Latch
Helping the baby to latch on correctly at the breast is very important in establishing good nursing. In order to nurse properly the baby must “milk” the breast with the pressure of the jaw and tongue on the areola and underlying ducts, not just suck on the nipple. Correct positioning prevents sore nipples and helps to produce a good milk supply. For more information please see Jack Newman’s handout on Latching pg. 20-22
Colostrum
During the first 1-3 days after birth the baby receives colostrum, a thick yellowish fluid containing antibodies and protein. Colostrum is present in small amounts, however the baby has a very small stomach (about the size of a chick pea) therefore it is the perfect food for the first few days of life.
Milk
Breast milk usually comes in around day 3-4 and can appear rather bluish in colour. Milk changes consistency and makeup over the months to meet the baby’s needs.
Engorgement
Engorgement usually occurs around day 3-5 when the colostrum changes into mature milk. The best remedy for engorgement is helping the baby to latch on well and breastfeeding frequently. If the baby is unable to latch because the breast is very firm try to express a small amount of milk by hand prior to latching the baby. Cold compresses after feeds or using green cabbage leaves as breast compresses can also provide some relief. Acetaminophen (Tylenol) and or Ibuprofen (Advil) are safe options for pain relief.
Blocked Milk Ducts
Blocked milk ducts are very common and are usually felt as hard lumps in the breast. Blocked ducts will almost always resolve within 24-48 hours. It is important that if you feel a lump in your breast you continue to feed the baby on the affected side. Draining the breast well will help resolve the blocked duct. Massaging the blocked duct while feeding on the affected breast, and feeding the baby in a position so that his/her chin points toward the hardened area can help drain the breast.
Client’s Diet
A well balanced diet is important for nursing clients. When nursing a client needs approximately 500 more calories per day than when pregnant. Some of the weight gained in pregnancy will help to meet this need. A high quality diet with emphasis on protein, fresh vegetables and fruit will help. It is important for a breastfeeding woman to drink fluids; however cow’s milk is not essential to milk production.
Supplementation
Breastmilk contains everything your baby needs for at least the first six months. There is usually no need to supplement with other fluids, however your midwife will discuss supplementation with you if necessary.
Helpful Websites
Stanford University Hand Expression Video
http://newborns.stanford.edu/Breastfeeding/HandExpression.html
Stanford University Maximizing Milk Production when Pumping Video
http://newborns.stanford.edu/Breastfeeding/MaxProduction.html
Kelly Mom Breastfeeding/Parenting Site
www.kellymom.com
Newman Breastfeeding Clinic & Institute
La Leche League Canada
www.lllc.ca
International Lactation Consultant Association (Find a Lactation Consultant)
101 Reasons to Breastfeed
http://www.notmilk.com/101.html
Toronto Public Health – Breastfeeding Information
www.toronto.ca/health/breastfeeding/index.htm