Breastfeeding for the new mother

Breastfeeding

For women everywhere

Media

Join the Boob-O-Lution [Breastfeeding]

Objectives

1. Describe the different kinds of milk 2. Recognize correct attachment techniques and positions 3. Identify the proper technique to get a baby to latch and what a good latch is 4. Learn to evaluate good breastfeeding techniques and habits 5. Understand some of the benefits of breast feeding for the infant and mother

Preknowledge

Ever wonder how the nation is doing as a whole in terms of breastfeeding? Wonder no more, this is an overview to get you thinking about breastfeeding on a national scale. The Center for Disease Control (CDC) has a report card on breastfeeding for the nation. So, how are we doing... http://www.cdc.gov/breastfeeding/pdf/BreastfeedingReportCard2010.pdf

Question

Do you know the nutritional benefits and facts for the baby and mother who breastfeed? Infant Nutrition 1. species specific An ideal balance of nutrients, efficiently absorbed 2. Higher levels of fatty acids, lactose, cystine, and cholesterol necessary for brain and nerve growth 3. Composition will vary depending on gestational needs 4. Long term benefits such as decreased risk for diabetes, cancer, obesity, asthma 5. Contains unsaturated fats 6. Infant determines volume of milk consumed Maternal health 1. Faster return to pregnancy weight 2. Breastfeeding associated with lower risk of breast, ovarian cancer Here's some extra information regarding breastfeeding and mother nutrition http://www.nal.usda.gov/wicworks/Topics/BreastfeedingFactSheet.pdf

Did you know

That breast milk comes in many different forms to benefit the baby at different stages of growth... Foremilk This is the milk that flows from the breast at the beginning of feeding. It is watery and high in protein. Hindmilk Rich in fat, this milk is the milk that is excreted during the “let down” (ejection of milk) process of breastfeeding. Colostrum This is the initial milk that begins to be developed during midpregnancy. It is packed with nutrition and has a thick, creamy yellowish fluid with concentrated amounts of protein, fat-soluble vitamins. It also contains antioxidants Transitional Milk It is light yellow in color but is more copious than colostrums and contains more fat, lactose, water soluble vitamins, and calories. Mature Milk Is white or slightly blue tinged in color. It is present in 2 weeks postpartum and continues thereafter. The contents of mature milk are 13% solids such as carbohydrates, proteins, and fats and 87% water.

Reading

A lesson on positioning and latching A. Positioning Whatever position the mother should choose should be comfortable and safe for the infant. Here are some key points to keep in mind: • Make sure the infant is in a light REM sleep. It is recommended that the baby is not crying. If the baby is sleeping it is important to remember that it may not take to the breast. Undressing the baby may help to awaken it and or a gentle massage to the baby’s feet. • Hold the baby tummy to tummy with the mother and support with pillows. • The mother should be in a comfortable sitting position, supporting her back. When offering the breast to the baby, the mother can hold her breast with all for fingers below and thumb above the breast. This is called the c-hold. • Making sure her fingers and thumb are not on the areola. This is so the baby has an unobstructed path to latch to the nipple. What follows are some of the positions to hold a baby in: 1. Modified cradle position a. Mother sits upright with good body position. Using pillows for support, she bring baby up to breast making sure to not learn over baby b. Place baby on mothers lap with baby facing mother. Line baby’s nose to mothers nipple. c. Left breast feeding. Mother uses right hand to support baby’s neck d. With left hand mother can offer the breast 2. Cradle position a. Mother sits upright with good body position. Using pillows for support, she bring baby up to breast making sure to not learn over baby b. Place baby on mothers lap with baby facing mother. Line baby’s nose to mothers nipple. c. Craddle the baby with left arm d. With free right hand mother can offer her breast 3. Football hold position a. Mother sits upright with good body position. Using pillows for support, she bring baby up to breast making sure to not learn over baby b. Left breast feeding have mother hold baby heading baby into feet first position with baby’s bottom on pillow c. Turn baby on side facing mothers breast d. Mothers left arm securely clutches baby close to her e. Mothers left arm supports baby’s left hand 4. Side Lying Position a. Mother lies on side b. Baby lies in side lying position next to mothers side with baby facing mothers nipple c. Mothers free hand can offer breast and mother can then rest in a comfortable position. Media The 3 P's of breastfeeding; Position, Position, Position... [Video on Positioning and other helpful hints] B. Latching C-Hold The purpose of the C-Hold is to ensure that the breast is held in a proper position to ensure optimal breastfeeding for the baby and comfort for the Mom. It is important in this position to be prepared so that as soon as the baby opens their mouth to begin feeding Mom is ready. The C-Hold is done by using the fingers and thumbs to make a C shape, and then placing the C around the areola with the thumb at the 12 o’clock position and the fingers at the 6 o’clock position. It is important that Mom is very careful about where the fingers are placed. They should be about 1 ½ inches away from the nipple to ensure that the baby is able to get the entire nipple in the mouth. Not grasping enough of the nipple is considered a shallow grasp and this can cause nipple pain. U-Hold The U-hold position follows the same principles of the C-Hold, but the positioning of the thumb and fingers are at different points. In this hold, Mom should make a C-shape with the fingers, but place the thumb at 3 o’clock, and the fingers at 9 o’clock. Again, it is important to make sure that the fingers are not blocking the areola so that the baby can get a full latch and nipple pain is reduced. This position may be more comfortable because Mom’s arm is against her body instead of sticking out as is the case in the C-Hold. Scissor Hold This hold consists of using two fingers from the side as if cutting the nipple with the fingers. This position is challenging for some women because it may be difficult to ensure that the fingers are not on the areola. It is also important to not press to hard in this position so that milk flow is not obstructed. Rooting and Attachment After the position and the hold have been established, the baby is ready to begin nursing. The next step is to ensure that attachment occurs correctly. The nipple should not be centered in the mouth. Instead, the nipple should be towards the roof of the mouth so that when the baby closes their lower jaw the nipple is compressed against the roof of the mouth to excrete milk. It is important to understand that the jaw is a hinge joint, and the top of the mouth is not able to move in order to create proper attachment. It may help to align the nose of the infant to the nipple, and tilt the head backwards to that the nose is slightly facing up. This will help with attachment. After attachment is accomplished, the rooting reflex will occur. Take the nipple and stroke the lower lip. This will stimulate the baby to begin to suck and move the muscles of the mouth. The initial response may not be latching, but Mom should continue to stroke the baby’s lower lip so that once the baby is ready, latching can occur. The stroking of the lip initiates the rooting reflex. It is also important to ensure that the baby is awake enough to feed. If the baby is not alert, latching might not occur properly. Media What moms are saying about latching [Ask Mum Video: Latching On]

Self Assessment

If a baby is getting enough milk they will probably: 1. They are nursing at least eight times in 24 hours 2. In a quiet room, their mothers can hear them swallow while nursing. 3. Their mothe’s breatst appear to soften after breastfeeding 4. The number of wet diapers increases daily until the fourth or fifth day after birth, and there are at leasrt six to eight wet diapers every 24 hours 5. Their stools are beginning to lighten in color by the third day after birth, or have changed to yellow no later than day 5 6. Offering a supplemental bottle is not a reliable indicator because most babies will take a few ounces I they are getting enough breast milk.

Web Resources

http://www.cdc.gov/breastfeeding/ http://www.fns.usda.gov/wic/breastfeeding/breastfeedingmainpage.HTM http://www.breastfeeding.com/ http://www.nlm.nih.gov/medlineplus/breastfeeding.html http://www.womenshealth.gov/breastfeeding/ http://www.aap.org/healthtopics/breastfeeding.cfm

References

• Davidson, M London., Ladewig, P. (2008), Old's Maternal - Newborn Nursing & Women's Health Across the Lifespan. Upper Saddle River, New Jersey: Pearson
• Wellstart International (2009) Lactation Mangement Self-Study Module Level 1, Third Edition, Shelburne, Vermont: Wellstart International.
• CDC (2010). Breast feeding report card – United States 2010. Retrieved November 14, 2010, from http://www.cdc.gov/breastfeeding/pdf/BreastfeedingReportCard2010.pdf
• WIC (2010). My pyramid in action: Tips for breastfeeding moms. Retrieved November 14, 2010, from http://www.nal.usda.gov/wicworks/Topics/BreastfeedingFactSheet.pdf