As you prepare to welcome your newborn, one of the most important decisions you will make is deciding how to feed your baby. Breastfeeding is considered best. If you have chosen to breastfeed, you can learn about it during one of Holy Name Medical Center's breastfeeding classes. Classes are held monthly in English and Spanish. Click here to view a calendar and to register.
After delivering your baby at Holy Name, skilled nursing staff members are available round-the-clock to assist you with breastfeeding.
Breast changes are one of the earliest signs of pregnancy. The breasts feel fuller as the milk duct system grows and the areola, the dark circle around the breast, grows and darkens. Nipples might feel tender, and breasts might be sensitive to touch. In some women, blood vessels in the breast become more prominent and visible. Breasts are fully functional to produce milk by the fifth or sixth month of pregnancy. Some women notice that their breasts leak a small amount of colostrum, the thick yellow or clear substance that is the baby's first food.
Once the baby is born and suckles at the breast, nerves that are stimulated around the areola send messages to the brain to produce important hormones to induce lactation – the making of milk. For the first few days, the breasts produce colostrum, which is thick and concentrated and full of important nutrients, vitamins and antibodies for the baby – a little goes a long way and baby needs very little to fill its tiny stomach. Gradually over 3-5 days, the colostrum transitions to milk, and the breasts begin to fill and feel firm.
Breastfeeding basically works on a supply and demand system. The production of milk is fully dependent on the stimulation of the breasts by the baby suckling frequently over the first few days. If there is little or no stimulation, the hormones will initiate little or no milk production. Babies need 8-10 feedings a day in order to satisfy their nutritional needs as well as stimulate the breast adequately to produce milk.
It is best to place the baby skin-to-skin with mom immediately after delivery or as soon as possible. Skin-to-skin means the baby's naked belly to mom's chest, belly or breast. This has many benefits to mom and baby and should be continued with every feeding for the first few days of life.
Nutrition - Breast milk is designed to meet the nutritional needs of all babies, including protein, carbohydrates, fats, nutrients and vitamins. It is easier to digest than formula and is custom made for each baby
Immunity - Breast milk provides immunity against infection and disease leading to fewer illnesses such as ear infections, shorter durations of illnesses and reduced mortality. Studies also suggest decreased rates of sudden infant death syndrome, insulin and non-insulin dependent diabetes, childhood cancers, multiple sclerosis, obesity, asthma and autoimmune diseases, such as Crohn's disease and colitis.
Social, emotional and cognitive development - Breastfeeding has been shown to strengthen bonding between mother and baby, increase cognitive ability and enhance visual development.
Emotional - Hormones produced to enable breastfeeding help mom relax and feel peaceful, leading to better quality sleep and lower incidence of postpartum depression.
Health - The hormone Oxytocin, released during breastfeeding, helps minimize bleeding after birth. It causes the uterus to contract, which helps return it to its normal size. Breastfeeding also burns an extra 500 calories a day, leading to easier loss of the weight gained during pregnancy. It reduces the incidence of multiple types of cancer, osteoporosis, heart disease, rheumatoid arthritis and insulin and non-insulin dependent diabetes.
Breastfeeding should be initiated within the first three hours of life, when the baby is alert and active and the instinct to feed is vibrant. After the first three hours, many babies fall into a deep sleep, and it is difficult to wake them to feed for several hours.
Colostrum is often referred to as "liquid gold" because it is so valuable and contains all the nutrients babies need in the first few days, as well as many substances that protect against infection. High in protein, colostrum may be thick as honey or more often, yellow or clear. Giving colostrum in the first hours of life gets baby off to a great start, providing a protective coating for the digestive system and starting the process of providing immunity while also helping to stabilize blood sugar levels.
The best time to establish a good latch is when the baby is wide awake. Mom's nurse will assist in positioning and latching the baby in a skin-to-skin position that is comfortable for both Mom and baby.
Breastfeeding should not be painful. Some soreness is common because nipples are not used to such constant stimulation, but bleeding, cracking, blisters and scabs are not a normal outcome of a good latch. The baby's mouth should be wide open, upper and lower lips flipped out and much of the areola in the baby's mouth. Mom should feel deep tugging, not pinching, biting or clamping, and the nipple should be as round when it comes out of the mouth as it was when it went in, not flattened or misshapen.
Mom should speak with her healthcare provider about alcohol consumption, and develop guidelines about what is safe for baby. Most healthcare providers will agree that an occasional alcoholic drink can be consumed safely during breastfeeding while taking specific precautions regarding timing and amounts.
Most medications are safe to take during breastfeeding, but it is important for mom to speak with her and baby's healthcare providers about what is safe to take. Please keep in mind that antihistamines and other over-the-counter medications that reduce secretions, for example, those used to treat a runny or stuffy nose, can also lead to lower milk supply, reducing the secretion of breast milk.
The American Academy of Pediatrics recommends breastfeeding for about six months, continuing as complementary solid foods are introduced for one year or more, and then for as long as mom and baby desire. The World Health Organization recommends breastfeeding up to two years or more. Medical contraindications to breastfeeding are rare.
Pumping in the first few weeks can help with engorgement or with low milk supply, but under normal circumstances is not necessary unless there is an expectation of separation between mom and baby. However, it is a good idea to start pumping and introduce a bottle of expressed breast milk by the end of the first month, so baby can get used to the sensation of feeding from a bottle when needed.
Fresh expressed breast milk can remain at room temperature up to 5 hours. After that, it must be refrigerated and can be used up to 5 days. If freezing breast milk, it is best to do that as soon after pumping as possible. It can be stored in the freezer for 6-12 months, depending on the quality of the freezer. Always store breast milk in the back of the refrigerator or freezer, and specifically, not on the door because opening the door raises the temperature of the items stored on it.
While breastfeeding does affect hormones and can delay ovulation and menstruation, many women do get pregnant while breastfeeding. This can be caused by combination feeding (formula bottles in addition to breastfeeding), skipping feedings regularly (i.e. skipping night feedings), or when solid food is started and baby relies on breast milk less for exclusive nutrition. It can even happen with exclusive breastfeeding, so it is recommended that mom consult with her physician.
Yes, tandem breastfeeding can be a very rewarding experience for mom, toddler and newborn. In the first few days it is important to always give the newborn the breast first because during the last months of pregnancy it changed to the colostrum that the new baby needs. Once the colostrum changes back and milk comes in, as long as the newborn is feeding well, having normal diapers and weight gain, it doesn't matter who goes first.
Over the first few days, mom and baby learn how to breastfeed together. It is a learning process for both, and episodes of trial and error and should be expected. Holy Name's staff is available to help troubleshoot and guide the process. In most cases, mom makes what baby needs, and baby needs what mom makes. Baby is able to get all her nutritional and emotional needs met at mom's breast. Mom's milk comes in gradually as baby's stomach size increases, and by the end of the first week, most moms have plenty of milk and breastfeeding challenges decrease.