Breastfeeding Support

• Breast milk is truly magical. Breast milk adapts to meet your baby’s nutritional needs (even changing from day to night!), is easily digestible, promotes good gut health, and enhances brain development. Breastfeeding can also reduce the incidence of infections, allergies, SIDS, as well as diseases such as diabetes, asthma, leukemia, and multiple sclerosis. Plus, it’s sweet and babies like it!

• Breastfeeding isn’t just good for your baby--it’s good for you, too. It reduces postpartum blood loss and helps your uterus shrink to its normal size faster. Breastfeeding reduces your risk of ovarian cancer, osteoporosis, and premenopausal breast cancer. It is also virtually free, so it can be good for your family budget, too!

• Early feeding cues can be licking/smacking lips, sucking/making sucking sounds, opening and closing their mouth, and licking or sucking on their hands, toys or anything nearby. This is the best time to nurse--before they is too hungry or worked up...babies often show these signs as they are waking up from a nap.
• If you miss early cues, don’t worry. Keep your eye out for active cues such as fidgeting/squirming, rooting around on your chest, trying to position themselves for nursing, crying, or rapid breathing. If they are showing late hunger cues, such as moving their head back and forth or crying, make sure to calm them first, maybe with some skin-to-skin, before attempting to put him to the breast. You’ve got this, mama!

•  Newborns (0-2 months) are often very sleepy, but should be woken to feed at least every 2 hours during the day (that's 12 times in a 24 hour day), and at least once at night until a healthy weight gain pattern is established. You can try removing some clothing or tickling toes to wake him.

• Ideal for early breastfeeding, when you are learning.
• Bring baby across your mid-section, tummy-to-tummy.
• Hold baby in crook of your arm, opposite the breast you’re feeding from.
• Support baby’s head, cradle close to your breast.
• Sit up straight, don’t bend over or lean forward.

• Similar to cross-cradle, but baby’s head is supported in the crook of the arm nearest to the breast you’re feeding from.
• May be better for mamas with carpal tunnel; reduces wrist strain.

• Good for post-c-section mamas or mamas with larger breasts.
• Good for tandem feeding/feeding twins.
• Hold baby beside you, with bent elbow.
• Cradle baby’s head in that same hand and face them toward the breast. Their back will lie on your forearm.

• Good for post-c-section or night nursing.
• Lie on your side and face baby toward your breast.
• Support baby with your free hand to bring them close.

• Lie in a semi-reclined position as baby lies against your body.
• Good for oversupply or a strong let-down because baby is working against gravity and can freely move his head.

• Baby’s nose opposite your nipple to start
• Baby’ mouth wide open (140 degree angle) and head tilted back
• Baby’s bottom lip and tongue reach the breast first. The nipple fills the upper half of her mouth
• Asymmetrical latch with more of the lower part of the breast drawn in
• Tip of nose and chin touch the breast during feeding
• Top and bottom lip is sealed around breast and lips are flanged out
• Rounded cheek line (not like she is sucking through a straw)
• Baby’s jaw moving in a rocking motion rather than a chomping/biting motion
• Her arms are free to encircle or even massage your breast
• If things don’t feel right, simply place your pinky finger in the corner of her mouth to break the seal and start again.

• You will know when your nursling is done eating when he removes himself from the breast and his hands and body are relaxed. Such a sweet moment!
• Also, look for an average weight gain of about 5-7 oz/week, 3+ wet diapers and 3+ loose, yellow stools/day after day 4. 

• Sit in a comfortable position and relax!
• Be careful not to lean over, adding stress to your back...because the amount of nursing you will do in the first few weeks will feel like a new workout routine to your body.
• While you may notice some nipple soreness or cracking in the beginning, breastfeeding should not be painful, and your nipples should look the same before and after a feeding. Think of it like this...your nipples are learning this new action that is performing over and over again. When you do something repetitively, your body feels sore before healing or getting used to the activity. Like writing a long story that makes your fingers cramp up or doing the same workout every day. Your body is getting used to this new 'job' it is performing. 
• Plus, breastfeeding releases oxytocin, the “love hormone” so you will still feel very tired, but relaxed!

• While this is a common concern, on average, your baby only drinks 67% of the milk your body makes. Frequent nursing encourages good milk supply and reduces engorgement. Aim for about 10-12 nursing sessions within a 24 hour period. You CAN’T nurse too much, but you CAN nurse too little.
• Maybe you’ve heard that milk production operates based on supply and demand? To ensure ample milk production, the key is to remove more milk from the breast with short, frequent feeds so that less milk accumulates in the breast between feedings. Milk production slows when milk accumulates in the breast and speeds up when the breast is emptied.

• Since breast milk digests quickly and babies’ bellies are tiny, breastfed babies eat small, frequent meals. By one month old, most babies are satisfied with 25-35 ounces of milk over a 24 hour period.Your body is amazing and it will adjust to your baby’s needs!
• Every baby’s feeding pattern is unique and changes as they grow. Nursing several times over a short period or cluster feeding is normal and most commonly occurs in the evenings.  Be flexible, don’t watch the clock, but watch for your nursling’s feeding cues instead.
• You may find that your baby’s feeding pattern changes and suddenly he wants to nurse longer and more frequently for a few days. This is called a growth spurt and often seems to happen around 2-3 weeks, 6 weeks, and 3 months.  He is doing exactly what he’s supposed to do to meet his growing needs--smart baby!

• Nipple pain or cracking can be normal in the early days of breastfeeding. Pain that is normal will last no longer than 30 seconds into a feeding, and should subside within the first week of breastfeeding. There should be no physical damage to the nipples and they should never be flattened, creased, or pinched.
• The first thing to do when experiencing nipple soreness is to check your latch to make sure an improper latch is not the cause.
• One of the best ways to treat sore nipples is with your own breast milk! The healing properties of breastmilk go a long way. Rub a little on your nipples and allow them to air dry. Try not to use any manufactured products--remember, whatever is on your nipples will end up in your baby’s mouth! Make sure to change your breast pads often to keep your nipples dry.

• It is normal for your breasts to feel larger, heavy, warm, and uncomfortable when your milk comes in. This typically occurs 2-5 days after birth and is commonly known as engorgement. In the early days, you may make more milk than your baby needs. You may leak and feel very “full.” It won’t last forever and your supply will adjust!
• One way to relieve the pain that comes from engorgement in the early days is by applying reverse compression. Using two fingers, apply pressure at the base of your areola and apply pressure back toward the chest wall. This will pull some of the milk away from the sensitive nipple/areola area and relieve some pressure!
• Another method that may be helpful is to get into the shower and face the water, allowing the warm water to hit your breasts. Once the milk starts to leak from your breasts, hop out of the shower and nurse your baby! Also, some mamas feel that a cold compress is helpful in reducing swelling and pain.

Sometimes mamas occasionally get a clogged duct that can feel like a small lump that is hot, tender, or reddened at the site. Even if it’s painful, do NOT decrease nursing from that breast! Milk removal will be key to resolving the clog. Try to nurse at least every two hours. Make sure your bra isn’t too tight so that your milk can flow freely. Use a warm compress before nursing, and massage the clogged area gently to loosen it. A nice hot shower, with the warm water hitting your breasts will help! Allow the water to hit your breasts until the milk starts flowing, then nurse your baby immediately. Try to begin nursing on the affected breast first, as baby’s suction will be stronger on the first side and more likely to effectively clear the clog.

Mastitis symptoms can be very similar to those of a clogged duct, but usually are more intense. There may be noticeable red streaks across the affected breast, and you may run a fever of 101.3 or greater. You may experience body aches and chills, similar to the flu. If you think you have mastitis, rest and fluids are key. Nurse as often as possible! Be sure to contact your healthcare provider, as mastitis can sometimes require antibiotics.

• Before you worry about increasing your milk supply, make sure that it is needed. Many mamas feel that their supply is low, when in reality they are doing just fine! If your baby is growing normally and gaining weight well, then you do not have an issue with supply. Feeling like your breasts are “empty,” the way your baby acts in between feedings, and not feeling a let-down are not reasons to be concerned about supply. Also, the amount of milk you pump is not equal to the amount of milk your little nursling can express. Don’t panic if your pumping sessions are less than stellar!
• If your baby is not having an adequate number of wet and dirty diapers, or if their growth is not what it should be, you may need to work on increasing your supply. You should stay in close contact with your pediatrician and you may want to contact a certified lactation consultant. 
• Milk supply operates on the principle of supply and demand, so generally the more often you put baby to breast, the more milk you will make! You cannot increase your milk production by drinking more fluids or eating certain foods. Make sure your little one’s latch is good, that they are removing milk efficiently, and allow them to nurse as often as possible. Offer both breasts at each feeding, allowing your baby to finish with the first breast, then offering the second. The more stimulation, the better! Adding a pumping session between feedings for extra stimulation can also be very helpful, but try not to stress out about it.
• Power pumping can be a good option to jump-start an increase in supply. To try this method, pump 5 minutes on, 5 minutes off, until you reach a total of 20 minutes pumping on both sides. Repeat this 1-2 times a day for 2-3 days and you should see a bump in supply!

• It is up to you whether you introduce a pacifier or bottle, but it isn’t recommended until breastfeeding is well established, generally after 3-4 weeks of exclusive breastfeeding.
• When introducing the bottle, feed based on cues rather than a schedule, and paced bottle feeding is recommended. This is similar to the breastfeeding experience because it mimics your let-down patterns, encourages the baby to be in charge of the feeding, and lengthens the time of the feeding to allow your babe to recognize satiety. There are several great paced bottle feeding videos on YouTube.

• Some pumps offer varying levels of suction. Only use enough suction to help milk flow well. Too much suction can cause tissue damage or nipple soreness. Faster and stronger is not always better in this case!

• After each session, disassemble and inspect the parts of your pump.
• Rinse any parts that come in contact with breastmilk, and place them in a wash basin (preferably one that is only used for pump parts and bottles!) with hot, soapy water. 
• Scrub the parts according to the manufacturer’s guidelines (check your instruction manual!), then rinse under running water or in a separate wash basin. 
• Lay them on a clean, unused dish towel or a paper towel to dry. Do not rub or pat them dry. 
• Make sure to clean your wash basin so that it is ready for the next time you pump!

• If your pump parts are dishwasher-safe, make sure to disassemble the parts and place small parts in a basket or mesh laundry bag before putting them in the dishwasher. 
• Use hot water and a heated drying cycle, or the “sanitize” setting on the dishwasher. This will help make sure to kill as many germs as possible! 
• If your parts are not completely dry when you remove them from the dishwasher, place them on a clean towel or paper towel and allow them to air dry completely before putting them away.

• The action of sucking releases hormones in baby and mom that promote sleep
  
• Breast milk also contains sleep-inducing hormones, amino acids, and nucleotides, which are more concentrated at night! Aren’t our bodies amazing?
• You and your breast are a place of comfort for your little one, not just a feeding trough. Cuddles are just as important as the act of nursing itself.

• This does NOT mean you aren’t making enough milk, so don’t be tempted to supplement! Just offer the breast as often as he wants it.

• Wear him in a sling or carrier! This will keep your hands free while you are still soothing them.
• Try a change of pace! Let dad hold him, or take him outside for some fresh air.
• Sing, hum, or talk to him.
• Try gentle motion! Swaying, rocking, and walking around can soothe a fussy baby.

• Biting usually happens at the end of a nursing session when she is no longer hungry and starts to get bored.
• Watch for signs of boredom and end the nursing session before she has the chance to bite!
• Watch for tension in her jaw. If she stops sucking and you see the jaw tense, remove your breast from her mouth.
• If she is teething, offer a teething toy or a cold washcloth to bite instead of you! If your baby has already bitten (or tried to), offer the teething toy afterward.
• Make sure her mouth opens wide and has a good latch at the start of your nursing session.
• If she is distracted, don’t force nursing!
• Be attentive. Some babies will bite for attention!

• Calmly remove her from breast and say nothing, or calmly let your little one know you are done nursing now. This will teach her that biting and nursing do not go together
• If she won’t let go, try to break her by inserting your finger between her gums. If this doesn’t work, bring her very close to your breast and she will release to get a better breath.

• Practice using your breast pump and start a supply of frozen breast milk. Just pumping once a day can create the supply you need for your baby’s first few days away from you. It’s awesome to see that stash pile up!
• Review your company’s breastfeeding/pumping policy and talk to your employer. If your boss is uneasy, share that research shows that nursing mamas take less sick days because their babies tend to be healthier. 
• If it is available to you, you may want to negotiate changes to your work schedule so that you can ease back into your position. Could you work part-time, take on less projects in the first few months back, work from home, etc.?
• Plan to return mid-week or start with ½ days for the first week to allow you and your babe a gentler transition and time to work out any kinks
• At the office, you will want an adequate place to pump that is private, with good lighting, a comfortable chair, an electrical outlet, and preferably a small refrigerator reserved for pumping mamas. A bathroom or storage closet is not an adequate or comfortable environment for such important work!
• Have a practice day before your first day back! Set your alarm, duplicate your expected morning routine, get you and your baby all packed up for the day, and arrange for your baby to have a half-day with her caregiver. Then go home and pump when you plan to have breaks at work, trying to get by on only what you've packed (so you can figure out if you've forgotten anything). And, you can have all the feels without your co-workers watching!
• Work out a schedule with your partner for help with childcare pick up and drop off, meal prep, and errands. You don’t have to do this all by yourself!

• Slow-flow nipples are recommended because they more closely mimic nursing from the breast and allow her time to realize she’s full. 
• Encourage the caregiver to allow her to feed until she’s satisfied, not until the bottle is empty. And, by filling the bottle with a only few ounces at a time, there’s less chance for waste or overfeeding
• Remember to never put breast milk in a microwave, but instead place it in a warm bowl of water for a few minutes before feeding
• If your water supply is safe for drinking, you don’t need to sterilize bottles or nipples. You can wash bottles by hand or in the dishwasher. Clean nipples with a nipple brush in hot, soapy water, preferably in a wash basin or large bowl that is only used for pump parts and bottles. Allow to air dry on a clean towel or paper towel

• Baby should be held in an upright position with the bottle held horizontal
• Offer the bottle by tickling the baby’s lips and in a way that allows her to draw the nipple into her own mouth rather than being pushed into her mouth
• To mimic the usual breastfeeding experience, aim for feedings to take 10-20 minutes. It takes some time for babies to realize they are full, so slow sessions reduce overfeeding
• Consistent with a breastfeeding rhythm, the caregiver should encourage frequent pauses while the baby drinks from the bottle. This mimics mama’s let-down and baby’s sucking patterns while nursing. Caregivers can simply allow the nipple to remain in the baby’s mouth, but drop the nipple every few seconds or when the baby naturally pauses so that milk isn’t constantly flowing into her mouth
• Switch cradling arms halfway through the feeding, since that’s usually what mamas will do too!

• Some pumps offer varying levels of suction. Only use enough suction to help milk flow well. Too much suction can cause tissue damage or nipple soreness. Faster and stronger is not always better in this case!

• After each session, disassemble and inspect the parts of your pump.
• Rinse any parts that come in contact with breastmilk, and place them in a wash basin (preferably one that is only used for pump parts and bottles!) with hot, soapy water. 
• Scrub the parts according to the manufacturer’s guidelines (check your instruction manual!), then rinse under running water or in a separate wash basin. 
• Lay them on a clean, unused dish towel or a paper towel to dry. Do not rub or pat them dry. 
• Make sure to clean your wash basin so that it is ready for the next time you pump!

• If your pump parts are dishwasher-safe, make sure to disassemble the parts and place small parts in a basket or mesh laundry bag before putting them in the dishwasher. 
• Use hot water and a heated drying cycle, or the “sanitize” setting on the dishwasher. This will help make sure to kill as many germs as possible! 
• If your parts are not completely dry when you remove them from the dishwasher, place them on a clean towel or paper towel and allow them to air dry completely before putting them away.

• Your little one might start nursing more frequently at night than before you returned to work, especially during the first few weeks. This is totally normal, and the great news is that levels of prolactin (the hormone that encourages milk production) are higher during night feedings, so this will help make sure your supply won’t decrease!
• Don’t be stingy with breastfeeding on the weekends! Breastfeed “on demand.” If your supply seems to dip during the week while you’re at work, this is your chance to rebuild it in the most natural way. If you pump at work, save that milk for when you’re away and nurse from the breast while you’re home.

• Whew, talk about pulling double shifts! If you are trying to juggle work and your babe during the day, above all, be kind to yourself and give yourself lots of grace.
• Save the most difficult work for nap time.
• Set realistic expectations at work so that your team understands your work day may look a little different than in the past.
• Have extra help on hand, if possible, even if it’s a teen who helps for a few hours.
• Try to adjust your schedule so that you work when your partner can help with your sweet baby.

• All your pump parts (pack a few extra membranes, just in case!)
• Battery pack and fresh batteries.
• Lots of milk storage bags or bottles.
• Ice packs for the return trip.
• On-the-go cleaning supplies like wipes for pump parts, microwave disinfecting bags, a small amount of dish soap. Branch Basics is a great options for non-toxic, cleaning products that are travel sized!
• Hand sanitizer.
• Access to a refrigerator.

• Don’t check your pump with your luggage, but keep it with you.
• Place your pump and breast milk in a separate bin and tell the agent the liquid is breast milk. Breast milk is NOT subject to the 3 oz TSA limitation.
• An agent may ask you to open the container and/or have you transfer a small amount to a separate empty container for testing. If you are not comfortable with this, talk to a supervisor for alternatives.