Supporting Breastfeeding

La Leche League Canada

Engorgement: Cabbage leaves and Other Treatments

Engorgement is the tender, full, larger feeling that many women get in their breasts between day 2 and day 6 after giving birth.  Some women describe it as feeling like they have Barbie Doll breasts.  The change in size and sensation is caused by increasing milk volume and increased blood and lymph flow to the breasts.  The increase blood and lymph flow supports milk production.

Women who have had intravenous fluids during labour are at an increased risk of having an extended period of engorgement while the body rids itself of the excess fluids.  If the baby is latching and nursing well the normal postpartum levels of extra fluid generally don’t cause any breastfeeding difficulties.  As the pregnancy and childbirth hormone levels decrease over
the next few weeks, mother’s breasts feel softer in-spite of the increased milk volume of established breastfeeding.

Several studies have shown that when babies feed more frequently in the early days mothers are less likely to experience engorgement.  An Australian study which compared mothers who were told to let their babies nurse as long as their wanted on one breast before offering the second breast found those mothers had less engorgement than the mothers who were told to be sure their babies took both breasts at a feeding.

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Treatments for postpartum breast engorgement have not been well studied so mothers will get lots of opinions and advice.  The ideas we know work well are those that get the baby nursing effectively and emptying the breast:

-Breastfed as often as baby is willing (at least every 2-3 hours) and allow the baby to stay on the first breast until he comes off on his own.  The second breast can be offered if the baby is interested.  If baby isn’t interested in the second breast right away make sure to offer that side at the next feeding whether that is 10 minutes or two hours later.

– Get assistance sooner rather than later from La Leche League or another trained breastfeeding support person if baby is not latching well.

– Cold compresses between feedings can help reduce the swelling and the often feel good.  A soft gel Ice packs or a bag of small dice frozen vegetables works well to sooth an engorged breast.  Protect the skin with a layer of cloth between the ice pack and the skin.

– Pain medication may be helpful while waiting for the increased breastfeeding and cold compress to be effective if a mother is experiencing a lot of discomfort from engorgement. Discuss appropriate pain control medication with a health care provider.

– Express some milk if baby isn’t able to latch on well due to the swelling.  Some mothers worry that by expressing milk they will increase their milk production and create a bigger problem. Draining the breast helps to decrease the congestion of extra blood and lymph in the breast tissues.  Milk volume is unlikely to increase beyond baby’s needs with the amount of milk expression needed to regain comfort and make it easier for baby to latch on.

– Gentle breast massage before feeding or expressing may help to make the milk flow more easily.

-Cabbage leaves have long been recommended as a treatment for engorgement.  The small amount of research that has been done shows they don’t prevent engorgement.  Another study showed that they don’t appear to be any more effective than frozen gel packs but mothers preferred using cabbage leaves over the frozen gel packs.  If mothers want to try using cabbage leaves as a treatment for engorgement, choose green cabbage not the red/purple variety (it stains skin and clothing!).  Take a rinsed, room temperature or refrigerated, cabbage leaf and cut out the heavy vein out of the middle of the leaf.  The leaf or leaves are laid over the breast directly on the skin.  Putting on a bra or snug top over top of the leaves will keep them from falling off.  Remove the leaves when they are wilted and soft (usually within a few hours) or when the baby wants to feed again.  Fresh leaves can be applied after a feeding or when the first ones are wilted.

La Leche League Leaders can help you work through engorgement and other breastfeeding challenges.

http://www.lllc.ca/thursday-tip-cabbage-leaves-and-other-treatments-engorgement

More information about engorgement can be found by clicking here.

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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Breastfeeding on One Side Only

Most people assume that you need to have two functional breasts to breastfeed a baby but there are women who, for a variety of reasons, nurse their babies, on one side only. The first concern people bring up is whether the baby will get enough milk. When you consider that mothers of twins (and more) can successfully breastfeed, it is clear that each breast will produce the amount of milk needed given the right stimulation.

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The most common reason for mothers to find themselves breastfeeding from one side only is past surgery for cancer or to remove a benign lump. If the ductal tissue of the breast has been removed or severely damaged, the breast may not produce milk or the milk may not reach the nipple. Other mothers have found themselves nursing on one side because of physical issues of their own or the baby’s, or they have a baby whose adamant refusal to feed from one breast can’t be overcome.

Producing an adequate milk supply when breastfeeding on one side only requires the same things as stimulating a milk supply in both breasts: putting baby to the breast early and often and ensuring that baby has a good latch. The breast that is not stimulated will, over time, stop producing milk.

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If you are surprised that breastfeeding is possible with only one functional breast you may be even more surprised to know that mothers have breastfed twins or tandem nursed a newborn and a toddler with only one breast. With knowledge, support and determination breastfeeding mothers can do amazing things!

http://www.lllc.ca/thursday-tip-breastfeeding-one-side-only

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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Newborns Have Small Stomachs!

It should be self-evident that very small people will have very small stomachs.  However, many adults are surprised when they learn about the limited capacity of a newborn’s stomach.

Here are some facts that may help you (or those around you) better visualize what baby’s tummy can hold:

Before birth baby never feels hunger as he is fed constantly via the placenta. After birth small frequent feedings help baby transition to an intermittent feeding pattern. To make this transition easier for baby mother’s breasts provide small amounts of milk (colostrum) on day 1.

Newborn stomachs don’t stretch. Zangenet al (2001) found that on day 1 a newborn’s stomach wall is firm and doesn’t stretch. By day 3 the stomach starts to expand more easily to hold more milk. Interestingly, day 3-5 is when the milk volume starts to increase for most mothers.

When breastfeeding is going as expected, each day baby feeds more effectively. In response, mother’s milk production increases and baby gets more milk, which encourages her to feed more effectively. Supply follows demand.

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Day 1:  baby’s stomach holds 5-7 ml (1 – 1.4 teaspoons) at a time. The mother will produce about 37 ml (one ounce) of milk/colostrum in the first 24 hours. The capacity of a newborn’s stomach is influenced by birth weight however the differences are not substantial.

1st week:  with frequent feedings milk production increases to about 280 -576 ml (10-19 ounces) per day by day 7. Baby’s stomach can now hold 30-59 ml ( 1 -2 ounces) at a feeding by the end of the week.

2nd & 3rd week:  with frequent feedings mother’s milk supply continues to build. Now baby’s stomach can hold 59 – 89 ml (2-3 ounces) at a feeding and baby is taking in 591-750 ml (20-25 ounces) per day.

4th & 5th weeks:  babies will now be taking an average of 89-118 ml (3 -4 ounces) per feeding and daily milk intake will be in the range of 750 – 1035 ml (25 – 35 ounces) per day.

At one month most mothers will be producing nearly as much milk as their baby will ever need. Because the rate of growth slows as babies get older, they continue to need about the same amount of breastmilk per day from one month to six months of age. The nursing pattern will change during that time even though the volume of intake over the day remains much the same.

Some people have trouble visualizing stomach capacity so using common objects can help make the capacity clearer:

Day 1:  5-7 ml is about the size of a large marble or a cherry

Day 3:  22-27 ml is about the size of a ping pong ball or a walnut

One week:  45-60 ml is the size of an apricot or plum

One month:  80-150 ml is about the size of an large chicken egg

 

Adult stomach size is equivalent to a soft ball or the size of your own fist clenched at rest and has a capacity of 1-4 liters.

When someone asks you why your newborn is nursing at least 10-12 times in 24 hours and suggests that your milk might not be filling up her tummy, you now have some information to help them understand that frequent feedings, on baby’s own schedule, is exactly what her tummy and your milk supply need.

 

http://www.lllc.ca/thursday-tip-newborns-have-small-stomachs

 

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

 

 

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Diabetic or Insulin Resistant Breastfeeding Mother

Women who have Type 1 or Type 2 diabetes or who are considered insulin
resistant or “pre-diabetic” can breastfeed and doing so is good for mother and baby.

Breastfeeding has a positive effect on a mother’s insulin response.  For Type 1 diabetic mothers, this can decrease their need for insulin during the breastfeeding period.  Mothers who have Type 2 diabetes may find they require less hypoglycemic medication while breastfeeding.  Good control of your insulin levels is important while breastfeeding.  You may need to do some additional monitoring and be in close contact with your health practitioner during the early weeks until your hormones and your milk productions stabilize.

Mothers who are diabetic are at an increased risk of pre-term birth and their babies may develop prolonged low blood sugar levels shortly after birth (a dip in blood sugar levels one to two hours after birth is normal with blood sugar levels starting to rise again within 2 to 4 hours). Planning ahead with your birth team to manage these potential events can be helpful so everyone is prepared and not making decisions in a stressful situation.  If at all possible, plan to breastfeed within the first hour after birth and at least once an hour until the baby’s blood sugar levels stabilize.  Skin-to-skin contact has been found to decrease the risk of hypoglycemia in newborns and it helps trigger the hormones that drive breastfeeding.
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A mother who is diabetic or insulin resistant may find that it takes a bit longer for her milk volume to increase after giving birth.  Colostrum is providing all the nutrients (vitamins, minerals and fats) that baby needs through the early days.  Frequent effective feedings will speed up the body’s ability to increase the milk volume.  In the event that supplementation is required during the first few days, human donor milk is the best option.  A non-cow’s milk based formula is the next best option of donor milk is not available.  Early introduction of cow’s milk is considered a risk factor for later development of diabetes.  Talk to a La Leche League Leader or lactation professional if you have concerns about your milk supply.

Breastfeeding may make your blood glucose levels harder to predict.  To prevent blood sugar dips:

Plan to have a snack before or during nursing
* Drink enough fluids (plan to sip a glass of water or a caffeine-free drink while nursing)
* Keep something to treat low blood glucose nearby when you nurse, so you
* don’t have to stop your child’s feeding
* Developing a meal plan with your health care provider or dietitian will allow you to achieve stable blood sugar which will help you meet your breastfeeding goals.

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Most medications used to treat diabetes or insulin resistance can be safely used during nursing, but be sure to check with your doctor.  The insulin molecule itself is too large to pass from your blood stream into your breast milk and it would be digested in baby’s stomach if any did pass through.  If you are considering taking herbs, like fenugreek, which may have an effect on blood sugar levels, discuss this with your health care provider.  Mothers with diabetes have an increased risk of thrush and mastitis, which is why it is important for them to look after their nipples and drain their breasts regularly.  Make sure that your baby is latched on properly and get help if you are experiencing sore nipples or sore breasts. When weaning, a diabetic mother should do so very gradually, so her body can adjust to the changing insulin requirement.  Close monitoring and medication adjustment may be required at the end of breastfeeding as it was at the beginning.

For a detailed look at Insulin resistance and lactation insufficiency by Diana Cassar-Uhl, MPH, IBCLC check out this link.

For information and breastfeeding support if you are diabetic or insulin resistant or facing any other breastfeeding challenges please contact a La Leche League Leader.

 

http://www.lllc.ca/thursdays-tip-breastfeeding-if-you-are-diabetic-or-insulin-resistant

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

 

 

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Tracking Newborn Weight Loss in Breastfed Babies

 

One of the biggest sources of stress for parents in the first days of baby’s life is wondering how much weight baby has lost compared to his/her birth weight. Most exclusively breastfed babies lose some weight and we know that this is normal. What hadn’t been clearly established was how much weight loss is normal and at what point parents and health care professions should become concerned.

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A new on-line tool for health care providers is available to help them compare the birth and current weights of an exclusively breastfed baby against the information collected from a large study cohort. This comparison will tell the parents and health care team whether the newborn has lost more weight, less weight or an average amount of weight based on how many hours old baby is. The goal of the researchers was to provide a tool that would help identify those babies who are at risk for excess weight loss so that their mothers can be prioritized for additional lactation support. Babies can be checked for problems such as tongue tie and mothers can be assisted to improve latching or encouraged to respond more quickly to early feeding cues before baby experiences any dehydration related problems such as increased effects of newborn jaundice or additional breastfeeding problems. The Newborn Weight Tool (NEWT) is available for free HERE.

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NEWT developer Dr. Ian Paul, a professor of pediatrics and public health sciences at Penn State College of Medicine and a pediatrician at Penn State Hershey Children’s Hospital stated “Although a small minority of babies do need formula, breast milk has many health benefits that have been well-documented. Hopefully by being able to know what the normal amount of weight loss is for exclusively breastfed babies, we can prevent the unnecessary use of formula.”

More information about NEWT and the research behind it is available HERE. Please share this information with anyone you know who cares for mothers and newborns.

http://www.lllc.ca/thursday-tip-tracking-newborn-weight-loss-breastfed-babies

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If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/ so we can continue to help others breastfeed. 

 

 

 

 

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Breast Engorgement

What is engorgement?  After you give birth, your body produces the early milk called colostrum which provides your baby with all the nourishment he needs plus important antibodies and other protective factors.  Sometime between the second and sixth day, your body will begin to produce mature milk.  Some women experience such fullness in the breasts that it makes their breasts feel hard and painfully full.  This is engorgement.  This fullness is due to additional blood and fluid travelling to the breasts as your body is preparing to produce milk as well as the actual volume of milk itself.  Some degree of breast engorgement is normal. Usually the fullness subsides within 12-48 hours.

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Engorgement can make the nipples flatten due to the fullness of the breast and make it difficult for the baby to latch on to the breast.  Mothers may experience pain in the breasts due to the fullness.

You can minimize the effects of engorgement by doing the following:

  • Nurse frequently, at least 8-12 times or more a day. Offer both breasts. A newborn should be nursing on each breast at least every two to three hours.  Remember to breastfeed as often as your baby indicates the need.
  • Engage in skin-to-skin contact with your baby.
  • Gentle Breast Massage – with the palm of your hand and starting from the top of your chest (just below your collar bone), gently stroke the breast downward in a circular motion, toward the nipple. This may be more effective when done while you are in the shower or while leaning over a basin of warm water and splashing water over your breasts.
  • Warm Compresses – Some mothers find that applying a warm, moist compress and expressing some milk just before feedings helps to relieve engorgement. Using heat for too long will increase swelling and inflammation, so keep it brief. Cold compresses can be used in between to reduce swelling and relieve pain.
  • Cabbage Leaf Compresses – Rinse the inner leaves of a head of green cabbage. They can be used refrigerated (best) or at room temperature. Between feedings, drape leaves directly over breasts. Change when the leaves become wilted or every two hours. Some authorities suggest twice a day for 20 minutes for a day or two.  Discontinue use if rash or other signs of allergy occur or when the swelling starts to go down.
  • Engorgement can cause the dark area around the nipple, the areola, to become hard and swollen. This can be a problem if the fullness makes it difficult for baby to latch on. A technique that can help is reverse pressure softening. Reverse Pressure Softening softens the areola to make latching and removing milk easier. It is not the same as hand expression. For complete instructions and illustrations click here.

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Contact your La Leche League Leader, International Board Certified Lactation Consultant, or health care provider immediately if:

  • Engorgement is not relieved by any of the above comfort measures.
  • You begin experiencing symptoms of mastitis: fever of greater than 100.6°F (38.1°C), red/painful/swollen breast(s), chills, “flu-like” symptoms.
  • Your baby is unable to latch on to your breast.
  • Your baby is not having enough wet and dirty diapers.

Engorgement of your breasts can seem to you like a huge complication at the time.  It’s a little bump in the road and is very time-limited to a few days.  You can take action to help yourself through this temporary hurdle and continue to enjoy breastfeeding your baby.

 

http://www.lllc.ca/faq-page

http://www.lllc.ca/hp-information-sheets

http://www.llli.org/faq/engorgement.html

https://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/06_hand_expression.pdf

http://www.lllc.ca/tuesday-tip-scoop-poop

 

If you need more information or have a breastfeeding problem or concern, you are encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

 

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The First Hour After Birth and Breastfeeding

Much of our prenatal preparation for baby’s arrival focuses on the steps and stages birth process. Birthing the baby is seen as the goal line and it is easy to get caught up and forget to think about what happens after baby is born.  The experiences of the first hour after baby arrives can have a major impact on breastfeeding.  Knowing what is normal behaviour in this time period and how to create the situation in which baby can move through these normal stages is as important as knowing the stages of labour.

Skin-to-skin contact between mother and baby during the first hour or two after birth provides the natural location, and the cues, for baby to move through the nine instinctive stages.  If mum isn’t able to hold baby skin-to-skin during this time then other family members can take on this role. If there are medical reasons why baby can’t be held skin-to-skin right after birth, then start as soon as possible. Continued skin to skin contact between mother and baby has benefits for many weeks.

 

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The nine stages happen in a specific order and they will happen on their own without any help.  The first stage is a cry.  This happens immediately after birth as baby’s lungs expand with the first breath.   Every parent waits eagerly to hear that first cry.  Right after the first cry most babies will relax.  This is when baby can be placed skin-to-skin on the mother’s chest and covered with a blanket.  Baby’s head is not covered.  Baby will be fully relaxed and won’t move.  After a few minutes baby will start to open his eyes and move his head and shoulders.  After about five minutes the movements will become stronger and there are increased sucking movements and rooting.  The baby may have a few minutes of activity and then go back to a resting state several times over the first hour.

About 35 minutes after birth the baby will start to make crawling movements with her arms and legs and she will approach the breast and nipple.  For the next half hour the baby will familiarize herself with the breast and nipple.  The hands may touch and massage the breast and baby may mouth and lick at the nipple.  Finally the baby will self-attach to the nipple and suckle.

This usually happens about an hour after birth.  If mum was given any medications during labour they may have passed to baby and then it can take more time with skin to skin contact for baby to move through the stages and be ready to suckle.

The final stage, which usually happens about 90 minute to 2 hours after birth, is when baby falls into a restful sleep.  Mum may be ready for a nap at that time too.

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It is not important to remember the stages as long as you remember to create the space in which they can happen on their own:   baby skin-to-skin on mum’s chest covered by a warm dry blanket.  Don’t try to rush the steps, they will happen naturally.  Pushing baby to latch on before he/she is ready to do so may prevent baby from getting a good latch for that first feeding.

Some additional information can be found at the following links:

The Magical Hour http://www.magicalhour.com/aboutus.html

UNICEF’s Baby Crawl video https://www.youtube.com/watch?v=0OYXd-mMSVU

LLLC’s FAQ page: Skin to Skin http://www.lllc.ca/faq-page

 

http://www.lllc.ca/thursday-tip-first-hour-after-birth-and-breastfeeding

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

 

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Establishing Your Milk Supply

 

A baby’s need for milk and his mother’s ability to produce it in just the right quantity is one of nature’s most perfect examples of the law of supply and demand.  Until the mass production of artificial formula, the survival of the human race depended on mothers’ ability to produce enough milk to nourish their babies.  Establishing and maintaining an ample milk supply can be easy, as long as you understand how it is regulated.  Knowing how to avoid things that upset the balance of supply and demand is important when establishing your milk supply.  A baby who is not gaining well should be checked by a doctor.  However, knowing the following information will enable you to improve weight gain while protecting the breastfeeding relationship.

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Milk is produced almost continuously:  the more often the baby nurses, the more milk there will be.  Frequent nursing and effective sucking signal the mother’s body to produce the amount of milk her baby needs.  These are the keys to an abundant milk supply and a contented baby.  The first milk the baby gets after birth is called colostrum.  It is rich in antibodies and other protective factors.  The small quantities give babies a chance to learn how to suckle without being overwhelmed by milk.  Production of colostrum starts during pregnancy and continues even after the mature milk comes in.

The delivery of the placenta tells the body to start producing milk.  This happens whether a mother is breastfeeding or not.  By day 3-5, mother’s milk comes in and volume increases. Frequent nursing and regular removal of the milk stimulates the breast to produce more milk. Milk changes through a feeding and throughout the day to meet a baby’s changing needs. Foremilk, at the beginning of a feeding session, contains less fat and more water.  Hindmilk, later in the feeding, contains more fat and is higher in calories.  Babies need both foremilk and hindmilk to provide total nutrition

Breastfeeding early and often is one of the most important factors in getting breastfeeding off to a good start.  Babies who are allowed to breastfeed within an hour of birth and then at frequent, unrestricted intervals, help mother establish a good milk supply sooner than those who are put on a strict feeding schedule.  Newborns usually nurse about every two hours, or at least 8-12 times per day; some may nurse even more frequently.  Feeds may not be spaced evenly throughout the day.  Some babies cluster several feeds together and then sleep for a longer stretch.

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Holding the baby skin to skin on your chest calms and soothes him after the journey of birth; it can help baby to regulate temperature and heart rate.  Skin contact also heightens the hormones that naturally produce milk.  Many babies can latch more easily when they are gently welcomed to the mother’s breasts.  In fact, many babies who are held upright between the mother’s breasts respond by squirming and bobbing until they position themselves at the breast and latch on.

Allow the baby to nurse as long as he seems interested, right from the start.  It may take the milk a few minutes to let down, or start to flow, so limiting breastfeeding to a short time frame may mean the baby won’t get sufficient milk.  A baby needs to nurse long enough to get the milk flowing and also to receive hindmilk.

Offer both breasts at each feeding, especially in the early days.  A newborn should be nursing on each breast at least every two to three hours (except for, perhaps, one longer stretch at night) in the weeks when the milk supply is becoming established.  Let the baby stay on the first breast as long as he is actively sucking and swallowing to ensure he gets hindmilk.  When the sucking slows down, it will be easy for you to release the latch, or your baby may come off by himself.

Offer the second breast.  If baby is still hungry he will latch on and suckle, showing signs of active swallowing with deeper jaw motions; if not, that is alright.  At the next feeding offer this breast first.  Offer both breasts at each feed, but let baby decide if he wants the second side.

Be sure the baby is latched and sucking effectively.  Positioning the baby correctly and ensuring a good latch (attachment to the breast) prevents sore nipples and allows baby to get plenty of milk.  The baby should have a large mouthful of breast tissue; babies breastfeed, not nipple feed.  Sore nipples may be a sign of poor latch; consult a health professional or La Leche League Leader for help.  Newborn babies often become sleepy after a few minutes of sucking. Your baby will feed more effectively when stimulated with some tickles or movement closer into the breast.

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Breastfeed as often as your baby indicates the need; this is called cue feeding.  Some cues include licking lips, restlessness, rooting (turning head towards breast) or mouthing hands. Crying is a late hunger cue.  Nature intended for babies to feed frequently.  Your baby is used to being fed continuously while in the womb.  Some newborns take time to learn their own signs of hungry and full.  They might suckle for several minutes, then come off, but start fussing or rooting if you try to put them down.  Many factors, such as birth experience, maturity, human contact, and access to the breast can affect the baby’s learning.  Respond to his cues and he will learn to trust that his needs will be met; and you will begin to recognize patterns to your breastfeeding sessions.  It gets easier as you get to know each other.  If your baby regularly sleeps more than three hours between feedings and is not gaining well, he may need to be awakened for feedings at least every two hours during the day until your milk supply is well established.

The law of supply and demand also works in reverse: the less often the baby nurses, the less milk there will be.  This might happen if you try to schedule feeds 3-4 hours apart, or if supplemental feedings with formula or water are introduced.  Pacifiers, which satisfy the baby’s need to suck, can also interfere with milk supply.  However, older babies (2-3 months old) do sometimes space their feedings further apart and/or reduce the time they spend at the breast, but still gain well.  This means that they can get the milk they need faster, and mother’s supply is matching baby’s demand.

How do I know my baby is getting enough to eat?  If the baby has six very wet diapers (more if you use cloth) and three to five bowel movements, each the size of a $2 coin, per day (after 3 or 4 days old) and is not being given anything but your milk, you can see he is getting plenty of nourishment.  An older baby may have bowel movements less frequently, but they should be plentiful.  The baby will also start gaining 115-200 grams (4-7 ounces) per week.

Growth spurts or frequency days occur 3-4 times in the first 3 months as the baby matures. Allowing him to nurse on cue, which may seem like all the time, for two or three days will increase your milk supply to meet his needs.  Trust that your milk supply can adjust and increase as your baby grows.

Newborns nurse for many reasons other than hunger.  Your baby may breastfeed often because he likes the feeling of security and close body contact, because he needs to satisfy his sucking need, or because he finds the sound of your heartbeat and the gentleness of your touch a great source of comfort as he adjusts to his new world.  Meeting these needs will not spoil your baby; it will teach him that there are people he can trust to keep him happy, safe and comfortable.

La Leche League group meeting

La Leche League group meeting

 

Mothers need the support of other mothers.  La Leche League meetings can be one place to find this support; Leaders are here to help you enjoy your breastfeeding experience.  With the support of your health care provider to help you see that your baby is growing well, and the practical and moral support mothers find from other mothers, you can ensure your baby thrives on the milk your body provides.  Find out more at lllc.ca

Quick Tips

  • Breastfeed early (within an hour of birth) and often(8-12 times / 24 hours).
  • Skin-to-skin contact between mother and baby enhances milk supply.
  • Ensure baby has a good latch. (Get help if needed, especially if nipples are sore.)
  • Offer both breasts at every feeding in the early days.
  • Ensure baby is actively sucking and transferring milk while at the breast.
  • Supply and Demand—the more the baby nurses, the more milk you will produce.
  • What comes out must have gone in: 5-6 wet diapers and at least 3 bowel movements the size of a $2 coin per day.
  • Babies breastfeed for comfort as well as food.
  • A supportive network of other mothers can help smooth out the bumps in the road.

http://www.lllc.ca/hp-information-sheets

 

If you need more information or have a breastfeeding problem or concern, you are encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

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Moving Forward After a Difficult Birth

 

If you feel that what happened during birth is getting in the way of your relationship with your baby, you’re not alone. Most mammal mothers have difficulties if they didn’t feel labor or birth, or if the experience was unusually traumatic, or if the baby is taken away from them. Many human babies won’t latch after a difficult birth and some mothers aren’t sure they even want them to. This makes a lot of sense biologically—the birth didn’t happen the way it “should” have, so neither of you received the sequence of motions and hormones that helps bonding happen immediately. You and your baby need to connect in a fundamental way. Here are some ideas to speed the process:

  • It can help to keep your baby with you 24/7, even if you don’t feel like you want to be with him yet. The familiarity that develops with being together will help your bodies to recognize each other on a primal level. He’ll grow on you. Bit by bit, you’ll find more about him to adore.
  • Spend as much of this time as possible with your baby’s bare skin against your bare skin. Smell him, feel him, caress him, savour him.
  • You could take a warm bath together by candlelight, just the two of you and no one else. Stroke and massage him as you enjoy the soothing water. Admire his wonderful skin, nuzzle him, kiss his toes. Let him nurse while you soak if he can and wants to.
  • Try holding your baby and watching his face while friends or family give you a relaxing massage—foot, scalp, shoulder, back—anywhere that feels good. Give yourself over to the sensation and open yourself up to the enjoyment. This releases oxytocin, the bonding hormone.
  • Make some decisions about him—what he’ll wear, how to hold him, how to comfort him. Taking responsibility for him helps you feel more nurturing toward him.
  • If your baby won’t latch, understand that it’s just temporary, and try to be patient rather than panicked or frustrated. Most babies will get there in time.

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Owning Your Birth

If absolutely everything you didn’t want happens to you, or even if your birth just isn’t what you hoped, this was still your story and nobody else’s. It’s a story that you will probably want to tell in detail someday to a caring friend or maybe even to your child. At some point—even years later—it can help to write it down. The good parts and the bad parts, what you saw and did, and how you felt. Your story will become precious to you for exactly what it is – the beginning of your life with your child.

There really is life after birth, and it really will be wonderful (most days). No matter how the birth goes, most mothers and babies can go on to breastfeed. In The Womanly Art of Breastfeeding, we’ll show you the basics of keeping your milk supply high, your baby well-fed, and your breast a happy place while you and your baby recover from any birth issues and learn to breastfeed. There are good days ahead.

WABExcerpt from The Womanly Art of Breastfeeding by Diane Wiessinger, Diana West, and Teresa Pitman

 

 

via http://www.llli.org/docs/0000000001_NB_PDF/nb_issue3_10_finl_txt.pdf

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

Newborn2

 

 

 

 

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Preparing to Breastfeed

Some women wonder what they need to do during pregnancy to prepare for breastfeeding. Actually, your body knows what to do.  Lactation (milk production) naturally follows pregnancy. The hormones produced during pregnancy prepare your breasts to make milk once your baby is born. The best preparation, and what most women need in order to breastfeed effectively, is accurate information and someone to provide support and encouragement.

During Pregnancy

At one time a great deal of emphasis was placed on preparing your nipples during pregnancy. However, it is now recognized that correct positioning and latch-on of the baby in the early days is the best prevention for nipple soreness.  So what should you expect before the baby is born?

  • Your breasts will likely get bigger.
  • Your breasts may feel tender.
  • Nipples may become sensitive to touch.
  • You may notice drops of colostrum (the first milk) leaking from your breasts.
  • Avoid soap, alcohol and antiseptics on your breasts.  Use plain water when you bathe.

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Choosing a Nursing Bra

You will probably find a supportive nursing bra helpful for comfort, at least in the early weeks. There are many different makes and styles, but some general considerations are:

  • Non-binding support.  There should be no pressure points; underwires should not dig in; and soft-sided bras should provide adequate support.
  • Easy access to the breast.  Ideally, with practice, you should be able to unhook and refasten the flap with one hand.
  • Room for expansion.  Your breasts may go up a full cup size when your milk comes in.
  • Breathable fabrics are best while breastfeeding.
  • Consider buying only 1 or 2 bras during the final weeks of pregnancy and waiting until a couple of weeks postpartum to add more to your wardrobe (a gift certificate for a new bra makes a great shower gift).   Many mothers-to-be like to know that their breast size will settle into a moderately larger size after about three months.

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Concerns About Nipple Size or Shape

In order for the baby to suck effectively, he needs to draw your nipple far back into his mouth. Babies can breastfeed effectively with a large variety of nipple shapes.  The nipple is only a part of the breast called the nipple-areola complex.  The softness and stretchiness of the tissue just behind the nipple is actually more important than the nipple shape.  If a mother has nipples that don’t protrude, she may need to work with her baby to get a good latch. But problems are unlikely if the areola can be properly grasped by the baby’s mouth.

To understand how the baby will grasp the breast, place a thumb and forefinger on the areola above and below the nipple and gently press together.  Give a light tug outward.  If your nipple protrudes a little more, this is the most common formation.  If it appears there is barely any movement inward or outward from the base of the nipple, it is called a flat nipple.  Inverted appearing nipples seem to be sunken into the breast, but, when stimulated, become erect and easily graspable.  Some nipples can be inverted at rest and also retract more when grasped at the base.  A true inverted nipple shrinks back into the breast when the areola is squeezed.

There is debate about whether pregnant women should be screened for flat or inverted nipples and whether treatments to draw out the nipple should be routinely recommended.  Some experts believe that a baby who is latched on well can draw an inverted nipple far enough back into his mouth to nurse effectively.  Although opinions and experiences vary, many women have found treatments for flat or inverted nipples to be helpful, and many breastfeeding experts continue to recommend them.  Each mother is unique, so approaches may differ depending on the degree of inversion and denseness of areola tissue behind the nipple base.  And some mothers find they don’t need to do any physical preparation at all before the baby is born.

There are several techniques that have been used by mothers with flat or inverted nipples to evert the nipple during pregnancy or in the early days after birth.  One such method for encouraging the flat or inverted nipple to be more outgoing is to stretch out the nipple and loosen any tightness at the base.  You can do this by placing a thumb on each side of the nipple, directly at the base, not at the edge of the areola.  Press in firmly against the breast tissue and at the same time pull the thumbs away from each other.  Repeat this stretch five times, moving your thumbs around the base of the nipple.  Repeat this exercise twice a day, working up to five times a day.

Being prepared to work at getting a good latch can be the most effective way to avoid difficulties; some mothers are pleasantly surprised how easily their baby latches with just attention to normal good positioning at the breast.  If you have concerns about your nipples or breasts, talk to a health professional or lactation consultant during pregnancy.

BFnewBaby

 

The Early Days and Beyond

Skin to skin contact in the early days makes learning to breastfeed much easier, so no special clothes are needed!  When it’s time to get dressed, there are lots of options.  Two-piece outfits—skirts, jeans or shorts, with a loose top or sweater—are ideal for discreet breastfeeding.  With your top, blouse or sweater lifted from the waist for nursing, the baby covers any bare skin.  When wearing a blouse that buttons down the front, you can unbutton from the bottom up.  There are specialty breastfeeding clothes available; some mothers like them for everyday wear, while others only use them for special occasions.

La Leche League Canada Can Help

Talking with other mothers who have learned to breastfeed is time well spent.  La Leche League information and support can help a mother as she learns how to breastfeed her baby.  Having correct information—even before her baby is born—can help a mother avoid many of the common challenges.  If questions arise, being able to call a La Leche League Leader is often the key to continued success.  Attending La Leche League meetings during pregnancy can be the very best way to prepare for breastfeeding your baby. Find out more at www.LLLC.ca.

http://www.lllc.ca/hp-information-sheets

 

If you need more information or have a breastfeeding problem or concern, you are encouraged to talk directly to a La Leche League Leader.  In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/

 

 

 

 

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