Natural Breastfeeding Blog

Does baby get anything before milk comes in?

2009-05-20T00:12:00.001-07:00

Question:
Is my baby getting anything before my milk comes in?

Answer:
Yes, your breasts supply colostrum, a very concentrated milk full of antibodies. This colostrum acts as a laxative, helping clear meconium (black tarry stool) and bilirubin (which may make baby jaundiced or yellow) from your baby.

Breastfeeding Images

2009-05-20T00:01:00.000-07:00

Does breastfeeding hurt?

2009-05-16T20:59:00.000-07:00

Question:
Does breastfeeding hurt?

Answer
Although some tenderness during the first few days of breastfeeding is relatively common, this should be a temporary situation which lasts only a few days and should never be so bad that the mother dreads nursing. Any pain that is more than mild is abnormal and is almost always due to the baby latching on poorly. Any nipple pain that is not getting better by day 3 or 4 or lasts beyond 5 or 6 days should not be ignored. A new onset of pain when things have been going well for a while may be due to a yeast infection of the nipples. Limiting feeding time does not prevent soreness.

Why Is Breast Feeding Important?

2009-05-16T00:05:00.001-07:00

Question:
Why Is Breast Feeding Important?

Anwer:
At birth, babies are immune to everything their mothers are, but they have no functional immune system of their own until at 6 weeks the faint stirrings begin. By the time babies are six months old, they will have functional, but still immature, immune systems to help keep them healthy and allergy free. Breastmilk gives babies all the immunities they need until they can make their own.

Video General Information on Breastfeeding

2009-05-15T23:55:00.000-07:00

Over 70% of American Mom's Give Nursing a Try:

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BreastFeeding Links

2009-05-15T23:50:00.000-07:00

Links to other sites on breastfeeding:

1. http://www.womenshealth.gov/breastfeeding/

2. http://www.nlm.nih.gov/medlineplus/breastfeeding.html

3. http://www.aap.org/healthtopics/breastfeeding.cfm

Supplemental Formula

2009-05-15T23:41:00.001-07:00

Question:

Should I Give My Infant suplimental Formula?

Answer:

1. Don't offer your baby any bottles of formula before he or she is 3 to 4 weeks old (Reason: it will interfere with establishing a good milk supply), unless directed by your doctor.

2. Exception: Medical indications to prevent dehydration or severe jaundice include the following: The milk is not in (day 2-4) and your baby is very hungry (especially preterms), inadequate number of wet or soiled diapers or the baby is quite jaundiced (reason: prevent dehydration). Method: give 1 oz. of formula after every breastfeeding for 1 or 2 days. Also see your doctor within 24 hours for a weight check.

3. After your baby is 3 to 4 weeks old and nursing is well established, give a bottle of pumped breast milk or 1 oz. of formula once daily (Reason: so your baby will accept bottle feedings if you need to leave the baby with a sitter or return to work outside the home—the "educational bottle"). If you wait until 6 weeks of age, your baby may be unwilling to try the bottle.

Length of feedings to bring in the milk supply

2009-05-15T23:37:00.000-07:00

Question:
What are the Length of feedings to bring in the milk supply?

Answer:
1. Offer both breasts with each feeding
2. Allow 10 minutes on the first breast and up to 15 minutes on second breast, if your baby is actively suckling
3. Alternate which breast you start on
4. Needing to stimulate your baby to take the second breast is normal

Signs of Adequate Milk Supply: (i.e. your baby is receiving enough breast milk)

2009-05-15T23:34:00.000-07:00

Question:
What are the Signs of Adequate Milk Supply? (i.e. your baby is receiving enough breast milk)

Answer:
1. Three or more good-sized, yellow-colored, seedy bowel movements per day (Exception: may not be present while the milk is coming in until day 5 of life) (Caution: infrequent BMs are not normal in breast-fed babies until age 4 weeks)

2. Six or more wet diapers/day (Exception: two wet diapers/day can be normal while the milk is coming in - until day 5 of life)(Note: if uncertain about diaper being wet, place a tissue in diaper)

3. Breasts feel full before feedings and soft after feedings

4. The let-down reflex is the automatic release of breast milk into the milk ducts just before feeding. It develops after 2 to 3 weeks of nursing. Initially, milk letdown may require 60 to 90 seconds of sucking.

What if I smoke? Can I BreastFeed?

2009-05-15T23:31:00.000-07:00

Question:
What if I Smoke?

Anwer:

It is best to avoid tobacco; however, the benefit of giving your baby your milk generally outweighs the risks of tobacco use.

The nicotine and its byproducts pass into the milk and may cause restlessness, increased heart rate, and loose stools. Heavy tobacco use (over ½ pack per day) can decrease your milk supply and affect letdown.

When used as directed, smoking cessation aids pose no more problems for the breastfed infant than smoking.

If you smoke, do not smoke around your baby!

What if I am sick

2009-05-15T23:26:00.000-07:00

Question:
Should I BreastFeed when I am sick?

Answer:
Continue breastfeeding, even if you have a fever (reason: breast milk carries your antibodies which can protect your baby from the full-blown infection).

Try to prevent the spread of infection by good hand rinsing, especially after blowing your nose (for colds) or after stools (for diarrhea).

Contraindications to breastfeeding are rare: AIDS, Herpes simplex rash (fever blisters) on the nipple/areola, substance abuse and tuberculosis. Talk with your doctor.

Books on Breastfeeding at Amazon

When to call a doctor

2009-05-15T23:24:00.001-07:00

Question:
When Would I need to Call a Doctor If?

Answer:
Your baby has trouble latching on with most feeds
Your baby is not sucking and swallowing consistently
Your baby acts hungry after most feeds ( e.g., crying after feeds)
Your baby starts acting sick
Breastfeeding is painful

Vitamin D and Fluoride for the Baby

2009-05-15T23:21:00.000-07:00

Q. Is Vitamin D and Fluoride for the Baby Ok?

A. Breast milk contains all the necessary vitamins and minerals except Vitamin D and fluoride.
Starting at 8 weeks of age, all breastfed babies need to receive 200 IU per day of vitamin D (AAP Committee on Nutrition 2003). Until separate Vitamin D drops become available, use Vitamin ADC drops (over-the-counter) in a dosage of 0.5 ml.
Continue Vitamin D supplements until the child receives at least 16 oz (500 ml) of formula or cow’s milk per day.
Starting at 6 months of age, children who are breastfeeding and not drinking any water (with fluoride) need 0.25 mg of fluoride drops each day to prevent tooth decay. This is a prescription item that you can obtain from your child’s physician.

Plugged Milk Ducts

2009-05-15T23:07:00.000-07:00

Q. What are Plugged Milk Ducts?

A. Plugged milk ducts feel like a pebble or a pea under the skin or areola. They are best treated with hot compresses, breast massage during feeding , and pumping after the feeding. Place the baby's chin toward the plug if possible, massage from behind the plug towards the nipple, and pump for ten minutes after each nursing until resolved. Make sure you are not wearing a nursing bra that is too tight or that has an under wire pushing into your milk ducts

Sleepy Baby

2009-05-15T23:04:00.000-07:00

Q. I have a sleepy baby? Is it my breastmilk?

A. This is a common concern for newborn infants. First I would take a look at any painkillers you are taking. Pain medication from the hospital can cause the baby to be sleepy. Tylenol, Advil, and Aleve are all safe for breastfeeding and will not make the baby sleepy. Next, be aggressive. New moms tend to be very gentle, but newborns don't always know when they are hungry, so you have to wake them up every two to three hours with no more than one five hour stretch in any 24 hour period. Techniques for waking a baby include, stripping him/her down to a diaper, using the clutch/football hold so the baby is more upright, washing their face before nursing, changing their diaper, rubbing their hands, face, feet, or back. My personal favorite is alternate breast massage. As soon as the baby stops sucking or swallowing and begins to fall asleep. Massage the breast from underneath towards the nipple. This wiggles the nipple and "milks" the breast into the baby's, reminding him or her to start nursing again.

Medications

2009-05-15T23:00:00.000-07:00

Q. What Medications are safe when breastfeeding?

A. Many medications are safe for breastfeeding and alternatives are usually available for those that are not so it is unusual to have to stop breastfeeding due to a short term drug regimen. Thomas Hale, PHD ( Breastfeeding Comprehensive
) is the foremost authority on medications and mothers milk and his book is vital for nursing mothers and health care professionals alike. This information is intended for reference only and is in no way to take the place of the individualized care of a qualified physician. If copying this information for publication, please include references at the bottom and a link to our web site: www.lactationconnection.com

We are listing some common medications which are approved by the AAP for use in breastfeeding mothers:

ACNE - Clindamycin (topical), Erythromycin (oral)

ALLERGIC RHINITIS - Triprolidine

ANESTHETIC - Bupivacaine, Fentanyl, Halothane, Ketorolac, Lidocaine, Lorazepam, Metoclopramide, Morphine, Thiopental Sodium

ANGINA PECTORIS - Metoprolol, Nifedipine, Propranolol, Verapamil

ANTICOAGULATION THERAPY - Warfarin

ANXIETY DISORDERS - Clomipramine, Propranolol

ASTHMA - Terbutaline, Theophylline, Methylprednisolone

BIPOLAR DISORDER - Carbamazepine, Valproic Acid, Verapamil

CARDIAC ARRHYTHMIAS - Atenolol, Digoxin, Disopyramide, Lidocaine, Metoprolol, Mexiletine HCL, Phenytoin, Procainamide, Propranolol, Quinidine, Sotalol, Verapamil, Warfarin

CONGESTIVE HEART FAILURE - Captopril, Digoxin, Enalapril Maleate, Hydralazine, Metoprolol, Nifedipine, Verapamil

CONJUNCTIVITIS - Ceftriaxone, Erythromiacin, Tetracycline (short term)

CONTRACEPTION - Levonorgestrel

COUGH - Cisapride, Codeine

DEPRESSION - Clomipramine

DIABETES - Tolbutamide

FEVER - Acetaminophen, Ibuprofen

GASTROESOPHAGEAL REFLUX - Cisapride

GLAUCOMA - Acetazolamide, Timolol

HEADACHE/PAIN, GENERAL - Acetaminophen, Codeine, Ibuprofen, Naproxen

HYPERTENSION - Atenolol, Captopril, Enalapril Maleate, Hydralazine, Labetalol, Metaprolol, Nifedipine, Propranolol, Sotalol, Verapamil

HYPERTHYROIDISM - Methimazole, Proprnolol, Propylthiouracil,

INFECTIOUS DISEASES

Acute Sinusitis - Amoxicillin+ Clavulanate, Cefprozil, Co-Trimoxazole

Chlamydia - Erythromycin

Gonorrhea - Ceftriaxone

Herpes Simplex - Acyclovir

Lyme Disease - Amoxicilin, Ceftriaxone, Penicillin G

Malaria - Chloroquine, Hydroxychloroquine, Quinidine, Quinine

Salmonellosis - Cefotaxime, Ceftriaxone, Co-Trimoxazole

Tuberculosis - Cycloserine, Ethambutol, Isoniazid, Rifampin, Streptomycin

INFLAMMATORY BOWEL DISEASE - Prednisone,

INSUFFICIENT MILK SUPPLY - Metoclopramide, Domperidone

LOW BACK PAIN - Acetaminophen, Codeine, Ibuprofen, Naproxen

MASTITIS - Cefazolin, Cephalexin, Clindamycin

METABOLIC BONE DISEASE - Fluoride, Vitamin D

MIGRAINE - Butorphanol, Ketorolac, Metoprolol, Nifedipine, Propranolol, Valproic Acid, Verapamil

MUSCLE SPASTICITY - Quinine

NIPPLE VASOSPASM - Captopril, Methyldopa, Nifedipine, Terbutaline

PELVIC INFLAMMATORY DISEASE - Ceftriaxone, Cefoxitin

PEPTIC ULCER DISEASE - Amoxicillin, Tetracycline (short term)

RADIOPAQUE/RADIOCONTRAST AGENTS - Trade names: Conray, Chlolebrine, Telepaque, Oragrafin, Bilivist, Hypaque, Gastrografin, Renovue-Dip, Angiovist, Optiray

RADIOACTIVE PROCEDURES - The following are approved with temporary cessation of breastfeeding: Technetium-99M Pertechnetate (pump and dump for 24 hours), Iodine 123 (pump and dump for 24 hours), Thallium 201 (pump and dump for 2 weeks)

RAYNAUD'S PHENOMENON - Catopril, Methyldopa, Nifedipine, Terbutaline

RHEUMATOID ARTHRITIS - Hydroxychloroquine, Ibuprofen, Ketorolac, Piroxicam, Prednisone

ROSACEA - Clindamycin lotion/gel, Erythromycin, Tetracycline (short term)

SEIZURE DISORDERS - Carbamazepine, Ethosuximide, Phenitoin, Valproic Acid

URINARY TRACT INFECTION - Trimethoprim

VENOUS THROMBOEMBOLISM - Warfarin, .

A list of drugs which are usually contraindicated in lactating women follows:

Amiodarone

Antineoplastic Agents

Chloramphenicol

Ergotamine

Gold Salts

Lithium

Phenindione

Radiopharmaceuticals

Retinoids

Tetracyclines (chronic use over three weeks may cause infant bone changes)

Pseudoephedrine (preliminary unpublished studies indicate inhibition of prolactin and milk production)

Feeding Frequency

2009-05-15T22:58:00.000-07:00

Babies under the age of six months will normally nurse every 2-3 hours from the beginning of one feeding to the beginning of the next which is usually 8-10 times per day. During growth spurts at 3 weeks, 6 weeks, and 3 months, they will up their feedings to 10-12 times per day. Between 6 and 12 months, babies will normally feed 4 or 5 times daily.

Positioning Baby at the Breast

2009-05-15T22:53:00.001-07:00

Q. How do I Position My Baby at the Breast

A. To position baby at the breast make sure that the baby's body is turned in to mother. For example, in the cradle hold, the baby would be tummy to tummy with mom so that he/she doesn't have to turn his/her head to swallow. The baby's ear, shoulder, and hips should be in a straight line. Use a pillow and stool to make sure baby is at breast level.

Breast milk Collection and Storage

2009-05-15T22:50:00.000-07:00

Q. How do I collect and store my breastmilk?

A. Before beginning collection of breast milk, always wash your hands. Make sure the pump parts that will touch the milk are sterile (can be sterilized in the top rack of the dishwasher, a Microwave Steam Sterilizer or boiling water for 5-10 minutes). After pumping store milk in 2-4 oz increments to reduce waste. Pump directly into hard plastic or glass bottles that you will seal with a solid or ring and disk lid or Milk Freezer Bags
that are specifically designed for storing mothers' milk. Breast milk is good at room temperature for 6-10 hours, refrigerator for 5-7 days, freezer for 3-6 months and deep freeze for 6-12 months. Make sure to freeze refrigerated milk within 24 hours if you are not going to use it within the 5-7 day time frame. Refrigerate milk immediately if you are not going to use it within the 6-10 hours that it is good at room temperature. Never refreeze breast milk or put milk back in the fridge. Never put milk on the stove or in the microwave. To thaw or warm, simply place the milk in warm water. To determine more closely how much breast milk to put in each bottle for a baby who is less than six months old, take the baby's weight and multiply by 2.5. Then divide by the number of feeding per day. After the age of six months, the baby needs 24-32 oz per day which is approximately 5-6 oz per feeding 5-6 times per day.

8-day-old baby on formula, can I start breastfeeding?

2009-05-15T22:45:00.000-07:00

Q. If I am bottle feeding can I switch to breast feeding?

A. it is definitely not too late to begin breastfeeding! First of all you might want to just try putting your baby up against your breast to see what happens. Some babies will go immediately to the breast even with nearly two weeks of bottles! My best friend did this 15 years ago when her baby had to stay in the hospital for two weeks after she was born. She brought her home, put her to the breast, and never looked back. That is unusual, though, and I would imagine that it would not be quite that easy.

It will take some work on your part, but it will be worth it! A clear silicone nipple shield will help tremendously if a baby is used to a bottle nipple. Medela makes such a shield. These are very inexpensive, usually about $5.00. You can call 1-800-TELLYOU and then enter your zip code to find a local source. You wear this shield over your nipple while breastfeeding because it will feel more like the bottle nipple to your baby.

After the baby is latching-on well with the shield, you can begin attempting to latch him on without it. Spend as much time just nuzzling your baby with skin to skin contact as you can. If would also be helpful for you to rent a hospital-grade electric pump to help bring the milk back.

An alternative idea is to purchase a supplemental device which you wear around your neck on a nylon cord. Formula is put into the bottle, and tiny tubes are taped to your breast. The baby feeds at the breast, gets the formula, but stimulates your breasts to make milk. This is how adoptive mothers can breastfeed their babies. Because there are a number of ways you can go, as well as different products, it would be extremely helpful for you to try to find a local lactation consultant to work with you. If you cannot find local help, please let me know. Cher Sealy, RN, BSN, IBCLC, LLLL