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Prenatal Care

Breastfeeding

 

 

Whether to breastfeed your baby or not is a very personal choice and is your decision to make. Mother Nature, though, has provided you with the best food to feed your baby. Human milk is a unique combination of fats, sugars, mineral proteins, vitamins and enzymes, custom-made to promote brain and body growth.

 

Colostrum, also called first milk, is a milky or yellowish fluid secreted by the mammary glands a few days before and after birth . Colostrum provides unmatched immunity against bacteria and viruses. Colostrum also acts as a natural laxative to clear the meconium (first bowel movement) from the baby’s intestine, thereby, decreasing the chance of jaundice.

 

There are several breastfeeding advantages such as breast fed babies have fewer ear and diarrhea infections, decreased vomiting and acute respiratory illnesses, a lower risk for diabetes, lymphomas and Crohn’s disease and breast fed babies tend to have higher IQ’s than bottle fed babies.

 

Breastfeeding Options for Working Mothers

 

Full-time Nursing

You can nurse the baby during the workday OR you want to express milk often enough (at least every 3-4 hours) to be able to provide all the milk your baby needs while separated from you. Formula will be used in only rare instances when you don’t have quite enough breast milk.

 

About seven to fourteen days prior to returning to work begin practicing with expressing milk by hand or with a pump to become familiar with the technique. It will take about 3 to 4 times before you become proficient.

 

Most women find they have more success expressing milk in the morning. Try this about one hour after the baby nurses.  Just express for 10 to 15 minutes at the most and do it consistently each day. Expressing more than 1-2 times per day is not recommended.

 

Milk can be stored in baby bottles, a pitcher or any clean container in the refrigerator. Don’t worry if you only get a small amount when you begin. Fresh milk can be added to the milk you already have in the refrigerator as long as the new milk is chilled first. Milk can be kept in the refrigerator for 5 days. After 5 days it should be frozen or discarded. Breast milk, when removed from the refrigerator or freezer, may appear discolored (yellow tinged, bluish green, even a little brown). This does not mean the breast milk is bad. Always check breast milk to be certain it does not smell sour or taste bad. Because breast milk does not look like cow’s milk when stored, taste and smell, not color, should determine if the refrigerated breast milk is good.

 

Remember that you only need enough milk for your first day back to work. What you express each day at work is what is used the next day.

 

Occasional bottle-feeding should begin at about 4-6 weeks after delivery even if you are not planning on returning to work until your baby is several months old. Introduce the baby to the bottle 1-3 times per week by letting dad or someone else feed some of your expressed milk by bottle. It doesn’t need to be a “full” feeding; the intent is for the baby to get used to how to drink milk from a rubber nipple and bottle.

 

When you are at work express milk every 2-4 hours. You do not have to express at the same time every day but express milk often enough to prevent engorgement. You should nurse as soon as you can when you get home and as exclusively as you can. If you find that your breast milk supply has dropped, try expressing milk before bedtime to help stimulate the supply a little.

 

Part-time Nursing

This involves the ability to nurse the baby or express milk occasionally during the workday. You do not expect to be able to feed or express milk often enough to maintain a full milk supply and meet all of your baby’s needs with your breast milk. Formula will be used frequently to provide all or most of the milk your baby needs while you are at work.

 

This option works better when babies are older and mothers do not have long workdays and long commutes. Mothers with babies less than 3-4 months old risk losing more of their milk supply than they planned on if they are not able to express milk at all during the day. “Comfort Expressing” (removing just enough milk to avoid discomfort from overly full breasts) can help you meet this goal better. Another variation of this option is expressing milk (even on a limited basis) at work until the baby reaches 3-4 months of age and then discontinuing it and using formula while you are working and continued frequent breastfeeding when you are at home.

 

About seven to fourteen days prior to returning to work eliminate one or two feedings that you will miss while you are at work. Replace breastfeeding at those feedings with a bottle of formula or breast milk. If your breasts are uncomfortable place some ice on your chest or express just enough for comfort. This will reduce the amount of stimulation your breasts receive and thereby, decrease the milk supply a little.

 

Try to express your milk while at work if you can, even if it is not every day or the same time every day. Nurse as much as you can when you are home.

 

Sore Nipple Management

Breastfeeding is meant to be a comfortable, pleasant experience. However, many new mothers still find their nipples tender for the first few days when the baby starts nursing. This usually disappears by 1-2 weeks. To help prevent nipple tenderness, start with the correct positioning and latch on.

 

Cradle Position

•Place a pillow or two in your lap to support your baby.

•Place your baby’s head on the crook of your arm

•Make sure your baby is turned toward you chest to chest at breast level

  1. Support your breast with yourhand in an “L” or “C” position, thumb on top of your breast, fingers below, away from areola.
  2. Tickle your baby’s lower lip until he opens WIDE, and then quickly pull him onto your breast. Be patient. This may take a minute.
  3. Make sure your baby’s lips are behind the nipple, encircling the areola.
  4. The tip of your baby’s nose should be touching the breast.

 

Football / Clutch Position

•Put a pillow or two at your side to help support your arm and your baby.

•Support your baby’s neck and the lower back of his head in your hand, with your forearm supporting his upper body against your side.

•Follow steps a, b, c, and d under the Cradle position.

 

Lying down Position

•Lie on your side with pillows supporting your back and your top leg, which is bent forward .

•Place your baby on his side facing you .

•Follow steps a, b, c, and d under the Cradle position.

 

Vary nursing positions for the first week.

 

Breastfeed frequently, about every one and one-half to three hours. Keeping your baby on an artificially longer schedule may make him frantically hungry and increase the likelihood of vigorous nursing and tender nipples.

 

Release the suction before you remove your baby from the breast. Do this by placing a clean finger in the side of your baby’s mouth between his jaws. Don’t take him away until you feel the suction break.

 

After nursing your baby, express a little breast milk and massage it into your nipples and areola, then air dry. Leave them open to the air as much as possible . Never use soap, alcohol or breast creams on your breasts or nipples. Water is all that is needed to clean your breasts when you shower or bathe.

 

If your nipples do become sore, try these suggestions:

•Use deep breathing, soft music or other relaxation techniques before and during breastfeeding.

•Limit the nursing time on the sore nipple.

•Express a little milk first to stimulate let down.

•Massage your breasts while nursing. This helps stimulate the milk to flow.

•Use non-plastic lined bras and/or bra pads. Change the pads frequently to keep the nipple dry.

•If your nipples become dry or cracked, use a little USP Modified Lanolin on them. This forms a moisture barrier so they stay dry.

 

Suggested Books on Breast Feeding

“The Womanly Art of Breast Feeding” by: LaLeche League International

“Breast Feeding your baby” by: Sheila Kitzinger

“Best feeding: Getting Breast feeding right for you by”: Mary Renfew, Chloe Fisher, Suzanne Arms

“The Nursing Mothers Companion” by: Kathleen Huggins .

 

 

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