A resource for breastfeeding moms and their families.

Transcription

1 A resource for breastfeeding moms and their families.

2 Table of Contents Page Introduction 1 Breastfeeding: Best for Baby and Mom 1 Milk From Breast to Baby 2 In the Beginning 3 Positions for Breastfeeding 3 Getting Off to a Good Start 4 Getting Ready 6 Getting Started 6 Checking the Latch 7 How to Unlatch 8 How Often to Breastfeed 8 How Long to Breastfeed 8 Signs of Baby Getting Enough Milk 9 Breast Compression 9 Sleepy Babies and Fretful Babies 10 Burping Your Baby 10 Baby s Output: Wet Diapers and Stools 11 Infant Weight Gain 11 When to Get Help! 12 Looking After Mom 12 Points to Ponder 13 Caring for Breasts 14 Common Concerns 14 Storing and Freezing Breast Milk 17 Thawing and Warming Breast Milk 17 Types of Breast Pumps 18 Your Partner (or Support Person) 19 Frequently Asked Questions 19 Where to Get Help 22

3 Introduction Congratulations! You may be thinking about it or have already made the choice to breastfeed. This handbook provides you with an excellent comprehensive overview about breastfeeding. Even though breastfeeding is a natural and beautiful experience a mother will share with her baby, you may need time to practice it. Know that there are many services available to help you along. Skin to skin contact with your baby is an ideal way to get started. Your baby being close to you (naked with a diaper not wrapped in blankets) promotes the most secure environment for your baby to feed. In fact, there are many positive effects for babies who are kept skin to skin immediately after birth for at least an hour. These effects include: More likely to latch on More likely to latch well Have more stable and normal skin temperatures Have more stable and normal heart rates and blood pressure Have higher blood sugars Are less likely to cry Are more likely to breastfeed exclusively longer Immediately after birth, the nurses and your Health Care Provider check to make sure your baby is healthy. These are important things that may take a few minutes. They will make sure your baby can breathe well, weigh and measure him and give your baby some important medicine. You may want to talk with your Health Care Provider about skin to skin contact before you deliver your baby and any special wishes you may have (for you and your baby). Breastfeeding: Best for Baby and Mom Best for Baby Provides the best food that is always fresh, ready and the right temperature. Increased protection against ear, chest and stomach infections. Protects against meningitis. Increased protection against allergies. Increased protection against illnesses such as childhood Asthma, Diabetes, Crohn s Disease, Celiac Disease, childhood cancers, obesity and cardiovascular disease. 1

4 May increase protection against Sudden Infant Death Syndrome (SIDS). Helps to promote proper jaw and teeth. May promote better brain development. Best for Mom Helps the uterus to return to normal size and controls bleeding after birth. Helps use up extra fat gained during pregnancy. Helps protect against cancer of the breast and ovary. Helps to protect against bone loss (osteoporosis) and hip fractures in later life. Saves money and time with no commercial infant formula to buy or prepare. Less garbage in our world (better for the environment). Milk From Breast to Baby The birth of the baby triggers the breast to make milk. What keeps it going is the baby suckling and removing milk from the breast. BABY NURSES EFFECTIVELY BREASTS MAKE MORE MILK BREASTS MAKE MILK BABY NURSES MORE Breast milk is made in the alveoli throughout the breast. The milk flows along ducts to the collecting sinuses under the nipple and areola. Each breast has 15 to 25 duct systems. The milk flows through the ducts by means of a letdown reflex. At each feeding this letdown may take just seconds or up to a few minutes to start. Some mothers, but not all mothers, feel this as a tingling around the nipples. Being comfortable and relaxed helps the milk flow. 2

5 Alveoli (milk sacs where milk is produced) Milk ducts (tubes through which milk travels) Collecting sinuses (where milk collects) Nipple Areola (the dark area around the nipple) In the Beginning... When to Start Nurse your baby as soon as you can after birth. Newborns are often alert and ready to nurse right away. Think of this first breastfeeding as a learning experience for you and your baby. The warmth and closeness will be special for you both. At first, your breasts produce small amounts of colostrum. It is an easily digested yellowish fluid, which is rich in nutrients and helps to protect your baby from infections. Sometime between the second and the fourth day postpartum, the colostrum begins to change to breast milk. This milk may look thin and bluish but is full of nutrients and is the perfect food for your baby. Ask for help in getting your baby positioned and latched on to you breast. A good position and latch every time your baby nurses will help prevent nipple soreness and keep a good milk supply. When your baby s mouth is opened wide around the areola, his jaws and tongue squeeze and stroke the milk into his mouth. Positions for Breastfeeding Modified Cradle Position This position is helpful when learning to breastfeed or if you have a small baby. If feeding from your right breast, rest the baby on your left forearm. Support the whole back of the baby s neck and head below his ears. Bring the baby across to your right breast, making sure he is on his side with his tummy facing your tummy. Use your opposite hand to support your breast by making a C with your hand and cupping close to the ribcage. Bring the baby to your breast. Once the baby is latched on, you can switch to the cradle position for comfort. 3

6 Cradle Position This position works well after you are comfortable with breastfeeding. Lie the baby on her side with her whole body facing you. Rest baby s head in the bend of your arm with her head tilted back. Support the baby s back with your forearm. Hold the baby s bottom or leg. Use your other hand to support your breast by making a C with your hand and cupping close to the ribcage. Bring the baby to your breast. Football or Clutch Hold This position is recommended for mothers who have large breasts, have had a caesarean section or have a small baby. Tuck the baby s legs under your arm. Hold the back of baby s head below his ears. Support your breast with your other hand, again by making a C with your hand and cupping close to the ribcage. Bring the baby to your breast. Side Lying Position This position works well if you find it too painful to sit, if you want to rest when breastfeeding or if you had a caesarean birth. Lie partly on your side. Use pillows for comfort. Lie your baby in the bend of your arm, facing you and his mouth at your nipple level. Use your other hand to support your breast. Bring the baby to your breast. Any comfortable, supported position is fine as long as the baby is latched on correctly. Sometimes it is helpful to try different positions while you and your baby are learning. Getting Off to a Good Start Breastfeed Early Breastfeed as soon as possible after birth. Your baby is most awake and ready to learn how to breastfeed during the first two hours after birth. Breastfeeding early will help you make more milk. 4

7 Breastfeed Right In the hospital, ask your nurse to help you put your baby onto your breast. Get help right away if you are having breastfeeding difficulties. Look for Community Resources (at the back of this handbook) for supports once you are home. Do not give your baby soothers or bottles unless medically necessary. If you decide to use these, it is best to wait until your baby has learned to breastfeed. This often happens by 4 to 6 weeks of age. Giving a soother or bottle too early may cause your baby to have trouble latching on to your breast and could make breastfeeding painful or even impossible. Breastfeed Often In the first months most babies will breastfeed well at least 8 times a day. This can be every 1½ to 3 hours. It is common for babies to have many feedings in a short period, then sleep longer between feeds at other times. This is called cluster feeding. There are no set times to feed your baby. Feed your baby when he is showing signs of hunger. These pictures are an example of your new baby s stomach size and how much milk it can hold. This reinforces that commercial infant formulas are not always needed. For example, colostrum (the early golden milk) is more than enough for most new babies. This also helps to show why infants feed so often, as their tummies can only hold so much milk each feeding. Small Marble Shooter Marble Ping Pong Ball Small Marble = Stomach capacity of a newborn on Day 1 Shooter Marble = Stomach capacity on Day 3 Ping Pong Ball = Stomach capacity on Day 10 Softball = Stomach capacity of an adult 5

8 Breastfeed Only Give your baby only breast milk. No extra drinks or food are needed for a healthy baby for the first 6 months of life. Extra drinks or food before this time can fill the baby, slow down your milk supply and may affect your baby s health (for example, your baby may develop increased risk for allergies). You may choose to breastfeed for up to two years of life and beyond. Getting Ready Feeding Cues Your baby will show one or more signs of being ready to feed, even if still very sleepy, Rapid eye movements. Makes sucking movements with her mouth. Moves hands to mouth. Overall body movement. Makes small sounds. It is best to feed your baby before she is too upset and crying loudly. Get comfortable and find a position that works well for you. Get clothing, yours and baby s, out of the way. Getting Started Position yourself comfortably with pillows to support your back and arms. Position your baby on a pillow with his head at the level of your breast and his mouth at your nipple. Massage your breast prior to feeding (massage is a useful technique to stimulate letdown and to help improve plugged ducts). To do massage, support the breast using the C hold, or with one hand on top and one underneath. Apply gentle pressure by moving the fingers along the breast towards the nipple. Rotate around the breast to ensure all areas are massaged. Tickle your baby s lips with your nipple pointed upward and wait for him to open his mouth wide (like a yawn) with his tongue down and out. 6

9 Bring your baby towards the breast chin first, catching the bottom lip on the breast approximately 1 (2.5 cm) away from the base of the nipple. Guide the top lip up and over the nipple, landing on the breast just above the nipple. Baby s chin should be on your breast. Baby s mouth should cover lots of the dark area around your nipple. Be patient. It may take a few tries each time to get it right. If needed, take a few minutes to calm your baby and yourself. Then try again. Checking the Latch A good latch should not hurt if you feel nipple pain, unlatch the baby and try latching again. Baby s mouth is wide open with top and bottom lips turned out. (Think breastfeeding not nipple feeding!) Baby s head is slightly tilted so chin is pressed into breast. The baby s nose will be lightly touching. Apply pressure between baby s shoulders versus her head in order to tilt her head back. The feeding begins with little sucks progressing to sucks that become deep and slow; there should be a pause during the suck when the baby s mouth opens the widest. The longer the pause, the more milk baby is getting. On average, there should be at least minutes in total of this deeper and slower type of suck at each feeding. You may hear gulping sounds or quiet sounds like ca or eh when the baby swallows. Your should not hear clicking or smacking with a good latch. If you are unable to identify swallowing, seek help from a breastfeeding professional. A good latch feels right. Breastfeeding should not hurt. In the early days, the first few sucks may be a little uncomfortable as the baby stretches the breast far into his mouth. This discomfort will not continue through the whole feeding and should disappear after the first week. 7

10 How to Unlatch Keeping your baby close to your breast, insert your forefinger or pinky finger into the corner of the baby s mouth, sliding your finger alongside of the breast far enough inside the mouth that you hear a gentle popping sound (suction/seal is broken). Quickly slide the baby away from your breast. How Often to Breastfeed The first feeding should be as soon as possible after delivery. It is important that your baby feeds frequently (every 1 to 3 hours) in the first few days. Newborns are often sleepy and need to be awakened and encouraged to feed. If your baby is unable to feed, pumping within the first 6 hours is recommended. After the first few days, your baby should be waking and showing signs of hunger on her own. If your baby is not, you may need to wake her to ensure she is feeding at least 8 to 12 times in 24 hours until back to her birth weight. After about two months you may be nursing 6 to 8 times in 24 hours. Remember, babies grow quickly and have times when they are hungrier and need more nursing. Growth spurts commonly occur at 3 and 6 weeks and 3 and 6 months, but may vary. How Long to Breastfeed At the start of the feed, your baby will have shallow and quick sucks. When your milk starts to flow the sucks should become deep and slow. There should also be a pause during the suck when your baby s mouth opens the widest. Your baby is drinking milk during this pause. Your baby may only feed a short time on the second breast or not at all. The length of nursing time varies with the age and nursing style of the baby. Feedings average 20 to 30 minutes, but may be shorter or longer. At the next feeding, begin by offering your baby the breast he last fed on. Often this breast feels the fullest. Ideally, in the first 4 to 6 weeks you should breastfeed only so that your baby will learn to breastfeed well. Do not give your baby soothers or bottles unless medically indicated. 8

11 Signs of Baby Getting Enough Milk Infant: Continuous, rhythmic suck/swallow pattern with occasional pauses. Swallowing can be heard. Relaxed arms and hands. Moist mouth. Satisfied after feeding. Mother: Strong tugging at breast which is not painful. Thirst. Contractions of the uterus or increased lochia (bleeding) flow during or after feeding for the first few days after birth. Relaxation or drowsiness. Milk leaking from the opposite breast while feeding. Breasts softening while feeding. Nipple looks longer after feeding, but not pinched or raw. Breast Compression Breast compression is applied to the breast while the baby is breastfeeding to increase and maintain milk flow. This can be useful to moms until milk is well established. It especially works in the early days before milk volume increases. Hold the baby with one arm, thereby freeing up one hand. With the free hand, hold the breast, thumb on one side, fingers on the other, keeping back close to the chest wall, clear of the areola. When the baby s sucking slows, when there are several sucks before a swallow or when the baby begins to fall asleep, compress the breast by squeezing the breast. The pressure should be firm but should not hurt. Hold the squeezing action until the baby stops sucking and swallowing, and then release. 9

12 If the baby continues to suck and swallow, do not compress again. If the swallow decreases, then compress again. Continue until the baby fails to swallow even with the compression applied. Sleepy Babies and Fretful Babies If your baby is sleepy Keep the baby close so he can feed frequently. Babies will breastfeed more often if they are kept skin to skin on mother s chest. It will be easier to feed him when he shows signs of lighter sleep and hunger cues. (refer to page 6) Some other suggestions: Unwrap and undress your baby. Talk to him. Change the diaper if wet. If he seems sound asleep, sit him up and lie him down by bending him at the hips with one hand while you support his back and head with the other hand (like sit ups). Most babies will start to waken if you continue these bend and stretch movements for a few minutes. Express a little milk from your nipple so when you bring him to the breast there is something to tempt him. Lift him to your shoulder and rub his back, or stroke the soles of his feet. Wipe baby s face and head with a damp cloth. Burping Your Baby A breastfed baby does not swallow as much air as a bottle fed baby but will still need to be burped. Air in her stomach can cause pain. Try to burp your baby once during a feeding (when changing breasts, if your baby seems uncomfortable or if she falls asleep too soon) and at the end of the feeding. Not all breastfed babies burp. Usually trying for 5 minutes is adequate. To burp your baby, support her head and pat or rub her back. A bubble can come up easier if the back is straight. Some babies spit up after feeding. As long as your baby appears contented and gains weight as the weeks go on, don t worry about the spit up now and then. 10

13 Baby s Output: Wet Diapers and Stools Baby s Age Wet Diapers Each Day Stools Each Day 1 day old At least 1 wet diaper. (A wet diaper is as heavy as 3 tablespoons of water.) 2 days old At least 2 wet diapers. On day 1 or 2 only, some babies have orange or red urine. At least 1 black and sticky/tarry stool. At least 3 or more black and sticky/tarry stools. 3 days old At least 3 heavy wet diapers. 3 or more stools which begin changing to a greenish colour. Stools then start the process of changing to yellow and seedy. 4 days old At least 6 heavy wet diapers. 3 or more stools (in the process of changing to a yellow and seedy appearance). 5 days old and beyond At least 6 to 8 wet diapers. 3 or more stools. Now yellow and seedy. If your baby is not producing the number of wet diapers or stools a day as listed on the chart above, you should see your Health Care Provider or breastfeeding professional as soon as possible. Dehydration can happen quickly in infants and can lead to serious complications. After 1 month, some breastfed babies may have very large, yellow stools every 1 to 2 days or may have none for as long as 12 days. It is normal for some breastfed babies to make some small and some large stools each day. Infant Weight Gain A good indicator that your baby is getting enough milk is their weight gain. Here is a general guideline for normal infant weight gain of a healthy full term breastfed baby. First 2 weeks Some infants lose up to 7% of their birth weight; should begin gaining by day 5 and back to birth weight by 14 days of age. 2 weeks to 4 months 4 7 ounces or grams per week. 4 6 months 4 5 ounces or grams per week months 2 4 ounces or grams per week. 11

14 Breastfed babies should be seen by their doctors within the first 7 days of life. When to Get Help! If your baby does not show weight gain, contact your Health Care Provider or breastfeeding professional. NOTE: You may weigh your baby by utilizing a scale available at some OEYC/Breastfeeding Clinics. (see page 22) Your baby has less than 3 stools a day. (see chart at page 11) Your baby is has less than 6 8 wet diapers a day. (see chart at page 11) Your baby s urine appears dark in colour. Your baby has not fed well for 2 consecutive feeds. Your baby is feeding less than 8 times in 24 hours. You cannot tell the difference between sucking and swallowing. Your baby is sleepy and it is difficult to wake him for feedings. You are experiencing sore nipples. You have the signs and symptoms of mastitis. (see page 16) You are thinking of using a breast shield. You are thinking about using a supplement (commercial infant formula). Your breasts remain hard and full after a feeding. You are having difficulties with breastfeeding and are in need of support. We know breastfeeding is the best way to feed your baby. At times you may become frustrated or concerned. Do not hesitate to seek help right away. Babies can become dehydrated very quickly so be sure to seek help if concerned. As mentioned, your baby should be seen by a Health Care Provider within one week of life. In some cases, you may need to have your baby evaluated sooner. Looking After Mom Breastfeeding requires extra energy (an extra 500 calories of nutrient-rich food); therefore eat according to your appetite with a balanced diet according to 12

15 Canada s Food Guide. Include an extra 2 3 food guide servings each day while pregnant and breastfeeding. FOOD GROUP SERVING NUMBER EXAMPLES OF SERVING SIZE TRY TO CHOOSE Milk & Alternatives 2 servings 1 cup (250 ml) milk ¾ cup (175 ml) yogurt 50 g cheese Lower-fat milk products more often Vegetables & Fruit 7 to 8 servings including at least 2 vegetables ½ cup (125 ml) vegetables or fruit ½ cup (125 ml) juice 1 medium potato, carrot, tomato, peach, apple, orange Dark green and orange vegetables and fruit more often Meat & Alternatives 2 servings 50 g to 100 g Leaner meats, poultry and fish, as well as dried peas, beans and lentils more often Grain Products 6 to 7 servings whole grain or enriched 1 slice bread ¾ cup (175 ml) cooked or 30 g cold cereal, ½ bagel, pita or bun, ½ cup (125 ml) cooked rice/pasta Whole grain and enriched products more often Points to Ponder Do not diet while breastfeeding. Dieting may make you feel more tired and could reduce your milk supply. You do not need to drink extra fluids to produce enough milk. Drink to thirst. Choices should include milk, water, juice and non-caffeinated beverages. Limit your intake of coffee, tea, chocolate and cola. These products contain caffeine which appears in your breast milk and is passed to your infant. Herbal teas and herbal energy drinks should also be avoided as their safety in breastfeeding has not been determined. Alcohol also appears in breast milk and can be passed to your infant. Since there is no known safe level, it is best to avoid alcohol while breastfeeding. For more information about alcohol and breastfeeding, contact Motherisk at

16 Some babies react to foods in their mother s diet with extra fussiness or a lot of gas. If you think something you are eating bothers your baby, omit it for a week or two and then try again. It takes 4 to 6 hours for a substance mother ingests to reach her breast milk. Sometimes your body needs rest to continue with ample milk production. Resting when your baby naps and relaxing frequently will help you maintain an ample milk supply. All babies being exclusively breastfed require a vitamin D supplement. Please speak to your doctor. Caring for Breasts Bathe daily as usual. Try not to use soap on your nipples. Soap may dry your nipples and cause them to crack. After breastfeeding, express some breast milk onto the nipples and dark area around them to help protect the skin. Let the milk dry before putting on your bra. If you use breast pads, change them at each feed or if wet. Avoid using breast pads with plastic liners unless necessary for modesty when in public. Wear a bra that fits well and is not too tight. Do not wear a bra with under wires. A finger should slip between the fabric and your skin. A bra that fits too tightly can cause blocked ducts and may lead to a breast infection called mastitis. Cotton nursing bras allow air to circulate to the nipples, which is good for the skin. Cotton/spandex blends are accommodating to the changing size of breasts during pregnancy and postpartum. Breasts tend to increase one bra size during pregnancy (for example, 34 to 36 and B cup to C cup). Breast size can also increase temporarily right after having the baby. Common Concerns Always consider getting help from your Health Care Provider or breastfeeding professional. (see page 22) Engorgement As the milk volume increases, your breasts may become full, hard and painful for one or two days. Nursing your baby as often as every 1½ to 3 hours can help to manage this. 14

17 Other suggestions: Apply warm water (cloths, shower, bath) to breasts, then massage whole breast gently before nursing. Express some milk to soften the area around the nipple before nursing. This makes it easier for your baby to latch on correctly. If you have engorgement that lasts longer than 24 hours or you cannot latch your baby, seek help. Try a different nursing position to ensure a good latch. If the baby does not latch, or your breasts remain hard after feeding, pumping can ensure adequate drainage of the breast. Use cold packs around breasts after nursing for up to 10 minutes (chilled gel packs, ice chips or frozen peas in a bag). Sore Nipples If your nipples become sore (cracked or blistered), this may be due to a poor latch or poor position. Review Checking the Latch at page 7. Start feeding on the side that is less sore. Express some milk, before the baby latches, to start the flow. Express sore side for a feeding or two to allow time for healing. Your baby may feed more often when feeding only on one side. You may wish to use pure lanolin (Lansinoh, Pure Lan). Apply a thin coating after feedings. Ask a breastfeeding expert to check your nipples and the baby s latch while nursing, as well as for other advice. Thrush Thrush is an infection caused by yeast. Yeast lives in and on our bodies and when it overgrows, it can cause problems. Yeast grows in warm moist areas. 15

18 If you have thrush, you may experience sore nipples, burning or itching after a long time without any pain during breastfeeding. Your nipples may look pink or red, shiny or flaky and/or have a rash with tiny blisters. You may have shooting pain in the breast during and after feeds. Your baby may have white patchy areas on her gums, tongue and inside cheek. It does not come off when wiped gently with a clean cloth. The diaper area may be reddened and your baby may become cranky. Baby and mom must be treated at the same time even if only one has symptoms. See your Health Care Provider. You may need to consult with a breastfeeding expert if the thrush is difficult to eradicate. Plugged Ducts Sometimes you feel a sore spot when a milk duct gets plugged. You may also have a mild fever but no flu-like symptoms. Get plenty of rest. Apply warm cloths. Nurse on the sore side first. Massage gently toward the nipple during nursing. Make sure your bra is not too tight. Do not lie on a sore breast. Nurse baby every 1½ to 3 hours. Position your baby so her chin points to the sore area. Avoid tight clothing. Mastitis Mastitis is an infection of the breast that may occur in breastfeeding mothers. You may have a red area or streaks on your breast or experience tenderness. If you feel sick, hot all over, shaky or achy, call your Health Care Provider right away. Visit a breastfeeding clinic. Get plenty of rest. Continue to nurse baby every 1½ to 3 hours. Drink more fluids, such as water, juices, milk, soups. Nurse with baby s chin pointed toward sore area. It is safe to continue to breastfeed. Take medication as prescribed by your Health Care Provider. You may require antibiotics. 16

19 Storing and Freezing Breast Milk Freshly Expressed Breast Milk Can be Safely Stored At room temperature (up to 77 degrees F) for 6 to 8 hours. (If not freshly expressed, it must be refrigerated immediately). In the refrigerator for up to 8 days. Store in back of the refrigerator where the temperature is coolest. In an insulated cooler bag with ice packs for up to 24 hours. In a deep freezer for 6 to 12 months. In the freezer above, below or beside the refrigerator for 3 to 6 months. In the freezer compartment located inside the refrigerator for 2 weeks. Thawing and Warming Breast Milk Always use the oldest milk first. The baby may drink the breast milk cool, at room temperature or warmed. Breast milk may be thawed by placing the frozen milk in the refrigerator the night before, or by placing under warm running water or by placing in a bowl of warm water. Breast milk should never be heated in a microwave or on a stovetop. It may destroy the protective properties in the breast milk. The container should be swirled gently to mix the cream back in and to distribute the heat evenly. Do not save milk from a used bottle for use at the next feeding. Any milk left in the bottle should be discarded. Never refreeze breast milk once it is thawed or partially thawed. 17

20 Types of Breast Pumps Electric Pump ( Hospital Grade pumps available at hospitals and some pharmacies) Best pump to use if you cannot be with baby. Can pump both breasts at the same time. It will take less time to pump and will result in more milk production. Is often rented because it costs the most money. Some workplace insurance plans may cover the cost of renting the pump. Battery Operated Pump or Store Purchased Electric Pumps Good pump to use if you plan to pump for a short time or only once in a while. This breast pump cannot replace the baby at the breast. Can be used with one hand. Is easy to carry. Need to replace batteries often. (It is best to buy one that can also be plugged into an outlet.) Manual Hand Pumps Good pump to use if you plan to pump for a short time or only once in a while. This pump cannot replace the baby at the breast. Some can be used with one hand, and others with two hands (depends on the type of pump). Is easy to carry. Costs the least money. DO NOT use a pump with a rubber bulb. The suction on this pump is too strong and can damage your nipples. Contact local breastfeeding clinic for information regarding breast pumps. 18

21 Your Partner (or Support Person) Mothers are best at breastfeeding, but your partner/support person has special talents too. Changing the baby s diapers, bathing baby, carrying baby in his arms or in a carrier, singing to the baby, taking the baby for walks, massaging the baby, talking to the baby, burping the baby are some of the wonderful ways for your partner/support person to create a close and loving relationship with your baby. Your partner/support person can play a big role in supporting and encouraging you with breastfeeding. Partners/support persons who understand the benefits of breastfeeding want your baby to have the best. Relationships You and your partner will find that your relationship is different now that you have become a family. With family growth comes change. This may include role changes, compromising, planning ahead or being spontaneous when the opportunity is there. These changes may affect your sexual relationship. Mother s interest in sex is often less after having a baby but it will gradually increase as baby grows. Remember she has had nine months of hormonal and physical changes to prepare her for this baby. For the father the baby may not have seemed quite real until she was born. His attachment to the baby will grow with time and dad will enjoy the new family he has helped to create. Frequently Asked Questions About Breastfeeding Q. What should my baby s stools be like? A. Your baby s stools will have a mild smell and will usually be loose and seedy. They may be yellow, tan or dark green in colour. In the early weeks, your baby should have at least 3 bowel movements per day or may pass stool with every feeding. After the first month your baby may have fewer bowel movements and may go as long as 4 to 12 days. This is not constipation unless the stools are hard and dry. Many babies strain, grunt and get red in the face when they are trying to have a bowel movement, even when it is very soft. This is normal. 19

22 Q. Should I give my baby vitamins? A. At this time the Canadian Paediatric Society recommends giving all breastfed babies Vitamin D drops. Talk to your Health Care Provider about this. Q. Should I give my baby anything other than breast milk? A. Breast milk is all your baby needs until he is 6 months old. Your baby does not need water, other drinks or solid food until this age. Until 6 months, solid foods are not well digested, may lead to allergies and will cause him to take less breast milk. Q. Is it safe to breastfeed if I am taking medicine or if I am sick? A. In almost all cases, it is safe to continue breastfeeding. However, some medications are not safe while breastfeeding. Speak to your doctor and/or pharmacist. For additional information call: The Parent Talk Information Line , ext or , ext 7555 Motherisk Q. How long should I breastfeed? A. This is a personal choice. There is no right answer. The World Health Organization recommends giving only breast milk for the first 6 months. They support breastfeeding to continue with the introduction of other foods for up to 2 years and more. 20

23 Q. Are there foods and beverages I should avoid when breastfeeding? A. There are no foods that you must avoid when breastfeeding. Some babies react to foods like onions, garlic, cabbage and spicy foods by causing a lot of gas or fussiness. Caffeine should be limited to 300 mg per day (less than two cups of percolated coffee). Don t forget caffeine can also be found in tea, chocolate, energy drinks and cola. Herbal teas and herbal energy drinks should also be avoided as their safety in breastfeeding has not been determined. Q. Can I have an alcoholic drink while breastfeeding? A. Alcohol does appear in breast milk. Since there is no known safe level, it is best to avoid or limit the amount of alcohol you drink while breastfeeding. For additional information call: The Parent Talk Information Line , ext or , ext 7555 Motherisk Q. If I smoke should I still breastfeed? A. Nicotine can enter the breast milk. If you smoke, breastfeeding will still be good for your baby. Nicotine has been shown to cause fussiness in babies. As well, nicotine can lower your milk supply and affect your let down. If you are concerned, try to cut down on the number of cigarettes you smoke. Ensure that you smoke outside and away from your baby. Q. Could I become pregnant while breastfeeding? A. Yes, you could become pregnant while breastfeeding. It is recommended that you use a reliable form of birth control. Breastfeeding can be an effective method of birth control; however, there are very strict guidelines to follow. Contact your local La Leche League or breastfeeding expert for more information. 21

24 Where to Get Help Niagara Region Public Health Department Parent Talk Information Line , ext or Monday to Friday 8:30 am to 4:30 pm , ext 7555 Niagara Region Public Health Department Community Breastfeeding Clinics are located at Ontario Early Years Centres (OEYC) Call your local centre for an appointment St. Catharines Call Parent Talk Information Line , ext or for an appointment at YMCA , ext 7555 Niagara Falls Mary Ward School Welland Central United Church Port Colborne Port Cares (alternate Tuesdays) West Lincoln Memorial Hospital, Grimsby Joseph Brant Memorial Hospital, Burlington St. Joseph s Hospital, Hamilton pager 791 Hospital for Sick Children, Toronto Niagara Health System **Toll free number for all sites Niagara Falls Site , ext St. Catharines Site , ext Welland Site , ext La Leche League Leaders Web Sites Contact Your Health Care Provider 22

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