Breast feeding your baby: you can do it!

It is important that the family who plans to breastfeed, learn as much as they can about breastfeeding. As natural as it is, breastfeeding is a learned skill, and a new skill gets easier with practice.

The first days after your baby is born:

• Nurse your newborn baby within the first hour after birth. The newborn is usually awake and eager to nurse.

• If your baby does not nurse within the first few hours, ask your nurse to help you pump your breasts. Nursing or pumping frequently will help stimulate your breasts to produce more milk.

• Ask your nurse to teach you how to hand express the first rich breast milk called "colostrum", for your baby.

• Keep your baby in your room so you can watch for your baby's hunger cues and so baby can nurse often. Hunger cues include licking their lips, sucking their fingers or fists, or opening their mouths looking for food. Nurse your baby when you first see these hunger cues, do not wait until baby cries to feed.

• A newborn's tummy is small, about the size of their little fist. Babies need to eat every 1-3 hours (at least 8-12 times every 24 hours).

• It is important to be comfortable when you breastfeed. Sit in a chair, if possible. A pillow or cloth roll may be helpful to support you and your baby.

• Call your nurse to help with a proper latch especially if it hurts to breastfeed, if baby is sleepy at the breast, or if baby is fussy after nursing.

• Avoid formula, bottle nipples and pacifiers unless medically needed. These can confuse the baby and cause poor breast- feeding behaviors.

• Keep a paper record of feedings and diapers. Record your baby's feeding time, length of nursing, wets and stools.

• Ask for pain medication when needed. Most pain medication is generally safe while breastfeeding, if taken as directed.

• Consider scheduling "visiting times" so you will be able to nurse when the baby is hungry and rest when baby is sleeping.

• Trust your breasts. With frequent nursing or pumping, your breasts will make enough milk for your baby.   

What to expect in the first week at home:

• Breastfeeding is a skill that takes practice. It is common that most moms feel awkward and uneasy at first.

• Remember to take care of yourself. Rest when baby naps, eat frequent nutritious snacks, and drink water when thirsty.

• Nursing baby in a chair with good support will be more comfort- able and safer then nursing in bed.

• Every baby is different, but most feedings will last 15-45 minutes at least every 1-3 hours. You should hear baby swallow during feedings by 3-5 days of age.

• Baby should end the feeding by letting go. If not, insert your finger in the corner of baby's mouth and gums to break the suction.

• Wake a sleepy baby to nurse if it has been longer than 3 hours during the day, or 4 hours at night since the last nursing.

• Most babies will be back to their birth weight by 2 weeks of age.

• You may need to pump during engorgement and put breast milk in your freezer to use at a later time. Even a small amount of breast milk in the container is important enough to save.

• The American Academy of Pediatrics recommends breastfeeding your baby for one year or more.

Getting started:

• While sitting in a comfortable position, use a pillow if needed to support both you and your baby. Turn baby's body to face the breast. Hold baby at the level of your breast. Baby's arms should be placed on either side of mom's breast.

• Support the breast with your hand, placing fingers behind the areolar tissue (the dark area around the nipple).

• Align baby's nose with your nipple.

• Allow baby's head to tilt slightly backwards.

• Encourage baby to open wide by gently touching his/her lips with your nipple.

• Hand express a few drops of colostrum. Wait for baby to open his/her mouth wide with the tongue down and forward.

• Quickly bring baby onto the nipple/areola tissue for a good, deep latch. When latched properly, strong comfortable tugs will be felt.

• To release latch insert your clean finger into the corner of baby's mouth and gums to break the suction.

Signs of a good latch:

• Baby has both the nipple and areola tissue deep in his/her mouth.

• Baby's lips are flared out and the corners of baby's mouth are touching your breast tissue.

• The jaw moves down and forward with suckling.

• It does not hurt as your baby suckles.

• Mom's nipple is not flattened or pinched when baby is removed from the breast at the end of a nursing session. 

Signs of good nursing:

• Baby stays latched on your breast, suckling 4-10 sucks with brief pauses.

• Baby suckles vigorously for 10-20 minutes on each breast.

• Some swallows may be heard as baby nurses.

• Baby's body relaxes, and fist open as the nursing continues.

• The breast softens with the nursing session by days 3-5.

• Mom may feel menstrual-like cramps as the uterus works to return it to its pre-pregnancy size.

• Mom may feel thirsty and very relaxed while nursing.

How to tell if your baby is getting enough breast milk:

• The number of nursings, wet diapers, and stools should increase each day in the first weeks of life.

• Baby's stool color should gradually change from black, to green, to yellow by days 4-5. Normal texture can range from liquid to soft with some small curds (this is not diarrhea). At 6 to 8 weeks of age, it is normal for totally breastfeed babies to decrease the number of stools to only once every few days.

                 

  Day	Nursings	Wet Diapers	Stools
  One	8-12	1 or more	1 or more
  Two	8-12	2 or more	2 or more
  Three	8-12	3 or more	3 or more
  Four	8-12	4 or more	4 or more
  Five	8-12	5 or more	4 or more
  Six	8-12	6 or more	4 or more
  Seven	8-12	6-8 or more	4 or more

   

Treatment for common concerns:

Engorgement (full, hard breasts, usually occurs day 3-5)

Steps to relieve engorgement:

1. Shower or apply warm moist cloth a few minutes before nursing or pumping.

2. Use gentle breast massage before & during nursing or pumping.

3. Hand express or pump a little milk off before latching baby to soften the areola/breast tissue

4. Nurse your baby or pump your breast more often.

5. Pump, if baby does not soften both breasts at each.

6. Feeding. (Pumped breast milk may be refrigerated or frozen for later use.)

7. Apply cold cloths or chilled green cabbage leaves to your breasts 10-15 minutes after nursing or pumping.

8. Use over the counter pain medication (acetaminophen or ibuprofen).

9. If breasts become hot, swollen, painful and red, you may have an infection called mastitis. Call your doctor.

10. Call Allen Hospital's Lactation Service at (319) 226-BABY (2229) for breast/nipple care questions.

Sore Nipples

1. Review "Getting Started" and "Signs of a Good Latch".

2. Pump briefly before latching baby to soften the breast/areolar tissue and try to latch on briefly again.

3. If your nipples are too sore to nurse, pump and feed your breast milk to your baby for a few feedings.

4. If nipples are still too sore to nurse, call the lactation consultant for further assistance.

5. Apply a thin layer of medical grade lanolin after nursing to soothe your sore nipples. (There is no need to wipe the lanolin off before nursing.)

6. Lanolin may also be applied before pumping or showering for comfort.

7. Do not use too high of suction/vacuum settings on your breast pump.

Allen Hospital's Lactation Services is here to serve you.

We will answer your questions, help solve nursing problems and promote a healthy breastfeeding experience for you and your baby. Please call (319) 226-BABY (2229) or go online at unitypoint.org.

Make plans to attend one of our breastfeeding support groups. These weekly, free groups provide free baby weight checks, general baby care and breastfeeding information.