HOW DO I KNOW IF MY BABY IS GETTING ENOUGH MILK
You can't see exactly how much breastmilk your baby takes while breastfeeding. However, you can tell whether breastfeeding is off to a good start if you know what to look for. The following patterns are typical of well-nourished, breastfed babies during the first month of life.
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You start producing breastmilk abundantly 3 to 5 days after your baby is born.
Most vaginal deliveries will produce breastmilk at the earlier end of the spectrum, with cesarian sections being a little later (especially booked cesarians). If your baby seems to still be hungry after breastfeeding at most feeds or you do not think your breastmilk has come in by 5 days after delivery, speak to your doctor, midwife or a certified lactation consultant. There are natural and medicinal options to help you produce more breastmilk, speak to your doctor, midwife or a lactation consultant about these.
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Your baby latches on to your breast correctly and sucks rhythmically for at least 10 to 15 minutes at each feeding.
Allow your baby to remain at the first breast until it is well drained, so he will receive the rich, high-fat hind milk. When your baby starts to suck less vigorously, swallows less, or begins to doze off, you can burp your baby, change his cloth diaper and arouse him to take the second breast. Generally, babies get more breastmilk at a feeding by nursing at both breasts. Since the first breast gets drained better, begin each feeding on a different side. This way, both breasts will get about the same stimulation and emptying.
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Your newborn nurses at least 8 times every 24 hours.
Breastfeed your baby as often as she shows hunger cues, such as waking from sleep, becoming alert, bringing a hand to her mouth, turning her head, or moving her mouth or tongue. Remember that crying is a late sign of hunger and a baby may not breastfeed well after crying too long. For the first few weeks, you can expect your baby to want food about every 1 1/2 to 3 hours, with a single longer stretch (up to 5 hours) between feedings at night.
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Your breasts feel full before each feeding and softer after your baby has breastfed.
One breast may drip breastmilk while your baby breastfeeds on the other side. After the longest time between feedings at night, your breasts should feel particularly full.
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Your baby's bowel movements look like cottage cheese and mustard by the 4th or 5th day of life.
Bowel movements that look like cottage cheese and mustard are called "milk stools." If your baby is still having dark meconium, green, or brown stools by 5 days of age, you should have your baby seen by the doctor or midwife.
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Your baby urinates 6 or more times a day once your milk has come in.
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Your nipples may be a little tender for the first several days of breastfeeding, especially at the beginning of feedings. The discomfort should be nearly gone by the end of the first week of breastfeeding. You can use expressed breastmilk, or some lanolin to help protect your nipples during those first few weeks.
· Nipple pain that is severe, lasts throughout a feeding, or continues more than 1 week after birth probably means your baby is breastfeeding incorrectly. If your baby doesn't latch on properly to breastfeed, your infant may not be getting enough breastmilk. If you do have very sore nipples, ask your infant's doctor or midwife to check your baby's weight and to refer you to a lactation consultant who can look at how your baby is breastfeeding.
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Two or three weeks after delivery you may notice the sensations associated with the milk ejection, or milk let-down, reflex.
Breastfeeding causes the release of the hormone oxytocin. This hormone causes the uterus to cramp, called "after-pains". After-pains become more severe after each birth, and most moms dont feel them at all with their first baby. These "after-pains" with breastfeeding are more noticeable than any early breast sensations. They usually go away 7 to 10 days after the birth of your baby.
The sensations of the milk ejection reflex are a tingling, pins-and-needles, or tightening feeling in your breasts as milk begins to flow. When your milk let-down occurs, your baby may start to gulp milk. Breastmilk may drip or spray from the other breast. You may find that just hearing your baby cry causes your breastmilk to let down, even before your baby starts breastfeeding. If you don't notice any signs of milk let-down, your milk supply may be low.
For more information or to find a certified lactation consultant in your area contact La Leche League www.llli.org
PUMPING YOUR BREASTMILK
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Some women manually express breastmilk for their infants; however most women who are frequently away from their babies choose to use a breast pump
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There are many models and types of breastpumps:
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Manual (least expensive but least efficient; suitable for occasional use, e.g. for when you will be out for an evening)
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Battery-operated
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Semi-Automatic Electric
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Self-cycling Electric (most expensive, but most efficient for frequent or long-term pumping, as will be needed when you return to work). This type allows double-pumping which saves time and yields the best milk supply
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You can purchase breastpumps at many drug stores, baby supply stores, from private lactation consultants, and online. Many hospital breastfeeding clinics rent out breast pumps
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ALWAYS follow the manufacturer’s instructions re: proper use, sterilization and care of the pump, and seek help promptly if you have challenges or concerns
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Choose your pump with plenty of time before you return to work, and ensure that you have about two weeks to practice using the pump and storing your breastmilk
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Moisten your breasts prior to pumping to ensure a good seal, and start the breastpump on the lowest suction level, gradually increasing it as desired and comfortable
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Remember that more frequent pumping sessions are more efficient than fewer longer ones
Resources for more information:
La Leche League
Canadian Lactation Consultants Association: www.clca-accl.ca
PREPARING AND STORING BREASTMILK
STORING
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Store at room temperature (66-72F or 19-22C) for up to 10 hours
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In a refrigerator (31-39F or 0-4C) for up to 8 days
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In a refrigerator freezer compartment for up to 2 weeks
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In a separate freezer for up to 3-4 months
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Store in glass or plastic containers or dedicated breastmilk storage bags, with 1 inch of space Left at the top, and keep well at the back of the refrigerator or freezer
PREPARING
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Store in 2-4 oz. portions to avoid wastage
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Thaw in warm water or in fridge, not on the stove or in the microwave, to avoid nutrient destruction and hot spots which can burn baby
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Use thawed breastmilk within 24 hours. Don’t refreeze. Discard unused portion.
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Gently mix the warmed breastmilk to blend the cream that rises to the top
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Test the milk temperature on your wrist before feeding baby
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Feed expressed breastmilk via a cup, sippy cup, spoon, or bottle
Resources for More Information
La Leche League
Peel Public Health
Dr. Jack Newman www.drjacknewman.com
BREASTFEEDING AND RETURNING TO WORK
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The majority of mothers today re-enter the paid workforce before their infant turns one. This necessitates some decision-making about how you will feed your baby when you are away. With a little planning and creativity, it is not only possible, but advantageous to continue feeding your baby your breastmilk.
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If you are not fortunate enough to have on-site child care or have your infant brought to you for breastfeeding, you can manually express or pump and store your breastmilk so that your caregiver can feed your baby.
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It is best to start thinking about how to combine work and breastfeeding early in your pregnancy. Decisions include when to return to work, employment options, childcare options, and feeding methods.
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Find out how supportive your workplace is towards breastfeeding, both in attitudes and resources. At the least you should be allowed enough breaks to pump, and have access to a private space (not the washroom!) which is well ventilated and equipped with a chair, sink, and storage facility for your milk. Know your legal entitlements.
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Try to delay your return to work for as long as possible, as studies clearly show that this increases breastfeeding duration, which provides many benefits to your baby.
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Recognize and accept that you may have conflicting emotions re: return to work, and the first few days may not be your most productive. Give yourself some time to develop a routine, and know that things will become easier with time
Resources for more information:
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