Good for Baby:
- Always fresh and ready
- Reduces risk of overweight and obesity
- May increase protection against illnesses such as childhood diabetes
- Increases protection against ear, chest and stomach infections
- May increase protection against Sudden Infant Death Syndrome (SIDS), also called crib death
- Helps to prevent constipation
Good for Mom:
- Promotes closeness and touching with baby
- Helps the uterus to return to its normal size after birth
- Helps to control bleeding after birth
- Helps to protect against cancer of the breast and ovary
- Saves money; formula is expensive
- Saves time; there is no need to prepare formula and bottles
- Does not produce any garbage; there are no formula and bottle packages to throw out
Taking care of your breasts
- When bathing, wash nipples and breasts with water only. Soap can dry the skin.
- Dry the nipples gently after bathing, or let them air dry. Extra rubbing will not toughen the nipples.
- Glands in the areola, the darkened part around the nipples, produce natural oils to keep nipples soft and clean. Avoid creams or ointments which may interfere with the natural oils unless recommended by your health care provider or lactation consultant.
- During the early days of breastfeeding allow colostrum or breast milk to dry on your nipples. Expose your nipples to the air for several minutes after each feeding.
- Many women are more comfortable wearing a nursing bra even at night, as the breasts are larger and heavier. Choose one that fits well and has wide shoulder straps. Avoid plastic liners.
- Make sure your hands are clean when handling your breasts.
Stop milk leaking from your breasts between feedings
- Leaking is common when you are just starting to breastfeed.
- To stop the leaking put pressure on the nipple until the tingling feeling in your breast stops. Use your hands or forearms.
- Cotton or paper breast pads (without plastic backing) may be used to absorb the milk. Change breast pads whenever they are wet.
Relieving hard breasts
This is called engorgement which occurs when your milk is first coming in around three days post partum. It may last 1 to 2 days. Later on you may still experience engorgement if breastfeeding sessions are missed.
- Feed your baby at least 8 times in 24 hours -.at least every 3 hours during the day. Continue night feedings.
- To soften breasts and increase comfort, try taking a gentle, warm shower or putting warm wet towels on your breasts before breastfeeding.
- Gentle massage and hand expression of a small amount of milk may make it easier for baby to latch on.
- Covered ice packs may provide comfort between feedings.
- If you have a fever, flu-like symptoms and/or notice a reddened painful area on your breast, you may have a breast infection or mastitis. Rest as much as possible. Breastfeed your baby frequently on the affected side. Consult your health care provider within 6-8 hours, if symptoms persist. You may need an antibiotic. Continue to breastfeed your baby frequently while you are on antibiotics.
Make sure your baby is well latched on the breast to avoid sore nipples.
- Try different breastfeeding positions.
- Begin breastfeeding on the less sore breast first.
- Try breastfeeding more frequently, as soon as your baby is interested (Get to know your baby’s early feeding cues. If pain continues or the baby does not let go of the breast at the end of the feeding, remove baby from the breast by placing your little finger between the baby’s gums to break the suction.
- Do not let your baby sleep at the breast. Leave a small amount of milk on the nipple after feeding.
- Air dry your nipples after breastfeeding.
- Only use nipple creams or ointments that have been recommended or prescribed by a health care professional or lactation consultant.
- Change breast pads if they become wet.
- Have someone who is knowledgeable about breastfeeding watch you nurse your baby. A public health nurse or a lactation consultant can give you more information.
Avoid: Using nipple shields, without consulting a breastfeeding expert. Nipple shields reduce the direct stimulation to the breast and may affect milk production.
Changes in breasts after delivery
After birth your breasts will go through several changes:
- At first, your breasts will stay soft and will produce colostrum. Colostrum is a clear yellow milk which is rich in protein. It helps protect your baby from infection.
- A creamy white milk will "come in" on the second to fourth day after delivery. For a few days, your breasts will feel full and heavier over the next few weeks, the milk turns to a bluish white colour. Your breasts will return to being soft and less heavy. This is normal and does not mean you are making less milk.
Thrush is caused by yeast that grows in the baby’s mouth and on mother’s nipples. Symptoms can appear in both mother and baby or only one or the other.
The mother may experience breast pain during and between feedings and may have itchy red nipples. It can appear as a white coating on your baby’s tongue and white patches in the mouth. Your baby may also have a diaper rash.
- See your health care provider.
- Both mother and baby should always be treated at the same time. Follow-up if you or your baby’s symptoms do not clear up.
For more information, please contact the Ottawa Public Health Information Line at 613-580-6744 to speak with a public health nurse.
How much and how often?
Feeding your baby often will help increase your milk supply. The more your baby breastfeeds the more milk you will produce – the principle of supply and demand. Most mothers will produce as much milk as their baby wants. The amount of milk made depends on the amount of milk removed from the breast by feeding or expressing.
Is my baby getting enough milk?
Babies need to feed frequently because breast milk is digested quickly. In the first few months, a well fed baby:
- Is feeding well at least 8 times in 24 hours. More frequent feeds are normal. Listen for swallowing or quiet “caw” sound
- At 1 day old has at least 1 wet diaper and at least 1 to 2 sticky dark green/black stools
- At 2 days old has at least 2 wet diapers and at least 1 to 2 sticky dark green/black stools.
** This is easier to notice urine in cloth diapers. A facial tissue can be placed inside disposable diapers, if you are not sure.
- At 3 days old has at least 3 heavy wet diapers and at least 3 brown/green/yellow stools. Occasional “red brick coloured” staining is normal until day 3.
- At four days old at least 4 heavy wet diapers and at least 3 brown/green/yellow stools.
- As the milk supply increases, baby has at least 6 heavy wet diapers and at least 3 large soft yellow seedy stools per day.
- Is back to birth weight by 2 weeks of age
Get help if any of the above signs are not present or:
- Your baby is very sleepy and hard to wake for feedings
- Your nipples are sore and do not start to get better
- You have fever, chills, flu symptoms or a red painful area on your breast
If you have these symptoms: nurse often, apply warm wet towels and get lots of rest. Phone your health care provider if you do not feel better in 6 to 8 hours.
Length of feeding
- The length of time your baby feeds at the breast depends on your baby.
- If your baby is latched on correctly and is actively sucking and swallowing, she can feed for as long as she wants.
- Your breasts are never empty of milk. As baby breastfeeds, more milk is produced.
- Feed the baby on the first breast until your baby seems satisfied and sucking and swallowing slows down, stops or baby unlatches.
- Offer both breasts at each feeding. Your baby may seem less interested in the second breast
- For the next breastfeeding session start breastfeeding on the side that the baby finished on.
Frequency of feeding
Babies should be fed whenever they seem hungry. Initially this is at least 8 times in 24hrs. Night feeds are important too. In the early days baby may need to be wakened to feed.
- At 6 to 12 weeks, babies will feed at least 6 times or more per 24hrs.
- At 3 to 6 months, babies will feed at least 5 times or more per 24hrs.
Your baby may start to tell you she is hungry by waking up, sucking on fists or fingers, rooting (opening mouth and searching for the nipple), smacking her lips and by crying. These signs are known as feeding cues.
Generally babies should be fed before they are crying. Crying is a late sign of hunger
Many babies have periods, especially in the evening, when they feed more frequently, usually a series of short frequent feeds over a few hours. This is called cluster feeding, it is normal and can occur at any time. Many mothers feel that babies are fussier and not satisfied but it does not mean that you don’t have enough milk.
During a growth spurt, babies grow quickly. They will feed more often to increase their mother’s milk supply. These growth spurts commonly occur at 3 and 6 weeks, and at 3 and 6 months. . These periods of more intense feeding will last from 24 to 72 hours.
Baby weight gain
Babies usually lose some weight during the first few days.
- Early and frequent feedings minimize weight loss.
- Most babies regain their birth weight by 2 weeks of age.
- In the first 6 months, babies usually gain 4 to 8 oz (112 to 224 grams) per week and double their birth weight by 5 to 6 months. Growth in length is about 1 inch (2.5 cm) per month.
- From 6 to 12 months, weight gain usually is 3 to 5 oz (84 to 140 grams) per week.
- By one year, baby usually triples his birth weight.
Baby’s growth will often reflect family growth patterns.
Tips for breastfeeding twins or multiples
- If you run into any difficulties breastfeeding, get help right away. Speak to a public health nurse or lactation consultant who may be able to help you solve the problem.
- Milk can be produced for two or more babies. Milk production is based on supply and demand. Frequent breastfeeding stimulates breasts to meet breastfeeding demands.
- Simultaneous feedings help get babies on the same schedule and saves time. Most mothers of multiples either feed simultaneously or one after the other. Your babies will let you know which method works best for them.
- Alternate breasts at each feed. It will be helpful to have a plan to remember who fed at which breast and when. One baby may be a stronger feeder than the other thus stimulating the breast differently. Alternating breasts encourages both breasts to produce milk.
- It isn’t unusual to have one baby who is a stronger feeder. When settling down for a simultaneous feeding, put the stronger feeder to the breast first then spend time settling and arranging the second baby. There is an automatic letdown from the second breast when the first baby latches on. Simultaneous feeding allows the second baby to take advantage of the automatic letdown and may encourage him/her to latch.
- For triplets or more - A helpful idea for increasing breast milk with triplets is to feed the first two babies simultaneously, then feed the third baby on both breasts. Such a routine provides the best opportunity to increase milk supply to meet the demand. Some mothers feed two babies simultaneously at the breast and will give a bottle of expressed breast milk to the remaining baby(ies). It is important to alternate which baby is receiving a bottle to ensure they will have equal opportunity at the breast. A written record may be helpful.
- If additional milk is required, you can pump after feedings. Collect and freeze expressed breast milk for bottle feeding. Be sure to label and date the bottles.
- Never microwave breast milk. This can create hot spots and there is a risk of burning the baby’s mouth. Breast milk defrosts quickly in a bowl of very warm water. The milk should not be hot – room temperature is preferred.
- Using a twin nursing pillow is a real advantage. This larger pillow can comfortably cradle two babies at a time.
- Babies have many growth spurts. As a result, they may feed more often. This is normal and does not mean a low milk supply. Continue to breastfeed according to the babies changing needs.
- Colostrum is the thick milk available for the first 2-4 days following birth. It is loaded with nutrition and antibodies to benefit babies. It is not recommended to pump colostrum as it is thick and may stick to the sides of the bottles and tubing. Breastfeed each baby or, if necessary, hand express into a spoon to feed to the baby. Even a few drops are beneficial to babies.
Adapted from Lynda P. Haddon, Multiple Birth Educator
Where can you get more information?
If you have multiples, contact the Multiple Births Families Association at 613-860-6565 for further information and support.
Vitamin D for your baby
All babies need vitamin D in order to meet their nutritional requirements. Health Canada and the Canadian Pediatric Society recommend Vitamin D supplements for breastfeeding babies.
It is recommended that all exclusively breastfed, healthy term infants receive a daily vitamin D supplement of 400 IU. Supplementation should begin at birth and continue until the infant’s diet includes at least 400 IU per day of vitamin D from other dietary sources or until the breastfed infant reaches one year of age.
For infants not exclusively breastfed, the recommendation for vitamin D supplementation will depend on the amount of formula the baby is receiving as all infant formulas are fortified with vitamin D.
For more information on vitamin D supplementation requirements for your baby please speak with your health care provider.
Medication and breastfeeding
Most medications are compatible with breastfeeding, consult your health care provider, a pharmacist or Motherisk to ensure it is safe to take while breastfeeding. Check with a professional before taking any over-the-counter medications.
Smoking and breastfeeding
Even if you smoke, it is still better to breastfeed your baby. Studies have proven that breastfed babies are healthier than formula fed babies even when they get the chemicals from smoking or second-hand smoke.
There are ways you can cut down the effects of smoke on your baby. The information below shows what you can do:
- Smoke outside: This will reduce exposure to second-hand smoke
- Cut down on the number of cigarettes you smoke. The more you smoke the higher the impact on your breast milk as well as the health of you and your baby. Nicotine may be in your breast milk and may cause fussiness and low milk supply.
- Smoke after breastfeeding your baby. The amount of nicotine in your breast milk decreases over time. And smoking just before you breastfeed can interfere with your milk letdown.