Why Should I Breastfeed?

American Academy of recommends exclusive for the first six months, followed by continued breastfeeding as complimentary foods are introduced. Babies should continue to breastfeed for a year and for as long as is mutually desired by the and baby.

FOR YOU: – Respiratory infections – Asthma Breastfeeding provides benefits to in the following ways: – Type 1 and type 2 diabetes • Saves time, and baby’s food is always – Childhood leukemia ready and the right temperature – Necrotizing enterocolitis (a severe • Reduces risk of breast, ovarian, and illness that affects the intestinal track uterine cancers in pre-mature ) • Less gas and fewer feeding problems • Decreases risk for osteoporosis (brittle bones), diabetes, and anemia • Reduces risk for allergies and food sensitivities • Helps you lose weight after baby is born • Helps baby’s brain development — • Enhances emotional health because studies show higher IQs mothering hormones are calming when breastfeeding • Reduces risk for SIDS (Sudden Death Syndrome) • Lower risk for obesity FOR BABY: Breastfeeding provides benefits to infants in the following ways: FOR YOUR FAMILY: • Creates a special bond between Breastfeeding benefits families in the mother and infants because of the following ways: frequent skin contact • Reduces days absent from work • First helps baby’s digestive because breastfed infants are healthier system grow and work properly • Saves money otherwise spent on • Easy to digest — human milk is the best formula and feeding supplies nutrition for your growing baby • Reduces family health care costs, • Large decrease in risk for certain types including out-of-pocket costs and of infections and illnesses, such as: services not covered by insurance – Ear infections • Improves the effectiveness of – Stomach viruses – Diarrhea

osfstjoseph.org Why Should I Breastfeed?

Risks of Formula Feeding: • Incomplete nutrition • Contamination, such as risk of recalls • More sickness in babies • Increased risk of obesity later in life • Significantly more incidents of SIDS • More from rot • Very expensive • More waste in landfills

osfstjoseph.org Prenatal Preparation and Breast Changes In Pregnancy

COLOSTRUM: THE FIRST MILK • Cancer and radiation treatment for breast or brain tissue depending on how Your breasts start to make colostrum in much and the location of tissue damage the fourth month of pregnancy. Some from therapy women may begin leaking colostrum as early as the second trimester, but it is more common to leak colostrum in the last Women with any of the above concerns trimester of pregnancy. Some women may may still be able to breastfeed. Talk with not leak at all. Women who have pierced your doctor during pregnancy and follow should remove piercings early in up after delivery with a lactation consultant, the pregnancy because the breast area nurse midwife, or physician to ensure becomes tender due to hormone changes, that breastfeeding is supported and well and leaking can occur from the piercing managed. site. Be sure to wash your hands and keep your breasts clean. You may need to wear PLANNING A NURSING WARDROBE breast pads. • Wear a good supportive cotton during your pregnancy with easy-open SPECIAL SITUATIONS fasteners for one-handed use. Get fitted Past medical history related to your breasts for your during the end of the needs to be reported to your physician or last trimester for a proper fit. midwife. The presence of incisions or scar • Choose with cotton-lined cups. tissue requires further evaluation. Here Avoid underwire bras, which increase are some possible factors that may cause the risk for plugged milk ducts because problems with your milk production: wires place too much pressure on breast tissue, obstructing milk flow from the milk • Breast biopsies, breast implants, breast glands. reductions, lymphectomy, lumpectomy, • Disposable breast pads, if used, must not and laser surgery depending on the have plastic liners. Breast pads are only surgical technique used needed if you are leaking breast milk. • Major injury to a breast, burns, blunt Machine washable breast pads are force trauma, and a car accident available. depending on how much the tissue was damaged and where

osfstjoseph.org Prenatal Preparation and Breast Changes In Pregnancy

Pregnancy Hormones That Cause Breast Changes • Estrogen makes your milk ducts grow inside the breast • Progesterone causes the milk-making tissue (alveoli) to grow • Prolactin adds to the growth of breasts during pregnancy

Normal Changes • Breasts grow larger, the skin appears thinner, and the veins become more noticeable. You can expect breast tenderness in the early weeks of your first trimester. • The size of the increases and the pigmentation (color) becomes darker. • Nipples become more erect and may leak colostrum. • Raised bumps of skin around the areola, known as the Montgomery Glands, become more visible. These oil-producing glands produce a lubricating and protective coating that helps keep your skin healthy and the areola elastic.

osfstjoseph.org Breastfeeding Resources

1. American Academy of Pediatrics Breastfeeding Policy Statement: www2.aap.org/breastfeeding/ policyonbreastfeedinganduseofhumanmilk. html Information and guidelines for your pediatrician to help support you and your baby when breastfeeding.

2. Illinois State Breastfeeding Laws, including laws for the workplace: www.Illinoisbreastfeeding.org

3. United States Lactation Consultant Association: Find a local lactation consultant at www.USLCA.org

4. The Center for Disease Control (CDC): www.cdc.gov/breastfeeding

5. The United States Breastfeeding Committee (USBC): A coalition of more than 40 organizations that support the mission to improve the nation’s health by working collaboratively to protect, promote, and support breastfeeding. www.usbreastfeeding.org

6. Academy of Breastfeeding Medicine: www.abm.org Protocols for evidence based practice found here. Breast Pumps

7. Baby friendly website: The Birthing Center staff is able to facilitate www.babyfriendlyusa.org personal breast pumps that are covered by private insurance and for patients served by Illinois Department of Public Health. OSF MarketPlace provides Medela breastfeeding supplies for retail purchase. Items include: retail breast pumps, bra pads, shields, storage bags, soft shells, replacement pieces for Medela pumps, and nursing bras. Please call (309) 665-4704 for more information.

osfstjoseph.org Good Nutrition for You and Baby Tips on Eating Healthy While Breastfeeding

• Your body burns extra calories making milk, bodies. Protein is found in meat, eggs, so you should try to eat at least 500 extra dairy products, soy products, beans, nuts, calories a day. Focus on eating a well- and seeds. balanced diet by eating a variety of all the • Another important piece to a healthy diet food groups, including lean meats, whole is omega-3 fatty acids. Foods that have grains, fruits, and vegetables, along with omega-3s are fish, especially fatty fish low fat or fat free dairy products. (examples are salmon, sardines, lake trout, • If you are a vegetarian, make sure to tuna and anchovies); walnuts or walnut oil; consume adequate amounts of protein, ground flaxseed or flaxseed oil; and olive, including soy products, beans, peas, nuts, canola, and soybean oil. Omega-3 fats and seeds, and to talk with your doctor a role in decreasing inflammation in about whether you need additional the body, preventing certain diseases, and vitamin and/or mineral supplements. You helping with brain and eye development may need to speak with a registered in infants. Avoid fish high in mercury, such licensed dietitian to make sure you are as shark, swordfish, king mackerel, and getting adequate nutrition for you and tilefish, because the mercury can get your baby. passed to the baby through your milk. • Continue to take prenatal vitamins while • Drinking plenty of fluids is important when breastfeeding. breastfeeding. Water is best, but other • Iron is an important mineral that helps acceptable drinks include low fat or fat carry oxygen throughout the body to give free milk, 100 percent fruit juice, tea, or you energy. If you are not getting enough coffee. Keep your caffeine intake to no iron in your diet, you may feel tired and more than 300 milligrams a day, which is run down. Some foods that are high in iron about two eight-ounce cups of brewed include beef, pork, beans, peas, soybeans, coffee. Caffeine can dehydrate you and shrimp, pumpkin seeds, spinach, and stimulates wakefulness in the baby at night fortified cereals. if you drink too much. • Folic acid helps the body make healthy • Breastfeeding moms need adequate new cells and is especially important if you calcium for healthy bones and teeth. You are planning to become pregnant in the can get calcium from dairy products such future. Some good sources of folic acid as milk, cheese, and yogurt. You can also are fortified grains, green leafy vegetables, get calcium from soy products such as oranges, beans, and eggs. tofu and soy milk, green leafy vegetables, canned salmon, beans, calcium-fortified • Breastfeeding moms need adequate orange juice, and calcium-fortified cereals. protein, which is the building block of our

osfstjoseph.org Good Nutrition for You and Baby Tips on Eating Healthy While Breastfeeding

Are there foods to avoid Losing weight after when breastfeeding? your baby is born There are no specific foods to avoid when Many women are concerned about losing breastfeeding except for high mercury fish. weight after their babies are born. Your All types of foods can fit into a healthy diet body needs time to heal after delivery, so as long as you are eating a well-balanced do not restrict your calories until after you diet. are no longer breastfeeding. While you are breastfeeding, you need a total of about 500 extra calories each day to stay If you have a strong family history of food healthy and to produce nutritious breast allergies or suspect your baby is having milk. Remember that one of the benefits allergic reactions to a certain food, to breastfeeding is that you will burn more discuss it with your doctor. You may want calories. A good rate of weight loss is half a to eliminate that food from your diet for pound to one and a half pounds per week. a couple of weeks to see if the baby’s Do not start any type of exercise program symptoms improve. Discuss with your until six weeks after your baby is born, and doctor when it would be appropriate to always talk with your doctor before you re-introduce this food. begin an exercise regimen. A registered dietitian can create an individualized weight loss plan for you. Discuss with your doctor whether this would be helpful to you.

1. Balance calories – Find out how many calories you need per day as 10 TIPS TO A GREAT PLATE a first step in managing your weight. 2. Enjoy your food, but eat less – Take the time to fully enjoy your food as you eat it. 3. Avoid oversized portions – Use a smaller plate, bowl, and glass. Portion out foods before you eat. 4. Foods to eat more often – Eat more vegetables, fruits, whole grains, and fat-free or one percent milk, and dairy products. 5. Make half your plate fruits and vegetables – Choose red, orange, and dark-green vegetables, such as tomatoes, sweet potatoes, and broccoli. 6. Switch to fat-free or low-fat (one percent) milk – They have the same amount of calcium and other essential nutrients as whole milk. 7. Make half your grains whole grains – To eat more whole grains, substitute a whole grain product for a refined product. 8. Foods to eat less often – Cut back on foods high in solid fats, added Go to www.ChooseMyPlate.gov for more sugars, and salt. information. US Department of Agriculture 9. Compare sodium in foods – Use the nutrition facts label to choose Center for Nutrition Policy and Promotion lower sodium versions of foods. 10. Drink water instead of sugary drinks – Cut calories by drinking water or unsweetened beverages.

osfstjoseph.org Medication Choices While Breastfeeding

Nearly all medications enter breast milk, but the amount that enters is usually very small, with very little — if any — harmful effects for the baby. Most medications are digested and broken down by the mother’s body and then released as waste by the mother and not absorbed by the baby. There are some exceptions, so make sure to ask your health care provider or pharmacist if you have any concerns about a medication. Whenever you need to take a medication while you are breastfeeding, ask for a drug check in the book “Medications and Mothers Milk” by Thomas Hale, clinical pharmacologist and professor at Texas Tech University School of Medicine. The “Physician Desk Reference” is not a valid source of current research on the use of medicine while breastfeeding.

Pharmacists often check the safety of medications on LactMed, a drugs and lactation database provided by the U.S. National Library of Medicine and approved by the American Academy of Pediatrics. The site is available to the public at http://toxnet.nlm.nih.gov/cgi-bin/sis/ htmlgen?LACT.

Lactation consultants, breastfeeding peer counselors, certified nurse midwives, some physicians, most hospital nursery nurses, and registered dietitians also have access to the reference book “Medications and Mothers Milk.” Before you stop breastfeeding, call them for answers.

Questions You Need to Ask Your Health Care Provider 1. Why am I taking this medicine? 2. I am breastfeeding. Is this medicine safe for my baby? 3. Will this medicine decrease my milk supply? 4. If not safe, what other medicine is a better choice to take while nursing? 5. When is the best time to take the medication — just before or after nursing? 6. How should I take my medicine and for how long? 7. What common side effects that may affect me or my baby should I watch for? 8. Is it safe for me to take this medicine with my other medicine? 9. Is there no other medicine that I can take that will be safer? Should I “pump and dump” my milk while taking it? 10. I have medicines at home I have bought at the drug store for colds, flu, sinus, allergy, headache, fever, and pain. Can I take them while breastfeeding?

osfstjoseph.org Smoking, Alcohol, and Substance Use While Breastfeeding

SMOKING: Babies brought into a house with smokers are likely to have colic, respiratory infections, gastric reflux, asthma and allergies, and could experience sudden infant death syndrome (SIDS). Infants who are breastfed are also at risk for the same conditions, but their risk is lower even if their mothers continue to smoke. For mothers, breastfeeding is still the best option regardless of whether they smoke. According to the American Academy of Pediatricians (AAP), breastfeeding and smoking is less harmful to the child than formula-feeding and smoking.

If you must smoke, lower the risks of smoking for your baby. Some ideas are: 1. Smoke as far away from your baby as much possible. Outside is best. 2. Smoke right after nursing instead of before. The level of nicotine in your body declines mothers who limit their drinking can usually return over time; so 90 minutes after smoking, the to breastfeeding as soon as they feel steady and level in your blood is only half of what it was. normal. 3. Protect your baby by washing your hands after smoking. Wear a “smoking jacket or Mothers who are heavy drinkers or drink often shawl” that you can remove after smoking should not breastfeed. Pumping and discarding before handling the baby. This will keep the milk could occasionally be an option, but serious smoke left on your clothing away from the problems may arise with breastfed babies whose baby. mothers regularly drink heavily. 4. Cut down on smoking. Smoking fewer You may have heard that drinking beer increases cigarettes will decrease the level of nicotine the production of the hormone prolactin, which in your milk and will keep your baby away improves let-down or the release of breast milk. from smoke and cigarettes. Research has shown it is the barley in beer — not 5. Make an effort to quit. Your doctor can the alcohol — that makes the hormone prolactin prescribe safe treatments and recommend increase, so non-alcoholic beers will have the programs that are safe while you continue same effects as alcoholic beer. breastfeeding. Nicotine patches can be used safely while breastfeeding if the mother no longer smokes. Patches should be removed SUBSTANCE USE: at bedtime to reduce nicotine levels during Women who choose to use street drugs should nighttime feedings. not breastfeed their babies. These drugs include 6. Watch your baby’s weight gain carefully. marijuana, speed, crack, cocaine, heroin, PCP, Nicotine lowers the hormone prolactin, which and all other drugs. Street drugs pass into breast can lower your milk supply over time. milk and may create very serious problems for both mom and baby, which can include death. It is never okay for any mother to use an illegal ALCOHOL: drug, breastfeeding or not. The AAP strongly insists Studies show that babies might receive less milk no drug should be taken by nursing mothers. after their mothers drink alcohol because alcohol can decrease milk production. An adult breaks down one ounce of alcohol in three hours, so

osfstjoseph.org Breastfeeding Works When You Work, But How?

Create a Breastfeeding Plan: break time could be somewhat flexible so that you are not going too long between breastfeeding or pumping. Many women Talk to your boss about breastfeeding. use their lunch break to pump while eating Develop a plan and discuss it with him or or have their baby brought to them to her while you are still on maternity leave. nurse if their employer allows this. About a week before you return to work, review the plan with your boss and any Select a caregiver who is supportive of co-workers who might need to cover your breastfeeding. Try to breastfeed the job responsibilities while you pump. For baby right before you leave for work and those who cannot pump often at work, then again as soon as you return home feeding more while at home may help keep from work. Ask your caregiver not to give up their supply. Questions you should ask: the baby a bottle right before you are expected home from work. Where will you be able to pump? Your employer should be able to help you find Purchase or rent a pump that will meet your a clean, private location other than a pumping needs. Your medical insurance bathroom that has access to electricity if may cover all or part of the cost of a breast you need it. Don’t be afraid to ask; there pump. A lactation specialist can help you are laws that protect your right to pump choose the right type of pump and can milk at work. help you come up with ideas on how to keep breastfeeding even if your employer is When will you be able to take breaks to not so supportive. pump? It only takes about 15-20 minutes to pump with a good electric . Start using your pump about three weeks Keeping in mind you should pump within before you return to work so that you can four hours after last feeding your baby, become familiar with your pump and store talk with your employer to see if your some milk for your first week back to work.

osfstjoseph.org Breastfeeding Works When You Work, But How?

Options for Your Breastfeeding Plan: Returning to work mid-week might make your transition back to work a little easier.

Wait until about four to five weeks to introduce a bottle. • This helps to build a full milk supply. • Select a slow-flow newborn nipple with a wide base to help your baby better. • Have someone else introduce the bottle. Babies may refuse to take a bottle from their mom.

Another Option: Things to Remember: Hand Expression • Start back to work mid-week instead of on a Monday to shorten the span of time Manually pumping your breast milk through away from baby. Build up your supply by hand expression is easy to learn and can only breastfeeding over the weekend. If be quite useful for some women. It can working seems to be affecting your milk be very helpful if you are having difficulty supply, call your OSF St. Joseph Medical with engorgement, latch, or using a breast Center breastfeeding consultant for help pump. at (309) 665-4704. The sooner you get help, the better. A mother might want to hand-express her breast milk because: • Every time your breasts feel full, your milk supply slows down. The more times • It brings milk to the surface of the nipple each day you empty your breasts by and helps baby to latch wider. breastfeeding or pumping, the more milk you will make. Try not to go too long • Hand massage makes milk glands (more than four or five hours) without release milk, helping the milk flow easier. breastfeeding or pumping. • Added massage can help increase your • Try to pump at work every three hours. milk supply and helps the breast empty. If you can’t pump this much at work, • Some moms experience difficulty and make up for it by breastfeeding more discomfort with using a breast pump. often at home. • Skin-to-skin contact helps make more • Freeze milk in two ounce portions. Small milk and could help make hand amounts will thaw more quickly, and you expression easier. will waste less milk this way. Always warm breast milk in a cup or bowl of warm tap water. Do not ever use a microwave. Follow milk storage guidelines provided to you by the hospital.

osfstjoseph.org Smart Feeding Plan for Breastfeeding

All obstetrical nurses at OSF St. Joseph Medical Center have taken 20 hours of additional training to assist in your breastfeeding success.

• After you deliver, your baby will Breastfed babies feed eight to 12 times or immediately be placed on your chest more over 24 hours. Both breasts are offered for skin-to-skin contact. each time. Newborns feed often at night • Feed your baby as soon after birth as because they are sleepy during the day. Ask possible. your nurse for help getting the baby to latch.

• Try to breastfeed your baby within Babies become easily confused and have 30 minutes following a vaginal birth trouble latching when bottles are used or a cesarean delivery, and before the first week. Just one bottle of formula the baby’s bath. Your breasts first changes the digestive tract and interferes make colostrum – rich, concentrated, with latching. The latch on to your breast is yellow or clear drops of food perfectly completely different than the baby’s sucking designed to nourish your baby and from a bottle. Let him learn from you first. to protect and coat baby’s intestines. Baby’s stomach is very small — the size of a large marble — and takes time to Benefits of Rooming In digest food and to grow. Colostrum is released when baby sucks even if you • Decreased likelyhood of jaundice don’t see it. Ask your nurse or lactation consultant to show you how to hand- • Increased milk production for mom express a few drops onto baby’s lips to • Better bonding between mom and baby start him off right. • Better able to identify early feeding cues • Learn night time behaviors

osfstjoseph.org Feeding Cues and

When the newborn roots, sucks on his/or In 2005, the American Academy of her hands or fists and/or fusses, the baby Pediatrics (AAP) recommended the use is exhibiting feeding cues and needs to of pacifiers to help infants fall asleep be fed. When the baby receives a because it was thought to decrease the risk rather than nursing during the first few of sudden infant death symdrome (SIDS). weeks, he/she does not receive the calories Specifically they stated: needed to regain the weight lost after birth. The newborn needs food to help the baby “The pacifier should be used when begin to produce stool frequently, which placing the infant down for sleep and decreases his/her chance of developing not be reinserted once the infant falls jaundice, a yellowing of the skin and eyes. asleep. If the infant refuses the pacifier, he or she should not be forced to take it. Babies do not need a pacifier to learn how to suck. Research has shown that breastfed Pacifiers should not be coated in any infants who use a pacifier in the first month sweet solution. of life breastfeed for a shorter period of time. The use of a pacifier has also been Pacifiers should be cleaned often and associated with a lower milk supply, and replaced regularly. engorgement and sore nipples are more common if the infant uses a pacifier in the For breastfed infants, delay pacifier early weeks of life. introduction until one month of age to ensure that breastfeeding is firmly Infants who routinely use a pacifier have established.” more infections, such as ear infections, wheezing, diarrhea, colic, and vomiting. If you choose to use a pacifier when you They are also more likely to develop oral are “nursed out,” then hold your baby close thrush, a condition in which the fungus to you while you give it to Candida Albicans builds up in their mouths, him/her for a short period and cavities in their teeth. of time rather than simply using it to get him/her Prolonged use of pacifiers is associated with to sleep while he/she delayed onset of speech and increases the is in a crib or . chance of the child requiring braces due to Be careful not to rely on the pressure of the pacifier against the roof a pacifier to keep your of the mouth and front teeth. baby from expressing himself/herself.

osfstjoseph.org Ten Steps to Successful Breastfeeding

The Ten Steps to Successful Breastfeeding were developed by a team of global experts and consist of evidence-based practices that have been shown to increase breastfeeding initiation and duration. Baby-Friendly hospitals and birthing facilities must adhere to the Ten Steps to receive, and retain, a Baby-Friendly designation.

The Ten Steps to Successful Breastfeeding are:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

2. Train all health care staff in the skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within one hour of birth.

5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. The Ten Steps are endorsed and promoted 6. Give infants no food or drink other than by the major maternal and child health breast-milk, unless medically indicated. authorities in the United States, including:

• American Academy of Family Physicians 7. Practice rooming in – allow mothers and infants to remain together 24 hours a • American Academy of Nurses day. • American Academy of Pediatrics • American College of Nurse-Midwives 8. Encourage breastfeeding on demand. • Academy of Breastfeeding Medicine • Academy of Nutrition and Diatetics • Association of Women’s Health, Obstetric and 9. Give no pacifiers or artificial nipples to Neonatal Nurses (AWHONN) breastfeeding infants. • Center for Disease Control and Prevention (CDC) • National WIC Association 10. Foster the establishment of breastfeeding • U.S. Breastfeeding Committee (USBC) support groups and refer mothers to them on discharge from the hospital or • U.S. Preventative Services Task Force birth center. • U.S. Surgeon General

osfstjoseph.org