Nursing Positions

February 11, 2011

Getting Comfortable
If you’re a first-time parent, breastfeeding your newborn may seem complicated until you’ve had some practice. But a little preparation can help you feel more comfortable.

Before you begin nursing, take a look at your surroundings. Many mothers like to sit in a glider or in a cozy chair with armrests. Footstools and pillows can provide extra support (try donut-type nursing pillows or “husband” back pillows with arms on each side for nursing in bed).

It’s also important to find a comfortable nursing position (or hold) for both you and your baby. Here are some common ones to consider.

Weaning Your Child

January 17, 2011

Weaning is when a baby transitions from breast milk to other sources of nourishment. When to wean is a personal decision. Moms may be influenced by a return to work, her health or the baby’s, or simply a feeling that the time is right.

Weaning a baby is a gradual process that calls for patience and understanding from both you and your child. MORE>>

Is it normal for my baby to spit up after feedings?

December 6, 2010

Sometimes, babies spit up when they:

•have eaten too much
•burp (the notorious “wet burp”)
•drool

Many infants will spit up a little after some — or even all — feedings or during burping because their digestive tracts are immature. That’s perfectly normal.

As long as your baby is growing and gaining weight and doesn’t seem uncomfortable with the spitting up, it’s OK. The amount of spit up often looks more than it actually is. But spitting up isn’t the same as vomiting all or most of a feeding.

If you’re concerned your baby is forcefully vomiting, or much of a feeding is coming up more than once a day, call your doctor. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical attention.

It also may help your doctor to properly diagnose the problem (if there is one) if you keep a record of exactly how often and how much your baby seems to be spitting up, then call your doctor. He or she should be able to tell you if it’s normal or something that’s cause for concern.

But again, it’s important to remember that spitting up is usually perfectly OK. If the doctor says your baby’s spitting up is normal, here are some things you can do to help alleviate it:

Burp your little one every 3 to 5 minutes during breast feedings, or after every 1 to 2 ounces during bottle feeds. Sometimes giving smaller, more frequent feeds can help rather than large volume feeds.Keep your baby upright after feedings — holding the baby is best, since the position of the baby in a car seat may actually make spitting up more common.

Don’t jiggle, bounce, or actively play with your baby right after feedings.

Keep your baby’s head above his or her feet while feeding (in other words, don’t hold your baby in a dipped-down position when feeding).Raise the head of your baby’s crib or bassinet. Roll up a few small hand towels or receiving blankets (or you can buy special “blocks”) to place under (not on top of) the mattress. But don’t use a pillow under your baby’s head. Make sure the mattress doesn’t fold in the middle, and that the incline is gentle enough so the baby doesn’t slide down.

If your baby also gets bottles of breast milk or infant formula supplements:

Don’t give the bottle while your little one is lying down.Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples may cause babies to gag or may simply give them more than they can handle, whereas slower flows may be frustrating to some babies and may cause them to suck more vigorously and gulp too much air.It’s also important to keep in mind that this, too, shall pass. Many babies outgrow spitting up by the time they’re sitting up. READ MORE>

FAQs About Safely Storing Milk

November 9, 2010

Entry taken from BrowardHealth.org/KidsHealth

Whether you’re a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common inquiries that mothers — new and veteran — may have.

How do I store my breast milk?
You can freeze and/or refrigerate your pumped (or expressed) breast milk. It’s important, though, to store it in clean and sterile bottles with screw caps, hard plastic cups that have tight caps, or nursing bags (pre-sterilized bags meant for breast milk). Also make sure to put a label on each indicating when the milk was pumped. You should not add fresh milk to milk that is already frozen.

How long, exactly, can I store my breast milk?
For healthy full-term infants:

•You can store it at room temperature:
◦for 4 to 8 hours (at no warmer than 77° Fahrenheit, or 25° Celsius)
•You can store it in the refrigerator:
◦for up to 2 to 3 days at 32°-39° Fahrenheit (0°-3.9° Celsius)
•You can store it in the freezer (be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes):
◦for up to 2 weeks in a freezer compartment located inside the refrigerator
◦for 3 to 4 months in a freezer that’s self-contained and connected on top of or on the side of the refrigerator and is kept at 0° Fahrenheit (-18° Celsius). But be sure to store the milk in the back of the freezer, not in the door)
◦for 6 to 12 months in a deep freezer that’s always 4° Fahrenheit (-20° Celsius)

If you thaw frozen milk, you can refrigerate it and use it within 24 hours, but do not refreeze it. And don’t save milk from a bottle that your baby already drank out of.

It’s also important to note that different resources provide different variations on the amount of time you can store breast milk at room temperature, in the refrigerator, and in the freezer. Talk to your doctor if you have any concerns or questions.

How much of my milk should I store in the freezer?
Although some women may choose to pump large volumes to be frozen, it’s a good idea to actually store the breast milk in small portions so as not to waste any. Label the bottles, cups, or bags 2 oz. or 4 oz. (59.1 or 118.2 milliliters), then freeze them.
You could also pour the milk into ice cube trays that have been thoroughly cleaned in hot water, let them freeze until hard, store them in freezer bags, then count up the amount of cubes needed to make a full bottle.

My frozen breast milk changed color. Is this OK?
Breast milk that’s been frozen or refrigerated may look a little different from fresh breast milk, but that doesn’t mean it’s gone bad. It’s normal for breast milk to look slightly blue, yellow, or brown when refrigerated or frozen. And it may separate into a creamy looking layer and a lighter, more milk-like layer.

How do I clean bottles and pump parts?
You’ll need to boil the nipples, bottles, and washable breast pump supplies (i.e., the breast shields and any other part that touches your breasts or your milk) for 5 to 10 minutes. Check the manufacturer’s recommendations for the length of time to boil the parts. (You also can sterilize them with a store-bought countertop or microwaveable sterilizer, but boiling works just as well and costs nothing.) Then you’ll need to wash the bottle and pump supplies in hot, soapy water (or run them through the dishwasher) after every use after that. Bottles and nipples can transmit bacteria if they aren’t cleaned properly.

Is it safe to microwave my baby’s bottles?
The microwave can create dangerous “hot spots” in bottles of formula or breast milk, so you should never microwave them. Instead, you can run the bottle or freezer bag under warm water for a little bit, swirl the bag or bottle around in a bowl of warm water, or thaw the milk in the refrigerator. You can also put your baby’s bottles in a pan of warm water (away from the heat of the stove) and then test the temperature by squirting a drop or two on the inside or your wrist before feeding your baby. You also can get bottle warmers for use at home or in the car. READ MORE>>

Where should my breastfed baby sleep?

October 25, 2010

Entry taken from BrowardHealth.org/KidsHealth

Although some mothers may want to keep their babies in bed with them to make breastfeeding more convenient at night, cosleeping with babies can be hazardous.

But you can still choose to keep your baby close and make nighttime feedings easier by letting your baby sleep in a crib, bassinet, or play yard in your room — right next to your bed, even — for the first few months.

You also can invest in a device that looks like a bassinet or play yard missing one side that attaches to your bed, allowing you to be next to each other while eliminating the possibility of rolling over onto your infant.

To make nursing in bed more comfortable, it may help to keep a donut-type nursing pillow on or near your bed or to use a “husband” back pillow with arms on each side.

Keep the room dimly lit for nighttime feedings and also keep stimulation (talking, singing, etc.) to a minimum. This will help your baby to realize that nighttime is for sleeping — not playing — and will encourage your little one to return to sleep sooner.

A word of caution, though: You should never let your baby sleep on a soft surface or in the same room with people who are smoking because of the higher risk of sudden infant death syndrome (SIDS). Babies should always be put on their backs to sleep to help reduce the risk of SIDS.

READ MORE>

Why is my co-worker still pumping breast milk for her baby?

September 20, 2010

Every once in a while, lactation consultants will hear (or overhear), the complaint, “Why is my co-worker (we’ll call her Suzy Q) still pumping milk for her baby?” It may seem like she is forever taking pumping breaks and storing an extra “lunch box” in the refrigerator at work! Here are a group of facts that will help you support your co-worker during the next few months.

-Suzy Q is providing the best-known nutrition to her baby with many long-lasting health benefits for her and her baby.

-Suzy Q needs to pump every three to four hours for about 15-20 minutes each session. If she skips a session, her breasts will become uncomfortably full (she might get a little testy) and more importantly, it will cause her supply of milk to decrease.

-Because Suzy Q’s baby will be healthier, she will have less absenteeism and make your job easier than if she were formula feeding her baby. In addition, Suzy Q’s productivity will be higher.

-If all new moms were as smart as Suzy Q, it is estimated that total healthcare expenditures would decrease by $13 billion countrywide. That would be a saving out of all of our pockets and a happier, healthier USA!

Tell Suzy Q (and all new moms) “Keep on pumping…”

How do I know if my baby is getting enough milk?

August 27, 2010

The most frequent question asked by new mothers is, “How do I know my baby is getting enough milk?” Breastmilk isn’t seen or measured as it passes from the mother’s breast to the baby’s stomach. New mothers may worry if the baby is getting anything at all! If this question is not answered, a mother’s concern can lead to unnecessary supplementation which, in turn can actually lead to a decrease in milk supply.

The easiest answer to this question is the old saying, “What goes in must come out!” If your baby is voiding and stooling appropriately, then he’s getting enough milk. The next question is, “How many wet and dirty diapers are enough?”

The answer to that changes with time: one wet diaper and one dirty diaper in the first twenty four hours are considered adequate. By day six, the baby should have 5-6 wet diapers and 4 yellow stools in twenty four hours.

Another sign that the baby is getting enough milk is the change in the color of the baby’s stools. The first two days after birth, the baby’s stools are usually black. (This is the meconium that was in the baby’s intestines before birth. By day three, the stool should turn green and then yellow by day four or five. Too few stools or stools that are still black or brown by day five, may mean that the baby is not getting enough milk. In that case, a concerned mother should consult with her pediatrician/lactation consultant. Baby may not be feeding frequently enough, may not be latched on properly to the breast or there may be another issue.

How can I be sure that I’ll make lots of milk for my baby?

August 9, 2010

Every mother is concerned that her baby has plenty of milk to eat. Breastfeeding mothers who can’t see how many ounces their baby is taking from the breast are often worried about how much milk they are making. There are a few simple steps that new mothers can take to get their milk supply off to a good start.

The first step is to have your baby put skin-to-skin with you right after birth. Whether or not the baby actually “latches on”, the positive flow of maternal hormones will boost your milk supply. Most babies do latch on by themselves, if given enough skin to skin time with their mothers (up to about an hour). This makes later feedings easier for both baby and mother.

Milk making works best when this first introduction is followed by frequent feedings and lots of skin-to-skin time. Newborns are meant to feed often (eight to twelve times in 24 hours) and to be in close proximity to their mothers. This frequent feeding in the early postpartum days brings in a milk supply geared to the individual baby’s needs. Mothers soon learn to recognize their babies’ hunger cues and don’t have to depend on the clock to know when to feed their babies. When babies are not fed frequently in the beginning, it is harder to build the milk supply up later.

A concentrated period of mother and newborn “nesting” and spending time building the breastfeeding relationship, usually pays off in a good milk supply. By about two to three weeks, babies begin to go on “auto pilot” and even frequent breastfeeding becomes very easy. For those mothers who are not able to breastfeed right away, early and frequent use of a hospital grade electric breastpump is the best thing to bring in a full milk supply.

Next week, we’ll talk about how to know if your baby is getting enough.

World Breastfeeding Week 2010

July 30, 2010

As we approach World Breastfeeding Week 2010, thoughts fly through my head about both the progress that’s been made in promoting and supporting breastfeeding and about how much more there is to accomplish.

Most mothers and mothers-to-be have gotten the message that breastfeeding is beneficial for their babies. What hasn’t been communicated as well is just how “good” for babies breastfeeding really is and how long lasting an effect on health it provides.

A recent study from the Netherlands shows that at least four months of exclusive breastfeeding reduces the risk of respiratory and gastrointestinal infections for babies by 45%. Six months of exclusive breastfeeding lowered the infection rates even more by 65%. The key word here is “exclusive”. Babies who were breastfed but supplemented with formula lost much of the protective effect. Yet how often are new mothers seduced by formula company advertising and “free” samples?

Then there is Mrs. Obama’s recent speech to the NAACP on childhood obesity “…one thing we can think about, is working to make sure that our kids get a healthy start from the beginning, by promoting breastfeeding in our communities.”

As we celebrate World Breastfeeding Week now in 2010, let’s all do what we can in our own communities and workplaces to encourage breastfeeding and give those babies a healthy start in life. We’ve come a long way in providing support and raising our breastfeeding rates in this country, but we still have a way to go.

What Do I Do if my Baby Bites?

July 14, 2010

Just because your baby has gotten his first tooth doesn’t mean he’ll bite when nursing. Many babies never try to bite and, of those that do, most are so surprised by their mother’s reaction that they never do it again.

When a baby is positioned well on the breast, the nipple is far back in his mouth and his tongue is between his lower teeth and the breast. While he is actively nursing, he is really unable to bite.

Biting most often occurs at the end of the feeding when the milk flow is slower and the baby is not really hungry. Also, a baby’s teeth often start to “come in” at about the same time as babies become more aware of the world around them and start to distract easily from breastfeeding. Their distraction may make them less interested in nursing vigorously and more prone to bite if their gums are sore.

If your baby bites, try to remain calm and quickly take the baby off the breast. If he seems to still be hungry, put him to the breast again after a couple of minutes. If he is distracted or not really interested in feeding and bites again, that is a signal that its time to end that feeding.


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