Breastfeeding

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There are lots of different positions you can place your baby in to breastfeed. Once your baby is born, you can practice these positions and get a feel for what works best for you and your baby. Your nurses and lactation consultants can assist you with positioning and latch while you are in the hospital.

• Make sure baby is in a drowsy or quiet alert state
• Use nipple to tickle baby’s lips
• Baby’s mouth should open wide to cover the nipple and about 1 inch of areola
• When mouth opens wide and the tongue is down, bring baby to breast, supporting baby at shoulders and base of neck
• Don’t push on the back of the baby’s head

Every time your baby breastfeeds, your body secretes two different hormones. The first hormone is called prolactin, which tells your brain how much milk to make for your baby, based on what milk was removed from the breast. In other words, the more milk removed, the more milk your body will make. For most women, nursing 8-12 times every 24 hours creates plenty of milk for their baby.

The second hormone your body secretes is oxytocin, which helps propel the breastmilk through the ducts in your breasts and down to the nipple for the baby. This is often referred to as “let-down.” Some mothers feel a tingling sensation during let-down, while for others, it goes unnoticed. As the breastmilk begins to flow during the feeding, your baby’s suckling will become deeper and slower and you will often hear the milk being swallowed. This transfer of milk from breast to baby will often last from 5-30 minutes. Allowing your infant to nurse on cue every 1-2 hours will enable you to have a full milk supply.

It is better to allow your baby to nurse until he shows you signs that he is done, rather than to watch the clock and take your baby off after a certain amount of time. Babies usually slow down their suckling, are less vigorous on the breast, unclench their hands and bring their arms to their sides as they come to the end of a feeding. Many will stop and unlatch on their own.

You can tell that your baby has gotten enough because your breasts will become softer to the touch and the feeling of fullness lessens. Your baby might fall asleep and let go of your breast. If not, put a clean finger to the side of your baby’s mouth to break the suction and release the nipple.

If your baby is showing hunger cues, you can change over to the other breast and continue to let your baby feed.

We recommend feeding your baby on cue. Bring your baby to your breast as often as the baby asks.

• At first this will typically be every one to three hours, or eight to 12 feedings per day (24 hours).
• At about two weeks of age, your infant will be back to their birth weight, and at this time may go longer periods at night without nursing (4-5 hours), while continuing to feed on cue for 8-12 feedings per day or 24 hours.

*A newborn should not go longer than 4 hours without a feeding, including overnight.

The length of a feeding is determined by your baby. Babies typically breastfeed for 10-30 minutes at each feeding, varying that length throughout the day and night. Follow your baby’s cues and offer the breast whenever your baby shows signs of hunger.

Your baby’s preference will ultimately determine the method for how often you’ll alternate breasts during feedings. Some babies are able to satisfy themselves nursing on just one breast during each feeding, while other babies nurse on both breasts.

Watch your baby for hunger cues after nursing on the first side. If your baby is still hungry, then nurse on the other side. Your baby will show you when a feeding is over. Alternate the sides on which you start your feeding, and do not worry about nursing the same amount of time on each side during a feeding.

You do not need to stop during breastfeeding to burp your baby. Doing it after the feeding is fine. Often times they do not burp, which is of no concern.

Some infants will spit up after breastfeeding and others will not. If you feel your infant is spitting up frequently, then consult your Wellstar Pediatrician.

Common signs that your baby is getting enough breast milk include:

• Your baby seems relaxed and content after feeding.
• Your baby is nursing 8-12 times in a 24 hour period.
• Your baby is back to their birth weight by 2 weeks
• After 2 weeks, your infant is gaining ½-1 ounce per day.
• Your baby’s stool changes from black to yellow in color by day 5.
• By day 6 after birth, your baby has six wet diapers per day and two to three bowel movements every 24 hours.

Trust your instincts. If you’re concerned your baby isn’t getting enough milk, see your Wellstar Pediatrician immediately.

Your baby will go through several growth spurts in the first year. During these times, your baby may require more frequent feedings. Signs your baby may be going through a growth spurt:

• Wakes more frequently
• Unlatches, fusses a bit, and re-latches
• Wants to feed more frequently than normal
• Has been sleeping through the night, but now wakes up several times each night
• Wakes early from naps

There is no set schedule for growth spurts, but approximate ages are:

• 2-3 weeks
• 6 weeks
• 3 months
• 6 months
• 9 months

Growth spurts typically last 2-3 days. The best solution for feeding your baby during growth spurts is to follow your baby’s cues for more frequent feedings. Your body will respond by making more milk to meet your baby’s needs. Call your Wellstar Lactation Consultant or Pediatrician if you need further assistance during a growth spurt.

You can begin weaning your baby at the time that is right for your family. The American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) recommend all babies be exclusively breastfed for the first six months, with introduction of solid foods at that time, while continuing to breastfeed for 1 year or longer. The World Health Organization (WHO) recommends six months exclusive breastfeeding, with introduction of solid foods at that time, and continuing to breastfeed for 2 years or longer.

In some cases it is the mother who decides to wean her baby from breastfeeding, and in other cases it is the baby who decides. Whatever the reason, it’s best to proceed slowly with weaning, both for physical and emotional reasons.

Abrupt weaning can be emotionally difficult for your baby as he/she will have become accustomed to physical closeness during feedings. Gradual weaning is also helpful in decreasing the breast fullness that can occur if you wean too fast.

As the demand for milk decreases with less nursing, your body will respond by producing less. When either of you decide to wean from the breast, contact your Wellstar Lactation Consultant or Pediatrician for advice.

Tips to ease the process:

• Give your baby plenty of extra attention and reassurance during the time you are weaning.
• Play with your child or engage in fun activities in the time that would have been spent nursing.
• Take your time and give your baby time to adjust.
• Before you start weaning, get your baby used to drinking expressed milk from a cup or a bottle.

Breast milk contains enough calcium and iron to meet a baby’s normal requirements. Breast milk may not contain enough Vitamin D, which helps your baby absorb calcium and phosphorous, both of which are essential for strong bone development. Ask your Wellstar Pediatrician about Vitamin D supplements for your baby’s diet.

Breast engorgement can occur after the onset of lactation. Engorgement occurs when the breasts aren’t emptied and can cause discomfort that varies from mild to severe. Swollen, tender, full-feeling breasts are indicators that you may be experiencing engorgement. Often times, your first time experiencing this is when your mature milk is coming in during the first week after birth. You may also experience engorgement when your baby starts sleeping through the night, begins eating solid foods, or you return to work.

Take these steps to help prevent the occurrence of breast engorgement:

• Feed your baby frequently, and if you are separated from your infant, pump for comfort.
• Help generate the flow of milk with warm, wet compresses on the affected areas for a few minutes prior to breastfeeding or pumping.
• Some women find it helpful to use a breast pump for just a few minutes, and then let the baby nurse to relieve the engorgement.
• Some women may find a brief application of ice to the breast and armpit area after feedings helps to relieve the discomfort.
• If engorgement persists, you can call and speak to a lactation consultant at one of the Wellstar Breastfeeding Centers, or call your obstetrician or midwife.

In most cases, you can continue to nurse your baby when you have a variety of illnesses, including colds and the flu. Your body makes antibodies against these germs, which are passed along to your baby through your breast milk. Exceptions to breastfeeding include treatments with radioactive compounds and anti-cancer drugs. Consult with your Wellstar Lactation Consultants or pediatrician when you’re ill to be sure the medications you’re prescribed are safe to use while nursing.

Your breastfeeding concerns are very important to us. The lactation consultants at the Wellstar Breastfeeding Centers can help with many breastfeeding problems, even after you go home from the hospital. Some examples are:

• Sore nipples/breast pain
• Breastfeeding after surgery
• Engorgement
• Low milk supply
• Baby not latching to breast
• Baby not gaining weight well
• Questions about medications while breastfeeding
• Breastfeeding if mom or baby is ill
• Breastfeeding twins or multiples
• Combining work with breastfeeding
• Pumping questions/instructions

Wellstar’s Breastfeeding Centers provide inpatient lactation consultations as well as lactation supplies and products needed for the breastfeeding mother. Items include baby scales and hospital-grade electric breast pump rentals, nursing pillows and stools, breast pads, nipple shields, or special needs feeders. Our certified bra fitters can also fit you for a breastfeeding bra.

The Wellstar Breastfeeding Centers also offer private outpatient consultations, by appointment, for assistance after you go home. As a courtesy, lactation consultation fees will be billed to your insurance company. Please check with your provider for more information regarding this service.