (bowel movements) in a 24-hour period.

To prevent nipple confusion, sore nipples, and breast engorgement; avoid use of bottles or pacifiers unless medically indicated, for at least the first 2 weeks following the initiation of breastfeeding. Your baby will be breastfeeding well and will have fewer problems with nipple confusion after 2-3 weeks of nursing. You can then let him take a bottle of expressed breast milk, water or formula, if needed.

General Feeding Techniques

Positioning: Correct positioning is important for comfortable and optimum breastfeeding. Some common positions you may want to try:

1. Cradle hold: Cradle the infant in the arm on the same side as the breast you wish to feed on. Put the infant's head at or near the bend in your elbow and level with your nipple. Use your arm to support the infant's body. You may want to use pillows or blankets under your arm so it won't tire as easily.
2. Football hold: Support the infant's head in your hand on the same side you wish to begin feeding. The baby's body can rest on pillows alongside of your hip. This position may work well if you have heavy breasts or to avoid pressure on an abdominal incision.
3. Cross-cradle hold: Often works well for very small or preterm babies. Hold the infant's head in the hand opposite from the breast on which the infant will feed, with the arm supporting the infant's body across your lap. The other hand holds the breast. This allows you to guide the infant's head to the breast, support it during feeding, and see your infant's mouth.
4. Side-lying: Avoids pressure on your abdominal incision and/or your episiotomy. Lie on your side with your lower arm supporting your head or placed around the infant. The upper hand and arm are used to position the infant on his side at nipple level and hold the breast. When the infant's mouth opens to nurse, lean slightly forward or draw the infant to you to insert the nipple into the mouth.

Hand position is also important. You should hold your hand in a "C" position around your breast with the thumb on top behind the areola (colored portion) and the fingers against your chest wall and supporting the underside of the breast.

Obtaining a good latch-on. After positioning your baby to face the breast, hold your breast so that the nipple brushes against the baby's lower lip. When the baby's mouth opens wide, quickly bring the baby close so the baby can latch on to the areola. As much of the areola as possible should be in the baby's mouth. Short pauses are normal during nursing. Don't jiggle the breast in the baby's mouth to try to start sucking again. This may cause the baby to lose the grasp on the nipple and result in chewing on the nipple and soreness. If necessary, take the baby off the breast, try burping, and start again on the same or other breast.

Removal from breast: Insert finger into the comer of the baby's mouth to break the suction, the remove the breast quickly before the baby begins to suck again. You can also indent the breast tissue with a finger near the baby's mouth and remove the baby when the suction is released.

Frequency of feeding: Because breast milk is digested more quickly than formula, the baby should be fed every-2 - 3 hours. Frequent feedings are especially important at-the beginning when stomach capacity is small. Also, breast milk is made according to supply and demand. You must breastfeed your baby in order to produce adequate breast milk. At night, infants should not be allowed to sleep more than 4 - 5 hours at a time without feeding. Long periods between feedings increase likelihood of engorgement as well.

Length of feedings: You should try to feed 7 - 10 minutes on each side to start. Increase- up to 20 minutes on each side. Offer both breasts at each feeding. Burp in between breasts and at the end of feeding. It is important to feed long enough for the baby to get the richer hindmilk. The milk, which comes out at the beginning of the feeding, is called the foremilk. It is thin and watery and may quench the baby's thirst. The hindmilk, however, comes out second. It looks thicker and creamier. It contains more fat, is more satisfying, and leads to weight gain. Baby may go to sleep after only getting the foremilk. When this happens, your baby will probably wake up more frequently and sleep less due to hunger.

The Sleepy Baby!

It is not unusual for babies to fall asleep at the breast after feeding only a short period during the first few days after birth. This does not reflect on your ability to breast-feed or on your milk. Try moving your baby's arms and legs and playing with him for a short time before feeding. Also, unwrap the baby's blankets and change the diaper. If your baby continues to sleep during the feeding, try rubbing the baby's hair or cheeks gently or shift his position. Burping will sometimes wake up your baby or you can try switching breasts. Sometimes-you can express a few drops of milk onto the nipple. When the baby tastes the milk, he may begin sucking again. If all else fails, you might want to try washing the baby's face with a lukewarm washcloth.

If none of these solutions works, a longer sleep period may be needed. Just put the baby down and try again in about an hour.

Storage of Breast Milk

Breast milk can be pumped and stored for a back-up supply to be used when mom goes back to work, for those middle of the night feedings when dad volunteers to help out, or for short trips away from home when breastfeeding will be hard-to accomplish. Your milk can be stored in the refrigerator for 48 hours, a refrigerator freezer for up to 3 months, or a deep freeze at 0 degrees for 6 - 12 months. It should be thawed by either letting it sit in the refrigerator for 12 to 24 hours or by letting it sit in a pan of hot water. You should not heat it in the microwave.

Diet for Breast Feeding Moms

While you are breast-feeding, you will need approximately 500 - 600 extra calories per day. You will need about 5 grams more protein, which can be satisfied with a small (5 ounce) glass of milk per day. This will also provide needed calcium.

Even though you will want to try to get back to your pre-pregnancy weight, dieting should be postponed for a minimum of 3 weeks after birth to allow yourself to recover fully from childbirth. You should avoid appetite suppressants, which may pass into the milk and may harm your baby.

Alcohol is another topic of concern. An occasional single glass of an alcoholic beverage may not be harmful, but larger amounts may interfere with the milk-ejection reflex. Foods high in caffeine should be limited. You will probably want to limit your caffeine intake to two cups of coffee or equivalent each day. Caffeine in excessive amounts can make your baby irritable and may decrease the iron content of the milk.

Nursing mothers should drink fluids sufficient to relieve thirst, which often increases in the early breastfeeding period. Eight to ten glasses of fluid, other than those containing caffeine, are adequate. There is no need to drink larger quantities of fluids, as was once recommended.