Teaching Handout: Lactation Services: Saint Francis Medical Center

EP1EO-2 b Education

No Pacifier Poster

In an effort to promote successful breastfeeding,

Please Discard Pacifiers for Breastfeeding Babies After the Hearing Screen and/or Circumcision has been done.

ØØØØØØØØØ Teaching Handout: Lactation Services: Saint Francis Medical Center

Does My Breastfed Baby Need Formula? Congratulations on Deciding to Breastfeed Your Baby! You have chosen to offer your baby the many benefits that exclusive breastfeeding provides.

Frequently asked questions:

Does my baby need more than my breasts will provide in the first few days? ►Breast milk is the ideal food for your newborn. In the first day of life your baby’s tummy can hold 1 teaspoon per feeding. ► Colostrum provides a small amount of food that your baby needs to receive every 2-3 hours. ►Breast milk volume is based on demand and supply – the more you stimulate your breasts, the more milk you will produce. ► Breast milk coats the baby’s gut to protect the baby from germs and disease.

Is my baby getting enough to eat? ►Over the next few days you milk volume will increase as the baby’s tummy is able to hold more food. ►Tracking feedings, wet diapers and dirty diaper on your breast feeding log will help you determine that your baby is getting enough to eat. ►Cluster feeding is your baby’s way of bringing in more milk

Why is my Baby fussy? There are times when your baby will be fussy for reasons other than the need to eat. The following are some ways that may help calm your baby: ►Skin to Skin contact while mother and baby are awake ►Swaddling ►Motion

My baby wants to nurse all of the time. How can I get enough rest? All new parents experience fatigue and lack of sleep during the first several months. Some things you might try are: ►Nap when the baby sleeps ►Limiting visitors while in the hospital ►Ask your support person to help with baby care ►Accept offers of help from family and friends once you are home such as meal preparation, housework, laundry etc.

My baby is having trouble latching on. Ask your nurse/lactation consultant for help with the feedings. Start pumping. ► Pumping will stimulate your milk supply. ► Pumping will provide expressed breast milk to feed your baby ► If your baby is not feeding at the breast it will be important to pump your breasts 8-12 times a day and feed expressed breast milk to your baby.

Remember, breastfeeding is a learned process for you and your baby. Give yourselves time; the rewards last a lifetime.

References: American Academy of Pediatrics Breastfeeding Initiatives American Academy of Pediatrics Policy Statement on Breastfeeding American Academy of Pediatrics Endorsement of 10 Steps to Successful Breastfeeding, 8/25/09 Riordan, J. 2005. Breastfeeding and Human Lactation, 3rd edition. Jones and Bartlett Publishers, Sudbury, MA.

Summary Breastfeeding Study – December 2010 - SFMC Mother/Baby Unit Total Deliveries: 228 Mother’s who initiated breastfeeding: 192 (6 were LPT remaining on the M/B unit) Excluded from the study: 40 NICU babies 1 mother with positive drug screen 6 babies with “unable to locate record” after DC or “no accessible visits” per Meditech

Total Mother/Baby couplets in the study: 145 Breast feeding babies receiving formula: 64/132 (44%)

Reason formula given:

Mothers choice: 20/64 responses (31%) ***some mothers gave more than 1 reason 1. Switch to bottle only: 9 2. Mom concerned baby not getting enough to eat/fussy: 4 . . 3. Too tired: 4 4. Too sore: 1 5. Plan to do both breast and bottle feed: 7

Medical Necessity: 39/64 responses (61%) ***some had more than 1 reason 1. 9% or greater weight loss: 2 2. Phototherapy: 2 3. Low blood sugar: 23 4. MD/NNP order: 10 (Low BG – 6; Bilirubin level – 2; Small baby – 2) 5. Mother too ill: 2 ( 1 had received radiation before delivery, 1 went back to OR)

Poor latch/Breastfeeding difficulties: 5/64 (8%) breastfed infants receiving formula feedings

Summary: - Overall, documentation about why formula was being given was significantly improved with 15 nurses noted to have no documentation with regard to why formula was given. - Nurses were noted to have gotten mothers started pumping and in many cases expressed breastmilk was given rather than formula when available. - Nursing documentation of teaching done with breastfeeding mothers has increased dramatically since our Aug data collection.