Is My Newborn Getting Enough?

Watch for these signs to be sure that your newborn is getting enough milk:

  • In the first few days of breastfeeding, you feel uterine cramping or notice an increase in vaginal bleeding while nursing. Some moms feel sleepy or thirsty.  These are all signs that your milk is “letting down”, or flowing.
  • You feel breast fullness 2-5 days after delivery. This is an indication of an increase in your milk supply.
  • You are feeding your baby on cue, around 8-12 times in 24 hours, and she seems satisfied between most feedings.
  • Your baby nurses as long as she wants on the first breast before you offer the other side.
  • After the first few days, your breasts feel full before feeding and at least one is softer after feeding.
  • Your baby is having several yellow stools each day and 6 or more wet diapers by the 5th day of life.

If you are not seeing these signs, contact a lactation consultant or your baby’s doctor right away.

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Be Comfortable Nursing Wherever You Go

Written by Marie Barnhurst, IBCLC

 Some mothers naturally feel comfortable breastfeeding their babies wherever they are.  They may think nothing of nursing in the middle of a crowded shopping mall, no matter who may be watching.  This is wonderful, and they are to be applauded.  But we are all creatures of our culture, and in American society, many moms feel a little bit shy about breastfeeding away from home.

If you are among them, will you be forced to stay at home near feeding times, to express, store and heat breastmilk in bottles, or to give artificial milk when you are out with your baby?  No!

Breastfeeding when you are out guarantees your baby fresh, readily available comfort and nourishment.  And it can be done so discreetly that no one but you and your baby will know.  In other words, nursing away from home does not have to mean nursing “in public.”  Here are some tips.

Plan ahead.  Choose a nursing bra you can open and close easily with one hand, and an outfit in which you can nurse with a minimum of fuss.  Loose-fitting tops that can be lifted from the bottom are a good choice, because your nursing baby will cover any portion of your midsection that would otherwise be exposed.  If you wear a button-front top, unbutton it from the bottom up.  Some mothers find that specially designed nursing garments, with strategically placed flaps or hidden slits, are helpful when nursing away from home.

Practice at home before you go out.  Try nursing in front of a mirror to help you learn how to get your baby latched on with a minimum of exposure.  If you find that the latch-on process shows more skin than you are comfortable with, try draping a blanket over your shoulder and the baby until he is settled and nursing.  Your mirror will prove to you that once he is latched on, a nursing baby looks just like a sleeping baby to an outside observer.

Start small.  Before attempting the shopping mall, try nursing at home in front of friends and relatives, or at a Nursing Mothers meeting.  The confidence you build by nursing in the presence of these supportive “audiences” will help you feel more comfortable when you venture out into areas that are more public.

Choose a relatively quiet, comfortable spot.  They can be found, even in public places like shopping malls.  Tried-and-true possibilities include department store fitting rooms or furniture departments, secluded benches in parks, restaurant booths, and furnished lounges adjoining restrooms in some department stores, theatres, hotels and other gathering places.  Try not to use the restroom itself – would you want to eat there?   

Bring allies.  If you go out with another adult or an older child, you can place them between you and the public while you breastfeed.  Having someone to chat with while you nurse may help you feel more comfortable.  Also, if you are focused on your companion, onlookers will be less likely to notice that you are nursing your baby.  When you do go out by yourself, you can turn your body so that you are facing away from more public areas, using your back to give you a bit of extra privacy.  Looking around you rather than at your baby while he nurses will help keep onlookers from focusing on the fact that you are nursing.

Feed early, feed often.  You can avoid attracting attention by feeding your baby before he is overly hungry and fussy. 

Feel proud.  The more confident you appear, the less likely you are to attract unwanted attention.  But more importantly, breastfeeding your baby shows your commitment to his health and well being and should be a source of pride, not embarrassment.  When you nurse outside your home, you set an example for others that may encourage them to breastfeed or empower them to do so more publicly.  Your courage in conquering your discomfort can help ensure that our daughters won’t have to feel shy about doing what is natural and right for their children.

There’s a big, wonderful world out there for you to help your baby discover.  Breastfeeding shouldn’t stand in your way.

How to Introduce Solids without Sacrificing Breastfeeding

A study published in The British Medical Journal in 2004 found that allowing babies to nurse during painful medical procedures appears to relieve pain.  The study observed 180 newborns who were placed into 1 of four groups when having blood taken for various reasons.  Babies in the first group were allowed to nurse; those in the second were held by their mothers but not fed; babies in the third group were given water as a placebo; and those in the fourth were given sugar water and a pacifier.

The babies were videotaped during the procedure; and researchers, who were not told of the details of the study, reviewed the tapes.  They measured the babies’ pain levels by documenting signs such as heart rate, crying, and facial expression.  Sixteen of the 44 infants in the breastfeeding group showed no indications that the blood test had even occurred; and 35 had pain scores of less than 3, which can be perceived as little or no pain.

These results prompted researchers to conclude:

 “To date the most potent nonpharmacological analgesia reported has been the use of a pacifier combined with a sweet solution.  We have shown that breast feeding {sic} is at least as effective as that observed with 30% glucose plus sucking a pacifier.  We believe that breast feeding is an excellent natural alternative to prevent or reduce pain during minor daily procedures undergone by neonates.”

So, the next time your baby needs to have a blood test or vaccination, remind your pediatrician of this research, and nurse with that needle!

Breastfeeding Relieves Pain

A study published in The British Medical Journal in 2004 found that allowing babies to nurse during painful medical procedures appears to relieve pain.  The study observed 180 newborns who were placed into 1 of four groups when having blood taken for various reasons.  Babies in the first group were allowed to nurse; those in the second were held by their mothers but not fed; babies in the third group were given water as a placebo; and those in the fourth were given sugar water and a pacifier.

The babies were videotaped during the procedure; and researchers, who were not told of the details of the study, reviewed the tapes.  They measured the babies’ pain levels by documenting signs such as heart rate, crying, and facial expression.  Sixteen of the 44 infants in the breastfeeding group showed no indications that the blood test had even occurred; and 35 had pain scores of less than 3, which can be perceived as little or no pain.

These results prompted researchers to conclude:

 “To date the most potent nonpharmacological analgesia reported has been the use of a pacifier combined with a sweet solution.  We have shown that breast feeding {sic} is at least as effective as that observed with 30% glucose plus sucking a pacifier.  We believe that breast feeding is an excellent natural alternative to prevent or reduce pain during minor daily procedures undergone by neonates.”

So, the next time your baby needs to have a blood test or vaccination, remind your pediatrician of this research, and nurse with that needle!

Food for Thought

Debi Ferrarello, RN, MS, IBCLC
 
Of all the myths that surround breastfeeding, rules about what the mother should not eat are some of the most pervasive.Over the past ten or fifteen years, mothers have frequently been told to avoid broccoli, cabbage and beans, chocolate, citrus fruits, tomato products, garlic, onions, spicy foods,
dairy, sushi, coffee, and carbonated beverages.  Basically, they have been told that if it tastes good, avoid it!

Let’s stop for a moment and consider that breastfeeding is a global activity.  People breastfeed all over the world and consume a wide variety of foods. For example, people in Mexico, India, and some parts of China do eat spicy foods
and nurse their babies.  People in Italy would never consider a cuisine free of garlic and tomatoes.  Chocolate makes women happy throughout Europe, and coffee is enjoyed by
nursing mothers all over the world.  Most cultures consume far more fibrous, gas-producing food than we Americans do, and would think it strange to avoid them while nursing.

Cabbage, broccoli, and beans are high-fiber foods.  The sugars in those high-fiber foods ferment in the intestines of those who eat them, causing gas to form. However, there are no chunks of broccoli in mothers’ milk – no stray beans, no fiber at all. So while the baby may not wish to be in the same room with the mother, it is highly unlikely that the baby will get gas from the high-fiber food ingested by mom.

Spicy foods, onions, and garlic do flavor mothers’ milk.  Research has been done on what babies taste and smell at the Monell Institute, right here in Philadelphia! Do you think that flavoring the milk is a bad thing?  Perhaps we should feel sorryfor the poor formula-fed baby who is deprived of the variety of flavors that his breastfed buddies enjoy!  The milk will be flavored by the spices in mom’s food, but it will not be hot!  No need to offer baby water to drink after mom’s chicken curry.

Sushi is a food that needs to be eaten with caution at all times.  It is important that the fish is fresh and the food is well-prepared.  If the food is safe for mom to eat, then it’s safe for mom to breastfeed.

Chocolate is a food frequently on the mothers’ avoidance list.  However, unless a mother consumes a pound or more chocolate at a sitting, chocolate is perfectly safe.
It can do wonders for mom’s general attitude toward life (but may slow the gradual, natural weight loss that nursing mothers usually enjoy.)

Caffeine is one of the most studied of all drugs.  Less than one per cent of the caffeine mother ingests is present in her milk.  The American Academy of Pediatrics has classified coffee
as “compatible with breastfeeding.”  Many motherswill agree that this news is worth waking up for.

And what of the often-heard advice that a mother should drink lots of water to increase her milk supply?  Nature tends to protect the youngest generation.  Generally, a mother needs to be truly dehydrated before her milk supply will be more fluids will send her to the bathroom more often, but will not have a direct effect on milk supply.

So, what should mom eat and drink?  As breastfeeding is a “normal” activity, she can eat a “normal” diet.  Mom should choose good foods that she enjoys, and drink enough that she is not thirsty.  This will help her feel her best as she enjoys caring for and feeding her baby!