Breast-Feeding
Breast-feeding
is the natural way to feed your baby. Both mother and baby
can benefit from it. Breast-milk provides the right food for
your baby, protects against infection, prevents allergies,
is easily digestible and there are no bottles to clean and
no formula to prepare. The nursing mother's body will return
to normal more quickly and you will have the satisfaction
of accomplishing something worthwhile for you and your baby.
A full milk supply depends upon rest, extra fluids and a good
dietary intake. However, even with ideal conditions, it may
take several weeks for this to develop. Do not be impatient.
Since breast-milk is so easily digested, your baby will probably
nurse every 2-3 hours for 10-15 minutes per breast.
Practically
all women can successfully breast-feed. Begin by nursing your
baby for 5-15 minutes per breast if your baby is willing and
there is no nipple soreness. Don't be discouraged if the baby
doesn't breast-feed well at first. Both you and the baby need
to learn the art. Begin each feeding at the breast you finished
with the previous time, especially if the baby did not feed
long at that breast. Put a safety pin on your bra strap to
remind yourself which breast to begin with at the next feeding.
Since the newborn may be sleepy for the first few days, some
feedings will be more successful than others. The baby may
fall asleep after nursing one side. Wake him/her up to finish
the feeding. You may want to burp the baby, unwrap him/her
slightly, sit him/her up, rub his/her back or change the baby's
diaper. You may need to encourage your infant to take the
breast every 2-3 hours to stimulate milk production and avoid
engorgement as the milk begins to appear.
Avoid sore nipples with correct positioning and latch-on of
your baby to the breast. Use water to cleanse the nipples,
and air dry after each feeding to prevent irritation and cracking.
When baby is finished nursing, place your finger in the corner
of your baby's mouth and pull out or press on the base of
the nipple to release the suction so that baby can be removed
without hurting the nipple.
If
engorgement occurs, use moist heat and massage before nursing
and feed frequently around the clock to relieve the fullness.
If the nipple and areola (dark area around the nipple) are
too swollen for baby to grasp easily, manually express or
pump some milk out to soften.
If you are still engorged after the feeding is over, you may
need to express enough milk to soften the breasts and relieve
the discomfort. Avoid excesses of any foods. Avoid large amounts
of caffeine and alcohol. Tobacco is to be avoided. Do not
listen to "old wives tales" and criticisms from friends and
relatives. Have confidence in yourself.
ADDITIONAL
HINTS ABOUT BREAST FEEDING
- Frequency
of Feeding: If the baby is crying and you are sure he/she
is dry and comfortable, he/she is probably hungry. At
first, the baby may be hungry every 2-3 hours.
- Milk Leaking:
This is normal. Wear breast pads inside your bra. Be sure
you change the pad frequently, so that your breasts don't
stay wet.
- Expressing
Milk: There are several ways to empty your breasts of
milk. When you are in the hospital after the birth of
your baby, the nurses can demonstrate these methods. If
you wish to use a breast pump, you may want to buy one
of the available cylinder type pumps or electric pumps.
These include Medela Pump, Kaneson Pump, Loyd-B Pump,
General Expressions, Egnell
Pump, or various other brands depending on your preference.
- Diet During
Nursing: A balanced diet with plenty of liquids is best.
If a mother is allergic to milk, high calcium foods or
calcium supplements can be substituted. It is helpful
to continue your prenatal vitamins while breast-feeding.
Check with your doctor before taking any medications that
might affect the baby, even over the counter preparations.
- Storing
Breast-Milk: Pour the breast-milk into a clean plastic
bottle or bag. Label the container with the date and time
you expressed the milk. Fresh milk can be stored in the
refrigerator for 48 hours at a temperature of 34 to 40
degrees F (1-4 degrees C). Milk can be stored in a freezer
inside a refrigerator for 3 weeks at a temperature of
20-28 degrees F (-7 to –2 degrees C). Milk can be stored
in a separate door freezer for up to 3 months at a temperature
of 5 to 15 degrees F (-15 to –9 degrees C). Milk can be
stored in a deep freezer for up to 6 months at a temperature
of 0 degrees F (-18 degrees C) or below. Do not store
milk in the door of the freezer. Do not add newly pumped
milk to frozen milk. This can thaw some of the frozen
milk and breast-milk should never be refrozen once thawed.
Thaw milk in the refrigerator or in warm water just prior
to use. Do not boil or microwave the milk, or leave it
out to thaw. Once defrosted, you can store milk in the
refrigerator for up to 24 hours or leave it at room temperature
for 1-2 hours.
- Effective
Nursing: To encourage effective caloric intake and to
prevent snacking, listen for swallowing. Stimulate the
baby or switch breasts if swallowing slows down or stops.
NURSING
TECHNIQUES
A common position for nursing is the "cradle-hold", with the
baby's head held in the crook of your elbow, using pillows
for support. Some mothers prefer to nurse lying down. The
"football-hold" may be useful for mothers who had a Cesarean
section (have your nurse demonstrate). The baby should be
lying completely on his/her side against your midriff. Hold
the breast with your hand in a "C" position, with the thumb
above the areola and fingers below, and move the breast slowly
up and down to lightly brush the baby's lower lip with your
nipple. Continue brushing until baby's mouth is open wide
(as with a yawn) and quickly pull the baby onto the breast.
If baby's sucking causes soreness or pain, break the suction
and begin the brushing process again.
It may take several attempts, so be patient and repeat until
nursing is comfortable. If soreness persists call your pediatrician
or breast-feeding consultant for advice. Soreness is not a
normal part of nursing. A lazy, sleeping baby benefits from
being switched from breast to breast every 5 minutes until
the feeding is over, with burping in between to keep awake.
Switching may also help produce more milk let down to satisfy
the baby.
When breast-feeding is well established (usually 2-4 weeks),
you should substitute a bottle-feeding several times a week
so the baby will accept the bottle. Parents who have not practiced
this may find their baby refusing all bottles later on, which
may create problems.
GETTING
STARTED: HOW OFTEN? HOW MUCH? HOW LONG? Many babies have a
1-2 hour period of alertness right after birth and then they
become very sleepy for the next few days. For many babies,
nursing is not a high priority during the first days of life.
The substance first produced by the breast is called Colostrum
and is a thick yellowish fluid. It is important for the baby
to receive this Colostrum to get the antibody protection it
offers. It also acts as a laxative to help the baby pass the
meconium from the intestines.
The act of sucking the Colostrum from the breast on a regular
basis will also encourage your milk to come in. Mother's milk
usually comes in between the third and fifth day after you
deliver your baby. Healthy, full term babies are born with
some extra fluid in their system to carry them over until
mother's milk is in. Unless there is a special circumstance,
the baby should not need water if they are encouraged to nurse
often.
In the first two days, nursing every 3-4 hours around the
clock is sufficient. The most important thing is to get comfortable
positioning your baby correctly at the breast. On day three
you should start encouraging your baby to nurse at least every
2 to 4 hours, or on demand. Eight to ten feedings in 24 hours
is very common for the newborn that is not yet an efficient
nurser (both baby and your breasts become more efficient over
time). If you are nursing frequently during the day and especially
into the evening, you can make the last feeding around midnight
then put your baby to bed and let him/her wake you for the
next feeding if it is not later then 6 a.m. Feedings are always
timed from the start of one feeding to the start of the next.
Remember,
most babies are accustomed to being up at night. That was
when they were awake and moving in utero. Many parents assume
the extreme nighttime fussiness is related to breast-feeding
dissatisfaction when it is usually just part of being a newborn.
The first few nights home from the hospital are usually the
worst. That is why resting during the day is essential.
Once
your milk starts to come in, frequent nursing will prevent
and help decrease the discomfort from engorgement. Bottles
that are given before breast-feeding is well established will
not only confuse babies on how they should be sucking, but
can also cause engorgement from missed feedings and eventually
decrease the amount of milk available from the breasts.
Newborns
will usually take 20-40 minutes to complete a nursing period.
Remember, this will improve over time. In order for you to
encourage your baby to be as efficient as possible, you will
need to start listening to your baby. You will be listening
for swallows at the breast.
When the baby goes to nurse, get him/her deep onto the breast
with his/her nose touching the breast. You won't need to push
down on the breast to clear the airway if you keep his/her
whole body tucked into yours. It will take 10-30 seconds of
active sucking to stimulate your milk to let down. You should
hear a soft exhalation with each swallow. Jaw motion on the
breast does not count as eating time since babies can pacify
on a breast for hours without actually eating. Listen for
the swallows. There should be about one per second. When the
swallows slow down or stop, rub the baby's back or feet without
taking him/her off the breast. Each time he/she stops swallowing
give him/her a little encouragement to start swallowing again.
If your baby won't start again, remove him/her from your breast.
Sit your baby up on your lap and burp him/her and then put
him/her on the other breast. Listen for swallows. Encourage
your baby when he/she stops and change sides when you can't
get him/her to resume swallowing any more. Switching breasts
will encourage your little one to get more milk in less nursing
time. Watching your baby instead of a clock tends to promote
a happier baby.
Feeding
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