Breastfeeding
BENEFITS:
For BABY
• Increased Immunity
• Age specific and according to gestational age
• Endorphins/Serotonin released to self sooth
• Develop jaw and mouth muscles
• Promote Bonding
• Hygienic
• Complete feed for water and nutrition
• ↓ incidence of obesity, heart disease and diabetes
• Easy to digest
For MOM
• Help uterus to contract
• Weight loss
• Convenience
• Economical
• Boost mom’s confidence
• ↓ incidence of cervical cancer
Key points for breastfeeding positions:
• Your baby must always be level with your breast
• Your baby’s ear, shoulder and hip must be in a straight line
• You and your baby must be tummy to tummy, skin to skin
• Comfortable sitting position for mother with back support and arm rests, pillow or breastfeeding pillow on your lap, so that baby is at your breast level. Don’t lean forward and pull up shoulders - try to relax
Key points for successful latch:
• Hold your breast in a C shape with your thumb on top of your nipple
• Lift your baby’s nose with your index finger
• Your baby’s mouth must be opened wide and over your areola
• Your nipple must be deep in your baby’s mouth
• Your baby’s lips must be flanged and you must see the inside of your baby’s bottom lip
• Try to rub the little hands or the crown of the head with your free hand to stimulate sucking reflex if baby is ‘sleepy’ on the breast
Tips before starting to feed:
• First check your baby’s nappy
• Then check your baby for winds
• Drink water or jungle juice with each feed. You can’t produce milk if you are dehydrated
Feeding cues:
• Niggly and restless
• Tongue comes out
• Hands go to mouth
• Rooting reflex where head turns to side when cheek is ‘tickled’
Your baby’s nappy status:
• Your new born baby will have 1 or 2 nappies/day
• Once milk has come in expect 4-6 wet nappies and 3-4 soiled nappies but each baby is different
• By day 5 your baby’s stools should be yellow and substantial (at least one tablespoon)
Your baby is having enough if:
• Your baby is restful and sleep for approximately 3 hours
• Your baby is gaining weight
Tips for winding your baby:
• Air travels up so always keep your baby upright
• Your baby’s mouth and tummy should be in a straight line
• Apply gentle pressure with the palm of your hand to your baby’s tummy
• Gently rub your baby’s back in an upward motion
Tips for waking up your baby to feed
• Undress your baby
• Open and check baby’s nappy
• Change baby’s nappy if necessary
• Wipe feet with luke warm face cloth
Tips for putting baby to sleep:
• Wind your baby
• Swaddle your baby
• Use your clean index finger for your baby to suck on to assist with self-soothing
• Read up on Dr. Harvey Carb’s 5 S’s for soothing
(Swaddle, Side, Sway, Shoosh and Suck)
Tips for storing expressed breast milk:
• Store in sterilized container
• Store in a refrigerator or freezer in the coldest part – not in the door
• Date your breast milk and use the oldest expressed milk first
• Never microwave your expressed breast milk as it destroys all the nutrients and forms hot spots that can burn your baby’s mouth
• To warm up milk, place the container in a bowl or jug with warm water
• Always check that the milk is skin temperature warm
Jungle juice to assist with breast milk supply:
Your baby may go through a growth spurt around:
• 2-3 weeks
• 6 weeks
• 3 months
Allow your baby to feed often to stimulate your milk production to meet your baby’s increased needs.
To increase your breast milk supply:
• Day 1: Drink 3 litres per day
• Day 2: Drink 2 litres per day
• Day 3: Drink 1 litre per day to sustain breast milk
NB -Jungle Juice recipe that helps with milk production:
(Not for diabetics)
2 litres of Rooibos tea made with 4 bags of quality Rooibos that were “slowly brewed” on low heat in a pot on the stove
60ml Schlehen Blackthorn Berry Elixir (available at Pharmacies or Health shops)
Optional: some Apple juice, 1 Cal-C-Vita and a few drops of rescue remedy or Rehydrate
Diet: (Everything in moderation)
• Balanced diet of fresh fruit and vegetables
• Drink between 6-8 glasses of water per day or until you are no longer thirsty
• Juices that are preferable are litchi, mango, sweet melon, paw paw, guava and pear
• Eat in moderation
Avoid:
• Gas forming foods like cabbage, beans, onions, Brussel sprouts, fizzy drinks an white bread
• Sweets like chocolate
• Steamed fruit
• Caffeine in coffee, tea and coke
• Sour foods like mayonnaise, tomatoes, pineapple and citrus fruits
Helpful tips to prevent an incorrect latch:
If you feel any pinching or pain or there is lots of sucking ‘sound’ effects:
• Break the suction with your finger (let the baby suck on your finger)
• Relatch the baby
• Make sure your baby’s mouth is wide open
• Make sure your baby takes a big portion of your areola
• Make sure your nipple is deep in your baby’s mouth,
• Look for jaw joint movements and the bottom lip slightly curled out/flanged
Helpful tips to prevent cracked nipples:
• Use a good Lanolin based nipple cream
• Rub a few drops of your breast milk on your nipples and allow to dry naturally
• Expose your nipples to air and sunlight, but not in the midday sun
• For cracked and painful nipples consult a lactation consultant, baby clinic sister or physiotherapist. You could also get a cortisone based nipple cream on prescription from your gynaecologist.
Helpful tips to treat engorged breasts:
• Take a warm shower where water run over your breasts (turn your back to the shower, not direct spray on breasts if tender) and massage your breasts gently to allow milk to flow out to relieve fullness
• Allow your baby to feed often – they must ‘clear the closets’
• Put cool refrigerated cabbage leafs in your bra (do not freeze cabbage) do not cover your nipples(very good remedy)
• Do not express, it will make engorgement worse!!
Helpful tips to prevent thrush:
• Change your breast pads after each feed to keep your nipples dry
• Do not use breast pads with a plastic lining as this will keep the area moist
• If you suspect thrush, contact your doctor or baby clinic sister as you and your baby may need to be treated. Don’t stop treatment until medication finishes, otherwise it will come back.
Info if your baby is premature:
• Expressed breast milk(Mothers Own Milk - MOM) is HIGHLY beneficial and gives your baby everything they need
• Easy to digest, so can prevent serious gastro intestinal disease.
• Increases health of baby
• Possibly reduce the time hospitalised and cost of treatment because it reduces some gastric complications
• We have Electric breast pumps in the ward, you just need to buy the attachment set at the pharmacy or you can bring a pump from home if you have one.
Please ask for lots and lots of help when you have to express for your little one in Neonates. You need to stimulate your breast by using a breast pump for 15minutes on each breast, strictly 3 hourly, even at night 4 hourly, you have to set your alarm and wake up and express. REMEMBER 8 or MORE in 24
Don’t give up, even a few millilitres of colostrum in the first few days is great and so essential for your baby!
Donor milk can be brought and used in NNICU but MOM’s milk is better!
MILK DONATION:
If any mother is considering to express and donate milk for other babies you can contact Sr. Ansju Blackbeard or go onto the website of the South African Breast milk Reserve (SABR) https://www.sabr.org.za/
Donor milk is needed for premature babies and you can save a LIFE! You can complete an online screening form and they will contact you directly and arrange and pay for your blood tests and later collect the frozen milk from you when all the tests are done and approved. It's an easy process.
Helpful tips if your baby has jaundice:
• Continue to breastfeed on demand if possible
• Baby may be sleepy and might have to be woken up to be fed
• Alternatively express your breast milk
A helpful tip if you have twins:
• It is important to ask family and friends for assistance
• Try to feed simultaneously otherwise it can be very time consuming
• Contact SAMBA, a multiple birth support group or feeding consultant
Tips when preparing a formula feed:
• Consult your baby clinic sister or Pead before • COW’S MILK IS NOT SUITABLE FOR CHILDREN UNDER THE AGE OF 12 MONTHS! formula feeding
• No need to bring formula milk or bottles to hospital, we provide if needed
• Always sterilize feeding utensils
• Carefully read the preparation instructions
• Hold your baby when bottle feeding. Don’t lay them down with a bottle ‘propped up’
Help and support:
• Ask the nursing staff questions, they are there to assist you when you are in hospital.
• Visit the Nursery in the hospital often for help.
• Ask your baby clinic sister or breastfeeding consultant for assistance
• Call Mediclinic Baby’s help line on 0860 233 333
How to be successful at breastfeeding your baby
1. Keep the baby in direct skin to skin contact with the mother and allow baby to drink as often as it wants to and minimize separation of mother and baby.
2. Remember that colostrum is also milk and even though it is only a few drops, it is all the baby needs.
5ml colostrum= 25ml of formula
3. Breast milk will be produced when:
• The placenta is removed and the hormones change from pregnancy supporting hormones to breastmilk forming hormones. This change over takes a few days and might only happen once you have been discharged.
• When the baby smells the mom the sucking reflex is triggered
• The baby suckles on the breast and stimulates the milk ducts around the areola. This sends a message to your brain to produce more milk (more hormones form)
4. Be patient, the milk will come. The more you stress, the less milk you will produce, because then your brain gets a message that you are in trouble and produce hormones to get you out of trouble that may oppose the good breast milk forming hormones. The same happens when you have pain, so please make sure you manage your pain well. Take medication strictly as prescribed and don’t wait until you are in excruciating pain. Ask for medication if you are uncomfortable.
5. The baby is in control now, not mom any more! (Sorry) Listen to your baby and feed them when they show signs of hunger or just don't settle.
6. Breastfeeding is a “team sport”. Make sure you have lots of help and support. If you want to sleep in the first 24 hours, dad can also comfort the baby and even do skin to skin. Dads should wear a buttoned shirt so baby can also lie skin to skin and close to his beating heart when cuddling. Talk and sing to baby to calm baby
7. Although it is a natural process, breast feeding is still an art that you and baby need to master.
8. If the breasts get fuller: ENGORGED B.M.W backwards!
• W – Apply warmth to the breast: Warm shower, warm towels, infra red lamp
• M – Massage the breasts gently from the outside to the nipple until the lumps feels better
• B – Put the baby on to suck and empty your breasts (Express with a breast pump or by hand if the baby is in NNU)
Expressing Breast Milk
• If you intend to a use bottle, introduce around 6 weeks for baby to get the feel.
• It is advisable to express after breastfeed to collect the excess milk and allow the breast to fill up for the next feed.
• Mornings are good as the volume is much higher.
• In the first week, the body produces 300-500mls of breast milk in a total 24hours.
• Then, 600-700mls in 24hours in the next 2-3 weeks.
• Demand and supply
Storage:
• Expressed Breast milk should be used within 6 hours of expressing.
• Place in the fridge within 1 hour of expressing if not for immediate use.
• It can be kept at the back of the refrigerator for up to 3 days.
• In a freezer, inside the fridge for up to 2weeks.
• In a separate freezer for up to 3 months.
• In a deep freezer for up to 12 months @ <-18 Degrees.
• EBM: baby’s current weight, multiply by 150, divide by the no of feeds baby has in 24 hours: E.g. 4kg X 150mls = 600/6=100mls/bottle