Family Birth Center
Caring for Your Baby: A New Mother's Guide

Breastfeeding

Nutritionally, mother’s milk is the best food available for an infant. Breastfeeding offers emotional benefits for the infant and mother. Although breastfeeding is the natural way to feed a baby, there is a certain amount of learning for mother and baby. Given simple advice and much support most mothers who want to breastfeed will be able to do so.

Beginning Breastfeeding
Lactation consultants and classes are available to assist in successful breastfeeding. Keep offering your breast whenever the baby is awake and interested, or at least every two to four hours during the day. After a day or two, the baby will have rested and adjusted and be ready to nurse more frequently. You need to watch your baby's cues, not the clock, to determine the frequency and length of each nursing period. Babies who are hungry will suck their fists, tongue and lips, make sucking motions, and root. Babies who are done feeding will relax and usually open their hands. Alternating breasts and rotating nursing positions will help prevent sore nipples and promotes adequate emptying of the breast. Switching between breasts helps stimulate milk supply evenly. Try burping baby when switching breasts. For breast discomfort, use warm packs for 20 minutes or take a warm shower before nursing. Breastfeeding mothers should wash their breasts once a day with warm water. Before breastfeeding, wash your hands. There is no need to wash your breast before each feeding.

Different Breastfeeding Positions
There are several different positions you can use during breastfeeding.

• Sitting - Sit in a comfortable chair or comfortable place. Use a pillow on your lap or under your arm to bring baby closer to your breasts.
• Side Lying - You may wish to try lying on your side on the bed. The baby will nurse from the breast closest to it as it lays next to you. You will need to move the baby to your other side and roll over to breastfeed from the opposite breast.
• Football Hold - This is another alternative. Support the head with one hand and the body of the baby with your forearm. Support the infant's body against your side. The infant's head will be next to your breast while its feet are sticking out behind you.

Breast Milk
Mothers are concerned about maintaining an adequate milk supply for their baby-it takes six to eight weeks to establish the supply. Your breasts may seem less full after the first week of nursing. This is because swelling has gone away, not milk. You will have plenty of milk if you nurse frequently. Good indicators of adequate milk supply are:

• Your baby has at least two to four stools and six to seven wet diapers per 24 hours. Stooling patterns after the first month vary greatly.
• Your baby is content for at least one and a half hours between feedings.
• Your baby is gaining weight-about a half to one and a half ounces per day.

If baby has been nursing well and on demand since delivery, the milk may come in around the second to fourth day. Initially, your breast contains a thick, creamy, yellowish milk that helps protect the newborn against infection. Sometimes, when the milk comes in, there can be accompanying swelling of the breast tissue. If it occurs, continue with frequent nursing every two to three hours, which will help regulate your milk, supply to your baby's needs. Use warm packs to the breast or warm showers followed by gentle massage prior to nursing. You may have to express some milk before feeding to soften the nipple area and allow the baby to latch on and attach to your breasts. If you are having difficulty nursing, lactation educators are available to help you.

Initiating Feedings
Here are some tips you may wish to try to make it easier to begin the breastfeeding process. Any or all of these techniques may be required when you are first initiating breastfeeding. Don't get discouraged:

• Nipple Rolling: By rolling the nipple of your breast between your thumb and index finger, you can help in preparing your nipple to be stronger and easier for the baby to latch on.
• Finger Position: By placing one finger above your nipple during the feeding, you can help your infant breathe easier as well as assist the baby in finding and keeping the nipple in its mouth.
• Techniques to Stimulate Sucking: Gently stroke baby's back or bottom of the feet to help arouse infant and keep the baby more awake for feedings.
• Express or squeeze a small amount of milk out of the nipple by gently squeezing the nipple and areola just prior to nursing.
• Position the nipple over the baby's tongue with the nipple pointing towards the roof of the mouth.
• Stroking the sides of the baby's mouth will cause the infant to turn its head towards the side stroked.

To take the infant away from your breast at the end of the feeding, gently insert your finger inside the infant's mouth to break the suction before pulling the infant away.

After Nursing
After nursing, let your breasts air dry by leaving the flaps of the nursing bra down for 15 minutes or at least two hours each day. For sore nipples, try using a small amount of breast milk as a moisturizer and rub it over the area. Be sure to wear a well-fitting support nursing bra 24 hours a day for as long as you're breastfeeding, and avoid the use of plastic lined nursing pads. Instead, if you wish to use nursing pads to line your bra to absorb any leaking which may occur, try disposable without plastic liners or cloth pads which can be laundered. Change your bra daily.

Enjoying the Nursing Experience
Most mothers find their nursing experience is enhanced when they regard it as a time to relax and take it easy. Some mothers like to be alone to nurse. Many like to listen to music or watch television. Nursing your baby is a good time to just look, talk to and get to know your baby. Take care of yourself by eating a well-balanced diet, drinking plenty of fluids and getting rest. Learn to sleep when your baby sleeps.

Breast and Bottle-feeding
It is recommended that you do not feed your breastfed baby with a bottle for 2-4 weeks to be sure your milk supply is well established. Many working mothers have continued to successfully breastfeed, either by pumping at their workplace or supplementing feedings with formula and breastfeeding when with their babies. It is important to remember that your milk is made on a supply and demand basis, so if you substitute bottle-feeding for breastfeeding too often, you will dramatically decrease your milk supply.

Expressing Breast Milk
Expressing breast milk-it is best to do this in the early morning or when your breasts still feel full after the baby is done nursing. If done manually, begin by stroking the breast from the outside region inward to the nipple. Express the milk into a nurser bag or plastic container. There are three different types of pump devices: hand held breast pump, the cylinder type, which is able to store milk in the same container and the electric pump.

Storing Breast Milk for Future Use
You can store breast milk in sterile plastic containers-preferably hard plastic with airtight lids-for 48 hours in the refrigerator. Be sure to use new containers and date each container each time you express. Do not store milk in glass containers, plastic is best. If you do not plan to use the milk within 48 hours, it should be frozen. Frozen milk can be stored for two to four weeks in a freezer which keeps ice cream semi-soft and up to 12 months in a freezer which keeps ice cream brick-hard. Thaw frozen milk in warm water to the desired temperature; do not thaw milk in a microwave or on the stove. Breast milk oftentimes will separate and form a bluish colored liquid on the top and a creamy liquid on the bottom. This is normal and the milk is still safe to use.

Weaning Your Baby from the Breast
This should be a gradual process of reducing the number of times you nurse each day and increasing the number of bottles you feed your baby. The feeding most often stopped first is the midday or early evening feeding. Replace the breast feeding you skip with a bottle or cup (if child is old enough). Allow several days to pass before weaning the next feeding. The last feeding to be weaned should be the one your baby seems to enjoy the most, usually this is the first feeding in the morning or the one at bedtime.

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