Breastfeeding Basics

It's amazing what a mother can do. Everything your baby needs comes from you. You provide the love, nurturing and even the food your infant needs. Congratulations, on behalf of St. Luke's, on your decision to continue breastfeeding!

As a breastfeeding mom, you are giving your child the best start in life. Studies continue to find strong links between breastfeeding and infant health. Breastfed babies have a lower incidence of ear infections, are less likely to develop Sudden Infant Death Syndrome (SIDS) and have a lower risk of food allergies. Beyond the health benefits, many breastfeeding moms say the bonding they experience with their child is the single greatest benefit.

As you may have discovered, breastfeeding is natural, but it is not automatic. Like any worthwhile endeavor, it takes practice. At St. Luke's, we also know that the first few weeks can be the most challenging. We're committed to helping you and your baby get off to a good start. This newsletter was designed to help answer your questions, encourage you through any stumbling blocks and give you and your baby the best experience. We also recognize that breastfeeding is a different experience for every woman. Our lactation specialist can help you with your individual needs or give you private assistance. They can be reached by calling 381-2592 (Boise) or 706-3119 (Meridian) . In addition, St. Luke's hosts classes on breastfeeding as well as a weekly support group so that nursing moms can share experiences in the quiet surroundings of our Women'sLife cottage.

The American Academy of Pediatrics recommends breastfeeding as the best possible food for your baby during the first year of life. Regardless of how long you decide to nurse your baby, you may find the questions and advice presented in this newsletter helpful.

Breastfeeding Benefits

• Breast milk is the best food for your baby.
• Babies are rarely allergic to their mother's milk.
• Breastfeeding may help to develop your babies intellect. Studies show breastfed babies may have a higher IQ.
• Breast milk is always ready and requires no special preparation.
• Breastfeeding reduces the risk of Sudden Infant Death Syndrome (SIDS).
• Breastfeeding may help some women lose weight.
• Breastfeeding saves money.
• Breastfeeding lowers the risk of asthma, colic, juvenile diabetes and ear infections

Common Questions
Q. I find breastfeeding painful. Will anything help?
A. Breastfeeding should not be painful; however, some women, especially those with sensitive nipples, may experience some discomfort in the first few weeks. It should subside as you and your baby adjust to each other. Pain usually indicates something is wrong, or that your baby is latched incorrectly. If the pain is severe or continues, talk to your doctor immediately, call St. Luke's lactation specialist at 381-2592 (Boise), 706-3119 (Meridian) or our health line, Call St. Luke's at 381-1200.

Q. Should I breastfeed on demand or keep my baby on a schedule?
A. This is a matter of personal choice. Some believe that feeding on demand is better for adapting to your baby's needs or is a good way to ease a fussy baby. Others believe a schedule works best, because it organizes feeding times around the family's needs or lifestyle and provides a consistent routine for baby. Experts make the case for both sides, so do what you feel works best for your child and your household. It's also important to remember that no two days are the same. So be flexible with whatever decision you make–newborns will tend to nurse at irregular times and shouldn't be forced onto a schedule in the beginning. Likewise, if you're feeding on demand it's important not to exhaust yourself.

Q. My newborn wants to nurse every two hours–and sometimes more often than that. Does this mean that I don't have enough milk? Is there a way to tell whether my baby is getting enough milk?
A. Your body produces milk based on supply and demand. The more your baby nurses, the more milk you produce. In the beginning, it's not unusual for a newborn to nurse every one to three hours. While this may exhaust you, your baby is not starving. She's just doing her part to encourage lactation flow. The good news is, in time your supply will match your baby's demand. On average, infants nurse about eight to 10 times in 24 hours, but don't be surprised if your baby nurses more often than that or at irregular times (more often during the day, for example, and maybe just once at night). You can tell if your baby's getting enough to eat if he has at least six wet diapers and several bowel movements a day.

Your pediatrician will also be able to monitor your baby's growth and development as another measure. Be sure to discuss any feeding questions or concerns with the pediatrician.

Q. Does what I eat affect my breast milk?
A. Many women neglect to eat well during the first exhausting and exciting months of motherhood. But eating well, drinking enough fluids and getting enough rest are important to maintaining your milk supply. So make an effort to eat plenty of fruits and vegetables, whole-grain bread and cereals and calcium-rich and protein-rich foods, like milk and cheese. Even if your diet is lopsided, your baby is getting everything he needs from your breast milk. It's nature's remarkable way of ensuring that your milk contains all the nutrients and calories your baby needs. If you don't eat well, you often suffer the most. You need to replace the extra calories your body uses up through nursing and receive the extra energy that a healthy diet provides.

Q. Can spicy foods or certain things I eat cause gas or an allergic reaction in my baby?
A. There is little evidence that this actually happens, but many moms believe they see a difference in their child. Many babies go through a fussy stage when they are generally fussy in the evening for a few hours. It is usually not necessary to avoid spicy or strong foods. Talk to your child's doctor before foregoing critical foods like dairy products or vegetables. Your doctor can help you determine whether a true allergy is the cause.

Q. How many bowel movements should my baby have in a day?
A. At least 2-5 bowel movements every day indicate a baby younger than 6 weeks is receiving enough breast milk. After 8-12 weeks, a baby may not have bowel movements every day. As long as your baby is breastfeeding, his stool will be loose, unformed and seedy.

Q. If I introduce a bottle, will that confuse my baby?
A. Babies have the remarkable ability to adapt. Some will find it easier to switch from bottle to breast than others. Even if you plan to exclusively breastfeed, introducing a bottle is a good idea, just to give yourself a break once in awhile. Bottle-feeding will also allow other loved ones the opportunity to bond with your baby. Pumped or expressed milk is recommended. If you plan to supplement with formula, talk to your doctor about when and how much. It is best to introduce a bottle after 3-4 weeks or when you feel breastfeeding is going well and you have a good milk supply. After 3 months, your child will more likely resist a new approach.

Q. My baby fusses while nursing. Is my milk not coming fast enough or is something wrong?
A. There are many reasons for a fussy baby. It may take a little time and patience to figure it out, but it probably has nothing to do with your milk. Your baby may need to burp, is colicky, have gas or is just tired. She may also not be hungry or is disinterested, so you may want to take a break and try another time. If the fussy behavior continues every time you try, call St. Luke's lactation specialist for assistance.

Q. Can I drink alcohol or caffeine while I'm still nursing?
A. Alcohol is absorbed in your breast milk and can be passed to your baby. The American Academy of Pediatrics Committee on Drugs considers alcohol consumption compatible with breastfeeding, although side effects are noted if alcohol is taken in large amounts. An occasional drink has not been found to be harmful to the nursing baby. Drinking alcohol can affect you and your ability to care for your child. If you have questions about alcohol, talk to your doctor or baby's doctor. Large amounts of caffeine can affect your milk production and can make your baby irritable. One or two cups of coffee a day should not affect your baby, but if your baby is having trouble sleeping or appears fidgety avoid caffeine.

Q. What if I get sick? Should I still breastfeed?
A.Yes, if you're physically able, continue nursing. Your breast milk provides the antibodies that help protect your baby from getting sick. Nursing will also continue to encourage your flow. Talk to your doctor before taking any medications.

Q. When will my baby begin sleeping through the night? Does breastfeeding help or hinder my baby's sleep?
A. Most babies begin sleeping longer at about 8 weeks of age, regardless of how they are fed. It is also normal for babies who are 4 to 12 months old to wake up during the night due to hunger, teething, separation anxiety or other reasons.

Q. Can I breastfeed in public?
A. Yes. This is a natural way to nourish your baby, and nursing mothers can breastfeed any time and anywhere they feel appropriate. These tips may make you feel more comfortable:

• Wear a loose-fitting blouse or top that pulls up from the bottom.
• Bring a shawl or blanket to throw over your shoulder and loosely cover your nursing baby.
• Wear a nursing bra.
• Look for a bench, restroom lobby or quiet spot to give you and your baby some privacy.

Q. What arrangements do I need to make when leaving the baby with a sitter or family member?
A. When you plan to be away from the baby for just a few hours, you can manually express or pump some breast milk ahead of time. You can leave the breast milk with the sitter to give to the baby in a bottle when the baby wants to eat. Pump or express your milk well in advance of the time you plan to leave so that you are not too rushed. Breast milk storage guidelines are provided on the following page. You may also want to keep a supply on hand to use any time you plan to be away. After breastfeeding is established, some mothers use formula for feedings when they are away from their babies. Check with your baby's doctor before making any change in your baby's diet.

Q. Can I return to work and continue breastfeeding?
A. You don't have to stop breastfeeding if you return to work. Planning ahead is the most important thing to do. One of the choices you will have to make is whether to provide breast milk for your child care provider to give to the baby. Check with the person who will be caring for your baby; most are happy to feed your baby breast milk. Discuss proper storage, thawing and preparation, because it’s important to keep your milk fresh. You will have to make adjustments in your nursing routines and decide if you will pump while at work. If you plan to pump at work, you will need a pump and the help of your employer to find a good place to pump and a method of storing the milk. If your childcare is located conveniently to your work place, you may want to use your lunch break to breastfeed your baby there. St. Luke's can help you prepare. Talk to our lactation specialist about your options.

Q. If I breastfeed less often or change the time of day I nurse, will I lose my milk?
A. Your body has the amazing ability to change with your needs. As long as you continue to breastfeed with some consistency, your milk should keep up with demand. It's more important to ensure your baby is getting enough fluids and nutrients. Talk to your baby's doctor about your baby's daily requirements.

Q. I would like to try expressing my breast milk. What are the best kinds of pumps?
A. There are three kinds of breast pumps: manual, electric and battery operated. The last two use a motor to create suction, requiring less energy from you. Portable battery-operated pumps give you some control over the suction force and work fairly fast. You don't need a pump, however, to express breast milk. It may take practice, but you can express by hand. Position your thumb and index finger one-and-a-half inches behind your nipple. Push your fingers straight back and then squeeze them together. Release and repeat. You can express directly into a bottle or a special bag, created to store and freeze breast milk for later use.

Breast pumping for times away from your baby
When you are regularly separated from your baby due to work outside your home, attending school or any other outside commitments, you can continue to breastfeed.

To prepare, consider the following:

• Choose an effective breast pump and learn how to express milk.
• Begin storing breast milk in your freezer.
• Find a child care provider who you can trust will support you in continuing to breastfeed.
• Arrange and plan for a time and place for nursing your baby and/or expressing milk at
  work or school.
• Help your baby adjust to taking a bottle/cup from his caregiver while you are away.
• Plan on taking the class Breastfeeding: Working, Weaning, Whatever offered monthly at St.Luke's Medical Center. (See coupon back page).
• Join the Breastfeeding Bunch that meets weekly at St. Luke's. FREE. Call 381-1200.

Storage Guidelines for Breast Milk:

Freshly Expressed Breast Milk
(in sealed container)

Freezer:

• 2 weeks in freezer compartment located inside the refrigerator
• 3-4 months in separate door refrigerator/freezer
• 6-12 months or longer in deep freezer (0°F or less)

Refrigerator:

• 3-5 days (mature milk) (39°F or lower)

Room Temperature:

• 12-24 hours (colostrum)
• 6-8 hours (mature milk) (78°F or lower)

Previously Frozen Breast Milk:
(thawed in refrigerator or under running water – not warmed or used)

Freezer: Do not refreeze.

Refrigerator: 24 hours

Room Temperature: 4 hours or less

There is no research indicating whether it is acceptable to save reheated breast milk.

You're invited to attend FREE classes as a gift from
St. Luke's

To register, Call St. Luke's at 381-1200. Congratulations on your decision to breastfeed!

Join the "Breastfeeding Bunch"
Meets weekly at St. Luke's in Boise and Meridian. Call 381-2592.

For Breastfeeding Assistance:

• St. Luke's lactation specialist, 381-2592 (Boise), 706-3119 (Meridian)
• Call St. Luke's 24-hour health information line, 381-1200.