100 Keys and Tips for Successful Breastfeeding

100 Keys and Tips for Successful Breastfeeding

  • Breastfeed Right After Birth Cuddle your baby on your chest to welcome him or her gently into the world. When you and your baby are skin to skin, covered lightly together, your milk production and baby’s feeding reflexes are triggered. This means baby will start looking for the breast and more breast milk will be made sooner. Babies are often more alert and interested in feeding in the first hour following birth. Remain skin to skin with your baby until after a successful breastfeed. This will help baby to stay warm and reduce stress, helping you both to recover from the birth. For caesarean births, the mother or father can hold the baby skin to skin until the baby can enjoy his or her first feed.
  • Getting Started The first milk is called colostrum, a fluid rich in vitamins, protein and immune factors to protect your baby. A newborn’s stomach is very small and cannot hold a large amount of milk – that is why your early milk is very concentrated and why babies want to feed often in the beginning. The chart below shows the average size of a newborn’s stomach and how much milk it can hold. The chart below shows the average size of a newborn’s stomach and how much milk it can hold. Learn how to express your milk by hand so that you can attract your baby’s attention by putting a few drops of breast milk onto your nipple, to help baby start a feed or, if needed, to relieve breast fullness. At the end of a feed, you can also express a few more drops of milk and gently rub them into your nipples to help prevent drying and cracking. Feeding your baby often will also help increase your milk supply. The more your baby breastfeeds – the more milk you will produce – “Supply and Demand”.
  • Watch The Baby Not The Clock! Instead of timing feeds by the clock, look for your baby’s early signs of wanting to feed, such as rooting, licking his lips or putting his hands to his mouth. Babies need to eat often in the first weeks – 8 or more times in 24 hours. This establishes active milk production and ensures that your baby regains his birth weight by the second week of life. Night feeds are important to establish breastfeeding and to maintain milk production. Mother’s milk is easily digested. When your baby is breastfeeding well and often, there is no need to supplement with food or other liquids, not even water (you should still give your baby vitamin D drops – see #4). The usual pattern is: feed your baby on one breast until he stops suckling, then a burp or diaper change, and then offer the other breast. The next time you breastfeed your baby, start with the breast on which he finished the last time. Some babies prefer several “short courses”; others prefer one long feeding. Don’t rush your baby – take your time.
  • Support for Breastfeeding With support, breastfeeding tends to continue for longer. Organisations such as La Leche League provide free support and information for breastfeeding mothers. A lactation consultant can also help with more serious problems. Meeting with other breastfeeding mothers through informal, community-based groups can keep motivation up and offers vital support.
  • Breastfeed When Relaxed The let-down reflex, which pumps fresh milk down through the breasts, is intimately linked with relaxation and self-confidence. Therefore it is well worth “setting the stage” for successful breastfeeding by consciously relaxing. Make sure to have enough pillows, sit or lie comfortably, and take some deep breaths before beginning. Visualisation can help too.
  • Correct Latch/Positioning If the baby is not correctly held and latched on to the breast, he will not be able to get a good “mouthful” and take enough milk in. This can also make the mother’s nipples sore and cause a discontented baby.
  • Be Patient Baby may not get it right away. This is annoying, but true, apparently, for many moms. If you have trouble at first, don’t give up until you’ve tried it for at least a couple of weeks, unless you are truly miserable or baby is showing signs of failing to thrive, in which case a switch to formula might be in order. Either way, it’s probably a good idea to check with your doctor before you do anything drastic.
  • Get Help If you’re feeling frustrated or have questions about anything even remotely breastfeeding-related (other than true medical emergencies), a quick call to your local lactation consultant might solve your problems. Most hospitals have a lactation hot line (or warm line, where calls are returned within a day). You can also try La Leche League, which offers advice to breastfeeding moms. Lactation consultants are usually very pro-breastfeeding — some militantly so — and will not only answer questions but also will probably convince you to keep at it if you’re feeling a bit discouraged.
  • Get Emotional Support This is a good time to lean on baby’s other parent. Not that breastfeeding is unpleasant (quite the contrary), but there may be times when you are feeling tired, and, well, you want your body back. This is a good time for hubby to chime in with lots of positive talk about what a great thing you are doing for baby. If he doesn’t think of this himself, you might have to prod him along (with a sharp object or a few well-chosen words).Look for the following signs that the baby is correctly latched on to the breast
  • Alternate the breast your baby begins with each time to reduce some of the soreness you may feel.
  • Seek an evaluation of your breastfeeding technique by a trained professional during the first 24 to 48 hours after birth.
  • Feed your baby whenever she shows signs of hunger. It is crucial that infants be fed on demand.
  • Nurse until your baby is satisfied. The fat content of breast milk increases during the suckling session. Let your baby finish the first breast (about 10 to 15 minutes) before offering the second.
  • Burp your baby once or twice during and after each feeding.
  • Avoid pacifiers until breastfeeding has been well established.
  • If possible, breastfeed exclusively during the first six months. Breastfeeding is ideal for your baby’s growth and development.
  • Do not give supplements (water, glucose water, formula, etc.) to your breastfed newborn unless a clear medical reason exists.
  • Your diet plays a crucial role in the success of breastfeeding. A diet based on the four basic food groups is recommended.
  • Understand Supply and Demand The more a baby is breastfed, the more milk will be produced. Giving other food or drink reduces the milk supply, as the baby will “ask” for the breast less often. In a few medical cases, a baby needs supplementary feeds of infant formula, but these are rare. Similarly, using pacifiers and artificial teats can also reduce the number of times baby “asks” for the breast, thus reducing milk supply.
  • Let Baby Set the Pace Allow baby to finish sucking on one breast before offering the other. If baby is taken off one breast before his sucking has slowed down and he seems satisfied, he may only get a taste of the watery “foremilk” and not be receiving enough of the richer “hindmilk” full of essential fats. This causes a risk of inadequate weight gain and other problems.
  • Eat Right You need extra calories — about 500 per day — to fuel the milk factory. They have to be healthy calories, too, which means you should probably hold off on buying that crate of Ho Hos until baby is weaned. Following the same health-conscious diet you followed when pregnant is a good idea, with a particular focus on calcium and protein. Keep taking those prenatal vitamins, too.
  • Self Care: Get Enough Rest Get whatever help you can in the first weeks, and don’t worry about the house being perfect. Don’t be afraid to ask: friends and family who visit can bring freezable meals and help with the dishes. Lying in bed and relaxing with baby as much as possible in the early days increases the odds of breastfeeding going well.
  • Self Care: A Good Diet Breastfeeding mothers need extra calories and quality food. Although no matter what mothers eat, enough milk will be made to nourish the baby, the mother’s health and energy levels can suffer if the diet is lacking. A normal, balanced diet with particular attention to calcium and zinc levels is advised.
  • Forget About Scheduled Feeds Because breastfeeding is a matter of supply and demand, feeding when the baby needs it, rather than according to any schedule, is the best way to ensure a plentiful milk supply. Mothers who feed “on demand” also have half as many cases of sore and cracked nipples, as those who feed four-hourly. If long breaks between feeds have become a pattern, the milk supply can be restored within 48 hours by breastfeeding whenever baby is hungry.
  • Keep an Eye on Baby  Because you don’t have a dipstick or any other handy gauge to tell you how full your breasts are, it’s normal to worry that baby isn’t getting enough milk. The best way to reassure yourself is to keep a dirty diaper diary — a log of how many diapers your child dirties in a 24-hour period. Once your milk comes in, and for the first six weeks of life, baby should have five or six wet diapers a day and two to five bowel movements per day, according to La Leche League. Also, your baby should average eight to 12 feedings per 24-hour period, says La Leche League
  • Find a Quiet Spot The first time you breastfeed will likely be in a hospital bed with a kindly (we hope) lactation consultant guiding baby’s mouth to the right spot. At that point, ambiance is the least of your concerns. But once you’re on your own at home, you’ll want to find a quiet place where you and baby can relax. Think low lights and limited noise. Not only does the right environment put baby in the mood, but it also sends your body the signal that it’s time to let the milk flow. Of course, this isn’t always possible. If you nurse long enough, you will inevitably find yourself in the backseat of your car (parked, of course), fumbling with your nursing bra, trying to calm a hungry infant and doing your best not to flash the guy parking the Explorer next to you. Setting the mood isn’t so important then, but that’s the exception rather than the rule.
  • Night Feeds Night feeds increase levels of prolactin, the hormone that causes milk to be produced, and therefore keep milk supply up. While most mothers would ultimately like their baby to sleep through the night, in the early months this is unlikely to happen, and should not be forced, as babies genuinely need the calories of the milk and the comfort and physical contact that breastfeeding provides.
  • Feeding On the Go It makes life much easier, and breastfeeding more convenient, if you can nurse in a sling or baby carrier. The Food of Love has some good tips on how to breastfeed in a sling. Breastfeeding not only offers many health benefits to both baby and mother but also sets the foundation for a loving, close relationship in years to come. It is well worth the effort, and enlisting as much support as possible can make all the difference.
  • Signs Your Baby is Getting Enough Breast Milk: Weight gain is a very good sign that your baby is breastfeeding well. By 2 weeks of age, your baby will most likely have regained his or her birth weight and will gain, on average, 5 or more ounces (141 grams) each week after that. Another positive sign to look for is 6 or more wet diapers a day by day 6 and frequent bowel movements. The first 4 to 6 weeks are a learning period while your body establishes your milk supply and you become more at ease with breastfeeding and understanding your baby’s cues. Time, patience, and humour can all help!
  • Get Comfortable Once you get baby latched on and happily sucking away, the last thing you want to do is disturb her just to keep your arm from falling asleep. Think ahead and grab something to support your arm as you hold baby. Try a nice firm pillow or one of those C-shaped nursing pillows on the market.
  • Milk Production The more your baby breastfeeds, the more milk you produce. As your baby gets older, he may breastfeed for a shorter time or less frequently and be satisfied. Your baby will have periods of growth spurts in the first few months. During these growth spurts your baby will feed more often for a few days, to satisfy an increased appetite. During these times, your breast milk will increase to meet your baby’s needs.
  • The Complete Food Research shows that breast milk is so important that it is the only food or drink your baby needs for the first 6 months of life. Remarkably, as your baby grows your milk will also change to keep up with your baby’s needs and continues to have just the right amount of nutrients*. Breast milk also contains antibodies and other immune factors that help protect against infections and disease — benefits that last a lifetime. Beginning at 6 months of age babies need to replenish their iron reserves by adding a variety of foods in addition to breast milk, which continues to provide nutrition and protection. Many mothers continue to breastfeed until their babies are two years old or more. New mothers should note that since sunlight is the principal source of vitamin D for all people, a vitamin D supplement of 10 ug (400 IU) is recommended for all breastfed babies in Canada to correct for a lack of exposure to sunlight. This supplement should be given from birth until the baby’s diet includes at least 10 ug (400IU) per day of vitamin D from other foods or until he or she is 1 year old. Breastfeeding has many health benefits for mom too, including nurturing a special relationship between mother and baby. Breast milk is convenient, always the right temperature, economical and better for the environment!
  • Have a Glass of Water Handy You may find that the minute baby starts nursing you’re suddenly very thirsty. It’s as if that little parasite is sucking you dry. Wait, he is, which would certainly explain your thirst. For this reason, it’s not a bad idea to have a bottle of water on hand at all times. You can even stash an extra near your favorite comfy chair for those times you forget to bring one with you and your spouse — and resident drink fetcher — is conveniently nowhere to be found.
  • Looking After Mom In the early days, try to rest when your baby sleeps. Eat healthy meals and drink when you feel thirsty. When your baby feeds, you may want to have a snack and something to drink. If your nipples are tender, make sure your baby is latched properly to your breast when feeding (see #1). Ask a nurse, midwife, lactation consultant or a successfully breastfeeding mother for help to achieve a comfortable breastfeeding technique. For the first few days, expose your nipples to air or light after each feeding. Allow some breast milk to dry on your nipples; it has lubricating and anti-infective properties. If your breasts get swollen and painful (engorged), cold compresses decrease swelling, then gentle massaging and warmth (warm towels or taking warm showers) will help the milk to flow. Expressing some milk before feeding to relieve fullness and breastfeeding more frequently will help your breasts to feel more comfortable.
  • Working and Breastfeeding Your baby can have all the benefits of your breast milk even if you plan to go back to work or school. When breastfeeding is well established, you can express milk and leave it with your caregiver for feedings throughout the day. Your breast milk can be stored in the refrigerator (3 days) or frozen (about 6 months). Refrigerate or freeze breast milk in clean bottles or bags and date them. Warm up the breast milk by standing it in hot tap water before it is used. Microwaving breast milk, or heating it on the stove, is not recommended because it can cause a loss of Vitamin C content and some of the milk’s special antiinfective properties. Microwaving and stove heating also causes the milk to have hot spots that can scald your baby. Ask your employer about some flexibility to have breastfeeding or pumping breaks, and access to refrigeration to store your breast milk. Some mothers have childcare facilities at their place of work, school, or nearby, so they can breastfeed during their breaks.
  • Breastfeeding and Pregnancy Exclusive breastfeeding (no food or liquids other than breast milk are given to baby) for the first 6 months of baby’s life may delay the return of your menstruation, but ovulation can still occur, so you and your partner should discuss other birth control methods with your doctor, nurse or midwife.
  •  Stick With It Pick a philosophy and stick with it. There are a couple of schools of thought on when to feed baby (i.e., every time he cries, every three hours or somewhere in between). Each school seems equally adamant that theirs is the right philosophy. What matters most is that you choose a philosophy that you are comfortable with and that you feel is best for your baby. Once you’ve picked one, be ready for other well-meaning mothers to advise you on how to do it right. Listen, but stick to your guns when it comes to doing what you think is best.
  • Thoughtful Reminders Try to sleep when your baby sleeps. Accept and/or ask for help with housework and meals from your partner, family and friends. Invite visitors only when you feel ready. Eat healthy and drink when you feel thirsty. You’ll find you may be extra thirsty, so have a glass of water, milk or juice every time the baby nurses. See Eating Well with Canada’s Food Guide (www.healthcanada.gc.ca/foodguide ) for information on healthy eating and balanced nutrition. While you are breastfeeding, you may gradually lose some of the extra weight gained during pregnancy as it provides part of the energy needed to produce breast milk. Remember that cigarette smoke is harmful, especially to babies. If you smoke, it is still important to breastfeed but look for ways to decrease your baby’s exposure to cigarette and second hand smoke. Alcohol and other drugs can pass into your breast milk and may harm your baby. Check with your doctor, nurse, midwife, lactation consultant or Mother Risk if in doubt about any medications or other substances you are using that might affect your breast milk
  • Talk to Others Motherhood and fatherhood are new roles that need to be learned together. Keep the lines of communication open! Contact with other breastfeeding mothers is important for confident breastfeeding. Don’t keep concerns to yourself. There are many groups and individuals available to help you, including: public health nurses, lactation consultants, the La Leche League, your doctor or midwife, family members, or friends who have breastfed.
  • Enjoy Your Baby Holding your baby close stimulates all of her senses. A baby who is smiled at, talked to and cuddled will develop a sense of security. Breastfeeding is more than simply providing nutrients and calories for physical growth – it contributes to an intimate and special relationship. You and your baby have the right to breastfeed anywhere, anytime and there are many techniques to help you achieve this comfortably. Ask your friends, family, midwife, nurse or lactation consultant, or attend a breastfeeding support group to see how it can be done.
  • Breastfeeding hurts. The degree varies, but even good latches can be, at  best, uncomfortable. Aside from Lansinoh, build up a stash of wound gel pads  (the hospital lactation consultant should be able to give you some). They are  lifesavers in the early weeks. You may also want to use Neosporin on any open  wounds (in fact it’s more effective than Lansinoh if you do have wounds), but  remember to wash it off before you breastfeed.
  • Don’t rush the latch. Take the time to get the latch right no matter how  heart wrenching your newborn’s cries are.
  • Babies can mess up a good latch no matter what you do. It takes two to  breastfeed and not everything is in your control. Sometimes, you’ll just deal  with a bad latch because you’ll know if you pop her off that she’s just going to  konk out and then she won’t eat at all. Despite what the LC’s preach, you can’t  always fix a bad latch. Breastfeeding isn’t perfect all the time.
  • Newborns are really sleepy. It’s a fine art to wake them up enough to eat.  Try blowing in their face, nudging them under the chin, stroking their heads,  tickling their feet, and putting cold hands on their feet.
  • The football hold is the best one to start out with. Be familiar with it  and don’t worry about the other positions until later.
  • Boppies are, depending on your height, hard on your back and neck. Test  your boppy. If it doesn’t sit just below your breast, it is too short. You will  either end up breastfeeding like the hunchback of Notre Dame or need a bazillion  pillows to get the baby up to your breast. Try a My Brestfriend pillow instead.  While it’s a bit of a pain because you have to fasten it around your waist, it  does allow you to control the height and customize it for your frame.
  • You can expect more than your nipples to be sore.  Remember to relax your shoulders and neck and don’t contort your hands into  weird positions. Have your spouse give you backrubs on a regular basis for the  first few weeks.
  • If your hospital/area has a breastfeeding support group run by a  Lacatation Consultant, go. Usually they have scales so you can weigh your baby  and be sure your supply is on track. Ask the LC while you’re in the hospital  about hospital run lactation support groups, they’ll fill you in on when and  where. La Leche League is another place to find support.
  • Newborns eat frequently. Expect to do almost nothing but breastfeed the  first six weeks. It’s important that you make the breast available on demand  during the initial newborn period as this is what establishes your milk supply.  Stock up on movies and books (if you can manage to read and breastfeed) because  you are going to be sitting a lot. Try to remember that this is temporary. It  will pass and you’ll gain more freedom as time goes on. In addition, just when you think you can’t take it anymore, keep in mind the  more your baby eats, the faster they gain weight and once they hit ten pounds,  most babies tend to sleep longer at night. So, you’re not just feeding your  baby, you’re working toward a good night’s sleep.
  • Keep in mind growth spurts when planning trips and other events. Growth  spurts can be so demanding that you spend more time with your shirt off than on.  In fact, you’ll wonder why you even bothered to get dressed. So, avoid big plans  for the third and sixth week of your baby’s life because, you’re already  booked.
  • Take a breastfeeding class before the baby comes and have good reference  books on hand. Breastfeeding is an art as well as a learned skill and you will  have lots and lots of questions. Education and support is the key to a  successful breastfeeding experience.
  • Always change your baby’s diaper before a feeding as newborns tend to  fall asleep on the boob and you don’t want to wake them up with a diaper change.  Especially at 2 am.
  • Know the signs of low milk supply. It’s rare, but, of all breastfeeding  challenges, this is one to keep an eye on because your milk can dry up fast and  you don’t want the baby to become dehydrated. If you are at risk for low supply  (i. e. you have PCOS) at least buy some Fenugreek and have it on hand. Time is  of the essence when it comes to low milk supply. Not every store carries  Fenugreek and you won’t have time to go looking for it.
  • Drink lots of water. Water makes breast milk. Proper hydration ensures a  bountiful milk supply. Aim to drink half a liter of water every time you sit  down to nurse.
  • Rest as much as you can. The bulk of breast milk is produced primarily at  night while you are asleep, so don’t stay up late cleaning the house (or  engaging in other such tomfoolery) while your baby is sleeping. Naps are also  important. Rest, rest, rest, and drink, drink, drink your water
  • If you or your baby were given antibiotics while in the hospital, ask the  hospital LCs about your risk of thrush (a type of yeast infection). Ask them to  evaluate your breasts and baby for signs of thrush. Thrush is painful and can be  difficult to eradicate, so catching it early is important. Both mom and baby  must be treated even if one or the other shows no symptoms. OBs are not terribly  familiar with thrush and you may have to be a bit firm when communicating your  needs.
  • Before you sit down to nurse, make sure you have everything you need. A  burp cloth. A drink. The remote. Nothing is more frustrating than to realize  you’ve forgotten the remote after you’ve started nursing.
  • Set up a nursing station. A small bookshelf to keep basic necessities  within arm’s reach is a lifesaver. Put a laptop on the bookshelf for one-hand  internet surfing while nursing. Be sure to stock tissues and other necessary  items like Lansinoh and nursing pads. More importantly, a nursing chair that not  only rocks and reclines, but also swivels will come in handy because, no matter  which side you’re nursing on, you can always spin around to grab a tissue (or  continue surfing the net) with your free hand.
  • Pumping is a whole different learning curve. Not quite as difficult as  breastfeeding, but it has its own set of rules and equipment and know how. If  you’re going to be pumping at work, take some time to read up on the  subject.
  • You can do this. Don’t give up. Take it one day at a time. Difficult is  normal, so don’t assume, if you’re having a hard time, that you can’t  breastfeed.
  • Number of wet diapers. For the first week, the number of wet diapers should be at least equal to your baby’s age in days: day 1 – one wet diaper, day 4 – four wet diapers and so on. What is “wet”? Take two ounces of water and pour it in a diaper. This is how your baby’s diaper should look and feel. Note the heaviness of the diaper. Watch the color of the urine which should be pale yellow or clear, not dark and smelly.
  • Number of soiled diapers. You should see two or more meconium stools daily for the first two or  three days. On day 4, look for AT LEAST three orange-brown to yellow stools. By day 7, look for AT LEAST six yellow stools, and ideally one during every breastfeeding.
  • Number of feedings. Your baby should be waking and asking for food (by rooting or mouthing its  fingers) every two to three hours for a total of at least eight feedings in 24 hours. Let your baby feed as long and as often as he or she wants. If your baby needs to be woken for all or most of its feeding, call us to make sure your baby is healthy.
  • A good feeding (first three days). Ideally your baby will feed for at least 10 minutes and perhaps take both breasts. During a good feed the baby’s lower jaw moves steadily with only brief pauses to rest, and the baby does not have to be stimulated to keep feeding but feeds steadily on its own. A full baby will release the breast by itself (the mother does not end the feeding) and is either asleep or contentedly awake. A full baby generally does not cry after a feeding.
  • A comfortable latch. Your baby needs to be attached to the breast correctly in order to transfer food. A good latch does not hurt. Sharp pain when the baby latches on, even if it eases after a minute or two, usually means the baby’s tongue is squeezing your nipple instead of your breast tissue.
  • Swallowing. Each jaw movement counts as one suck. Your baby should swallow every third suck  when the breasts contain colostrum and almost EVERY suck when the mature milk comes in (by day 4).  A swallow may be an obvious gulp (especially when the milk is in) but more typically you will hear a soft, nasal exhalation. Listen for this in a quiet room. If you watch your baby’s chin you will notice  short, choppy movements when the baby is not swallowing and longer, slower movements when the baby is swallowing.
  • Pacifiers. None for the first two weeks at least. If your baby wants to suck, offer the breast. This  stimulates a good milk supply and guards against underfeeding.
  • Supplements. If all goes as nature intended, no supplements are required for a breastfed baby. Check with your baby’s doctor if you feel your baby is not satisfied with breastmilk alone.

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