Breastfeeding education

Benefits for baby

• Breastfed infants tend to be healthier than non-breastfed babies. Babies breastfed for one year are half as likely to have any illness and are less likely to be hospitalized for any bacterial infection. They can be four times less likely to have diarrheal diseases. They have a decreased risk for ear infections and a decrease in risk for lower respiratory infections.
• Breastfed infants are at a reduced risk for developing insulin-dependent diabetes.
• There are fewer incidences of childhood cancers with breastfed babies.
• Breastmilk provides your baby with all the nutrients needed in the right amounts. It is easy to digest and gentle on your baby’s stomach.
• Breastfed babies rarely are constipated.
• Breastfed infants and children have a significantly reduced rate of food allergies. They often are protected from asthma and allergies because of immunologic properties of breastmilk.
• Breastfeeding has been shown to contribute to lower incidence of SIDS (sudden infant death syndrome).

Benefits for mom

• Breastfeeding helps to quickly reduce the uterus to its normal size and helps to prevent excessive bleeding following birth.
• Breastfeeding contributes to lower incidence of uterine, ovarian and breast cancer.
• Breastfeeding relaxes mom. The hormone that produces milk has a relaxing effect on mom while the infant is at her breast, and the baby loves the closeness.
• Breastfeeding decreases blood pressure.
• Breastfeeding will increase the effect of pain medication.
• Breastfeeding will help mom lose the weight she gained during pregnancy. It burns about 400 calories each day.

Benefits for the entire family

• Breastmilk is always ready. There is nothing to buy, carry, heat or measure.
• Nighttime feedings are easier when you breastfeed. You do not have to sterilize bottles, warm formula, etc.
• Because breastfed babies generally are sick less often, working parents may miss fewer days on the job because of infant illness.
• Breastfed babies smell good. Their stools do not smell bad, and they do not spit up often. When they do spit up, it does not have a strong smell and will not stain clothes.
• Breastfeeding is free.
• Breastfeeding is environmentally friendly.

Your nipples may feel sensitive or tender as you get started, but breastfeeding should not be painful. Your breasts start making milk (colostrum) while you are pregnant, so you have just the right amount for your newborn baby—and that is amazing.

Breastfeeding Mothers
While nipple tenderness is normal, breastfeeding should be comfortable (not painful) for you. Call your lactation consultant if pain is present.

• Clean breasts by letting water run over them in the shower. Do not use soap or lotion on breasts.
• Hydrogel pads and Lansinoh cream may be used on sore nipples.
• Allow breasts to be exposed to the air whenever possible.
• Use specially designed breast pads or a large handkerchief in your bra to prevent leakage through to your clothes.

Engorgement
Frequent feeding is the best way to avoid engorgement. An engorged breast will tighten the nipple, making it difficult for your baby to get enough of the nipple in the mouth. If the nipple is very tight, expressing milk for a few minutes before breastfeeding will soften your nipple.

Apply warm compresses to the breast before the feeding will soften the nipple. Cold packs after and in-between feedings may be necessary.

Babies normally will lose weight the first few days after birth and are usually back to their birth weight within two weeks. Your baby has a small stomach at first, and you will feed at least eight to 12 times every 24 hours for the first few weeks.

Keeping track of how often baby eats and the amount of wet and dirty diapers will help you know if he is getting enough to eat.

We encourage you to wait to introduce bottles and pacifiers until breastfeeding is well established. We recommend approximately one month.

Frequency of Feeding When Establishing Milk Supply
Your milk supply is based on supply and demand. When you feed (or hand express or use a breast pump) regularly, your body will continue to produce breast milk. If you do not feed (or hand express or use a breast pump) regularly, then your body will not continue to produce the amount of milk your baby needs. For help in hand expressing, watch an informational video at newborns.stanford.edu/Breastfeeding/HandExpression.html.

Feed your infant based on the information your pediatrician and nurses give you. It’s an amazing thing that your body produces the amount of milk your infant needs—and that milk is constantly changing to meet the needs of your baby.

Formula Supplementation
In some cases, it is medically necessary to supplement (give your infant milk substitute instead of breast milk). Your pediatrician and nurses will discuss this situation with you if applicable. However, in many circumstances, your baby will not need anything other than your breast milk. Our goal is to educate you on breastfeeding and its benefits as well as the risk of using a supplement so that you can make an educated decision for you and your family.

Mothers sometimes worry because their babies want to breastfeed more than they expected at first and wonder if their baby is getting enough milk. Early, frequent feeding helps your body establish your milk supply. Most mothers make plenty of milk for their infant without the need to supplement with formula. If breastfeeding, mothers should do so exclusively for the first six months because breast milk is all that infants need during that time. In fact, supplementing with unnecessary formula or foods can cause issues such as …

• An interference with mom’s milk supply, meaning she may not make enough milk for her baby if she supplements with formula or food.
• Early on, the mother’s breast may become uncomfortably engorged (see below).
• An increased risk for your baby to develop allergies, diabetes, or obesity.
• Even one feeding with artificial milk can cause problems

Hand expression is a useful skill when you need to empty your breasts (such as when you are separated from your baby or your baby is temporarily unable to breastfeed). In the first few days after birth, hand expression can be more effective at removing colostrum than using a breast pump. If your baby needs a supplement in the first few days, use hand expression to provide the milk he or she needs.

The hand expression routine is simple but takes practice and patience.

• Wash your hands. Relax and think about your baby.
• Use warm, wet washcloths on your breasts. Then, gently massage each breast in a circular motion using the flat part of your fingers.
• Make a “C” or a “U” with your fingers about an inch back from the edge of the areola (dark part of the breast). Press your hand inward toward your chest, not out toward the nipple. Compress the breast (not the nipple) with the soft pads of your thumb and fingers. Continue to press backward and avoid sliding your fingers down toward the nipple.
• Relax the pressure and start over again.

Change the position of your thumb and fingers on your breast. Rotate your hand position. This step will help stimulate milk from many of the ducts in your breast. After 10-20 compressions on the first breast, switch to the other breast. Continue switching back and forth between breasts until the flow of milk slows.

For additional help, watch Dr. Jane Morton’s video.

While in the hospital, you might hear your nurse or lactation consultant talk about a latch score. This score is a way your caregivers can assess how well the baby is breastfeeding.

Latch-on is the actual attachment of the baby’s lips and mouth to the mother’s breast. A correct latch-on ensures that the baby is getting enough milk and prevents excessive nipple soreness.

Signs of a successful latch-on:

• There is tugging, maybe some tenderness, but no sensation of pain.
• After the first few seconds, the baby does not easily fall away from your breast.
• No clicking sounds are heard as the baby suckles.
• A minimum of 1-1 ½ inches of areola is within the infant’s mouth.
• The infant’s tongue is positioned between the lower gum and your breast.
• The baby’s lips are widely flanged around the breast, creating a seal.
• While suckling, the infant’s cheeks are full and rounded (not dimpled).
• Movement is observed at the back of the jaw and above the infant’s ear. The earlobes may wiggle.
• Swallowing is heard. During the colostrum stage of milk, swallowing may be heard at least every few suckles. After milk volume increases (in 3-5 days), the infant should be swallowing as often as every 1-2 suckles.
• When removing your baby from the breast, insert your finger between the baby’s gums and your breast to break the seal. Removing your baby without breaking the seal may irritate the nipples.

Cradle: The mother’s back is supported; her shoulders are level. Her forearm supports the baby’s back; her open hand supports the baby’s bottom. The hand opposite the nursing breast supports the breast so that the mother can observe latch-on. The baby’s chest/abdomen directly faces the mom. If helpful, the mother can use a pillow in her lap to bring the baby to breast level.

Cross Cradle: The infant is in the same position as the cradle hold, but the mother uses the opposite arm to hold and support the baby at the breast. The mother uses the hand of the same side being nursed to support the breast. (This position is good for low birth-weight babies.)

Side Lying: The mother is lying on her side and places the baby on his or her side facing the breast. If needed, the mother may use her lower arm or a rolled blanket to keep the baby positioned at her lower breast.

Football: The infant is tucked under the arm of the breast being used with the feet toward the mother’s back. Use a pillow behind the mother’s back to leave room for the baby’s feet. Place a pillow under the baby at the mother’s side to bring the baby to breast level.