Tear- Sheet Toolkit

Lale_9780345518446_3p_all_r6.indd 447 available at llli.org. at available are copies care day Online or provider— need. you family whatever your put or sheets on these by your refrigerator Youcan your computer, or to them hand removed. be to ready sides, two own its on complete is section able to tear something something tear to able • • • • • • • Early Breastfeeding DON’T YOU SOMETIMES Door sign (hospital or home) (hospital Door sign It isn’t just about milk the the Feeding non- baby latching cues Feeding asleepy newborn Waking log Diaper Laid- ideas other and back breastfeeding Tear- Sheet Toolkit

want a whole book. And sometimes you want to be be to want you sometimes And book. whole a want from a book! Here’s your chance. Each page in this this in page Each chance. Here’s your book! a twenty 449 461 453 457 455 459 451 6/2/10 3:02:46PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 448 • • • • Bottles Working, Pumping, • • • • • Problem Solving • • • • • • • Day care provider Day care sheet— handling milk provider Day care sheet— paced bottle- feeding storage Milk log Pumping grimacing gulping, Gaining, Mastitis blebs and Plugs Websites caregivers for their moms and Medications scrubbing and Cleaning need toknow mothers What Breastfeeding— sensejust good isbreastfed? Your grandchild about partners? What Fussy baby ideas help sheet Refrigerator 448

the womanly art of breastfeeding of art womanly the 483 463 489 487 485 467 465 469 481 493 477 491 479 473 471 475 6/2/10 3:02:47 PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 449 n natural breastfeeding instincts. See biologicalnurturing.com for further further for information. biologicalnurturing.com See instincts. breastfeeding natural baby’s your and own your encouraging and baby your with comfortable • • • • • • breastfeeding, laid- back • • a team. a Help her as much as helpyou her like; do what she’sto do. You’retrying baby’s your Let cheek breast. rest bare your somewhere near you. against is front whole her sure make Just like. you position any in you you’re Since youback, don’t leaning have a lap, so your baby restcan on front touch whole your front. whole baby’s your Let supported. well shoulders and head your Have yours. to molded body his with position in him keep will gravity chest, your ﬂ Find a bed or couch where you can lean back and be well supported— baby your you and as choose.Dress yourself not Relax and enjoy and other. each Relax Hold breast your or you not,as like. at, but comfortably leaning back so that when you put your baby on baby your put you when that so back leaning comfortably but at, Laid- backBreastfeeding tear- toolkit tear- sheet or Biological Nurturing, means getting getting means Nurturing, Biological or

449 6/2/10 3:02:48PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 451 n diapers. Poopy diapers tell more about how a baby is doing. babyis a howabout more tell Poopy diapers diapers. forefi and thumb with make you circle “okay” International International Board Certifi Le Leche La Local provider ______care My health Baby’s ca health helpers: My breastfeeding Yellow diapers poopy (fi old days 4–5 X X X X X X diapers poopy to yellow Green hours) 24 (fourth old days 3–4 diapers poopy Greenish X X hours) 24 (third old days 2–3 diapers poopy sticky Brown X hours) 24 (second old days 1–2 diaper poopy sticky Black (fi old day 0–1 is baby your If . . . poopy only count Circle your when X the baby “okay” an has poopy diaper. EarlyDays Diaper Log: The Bottom Line rt2 or) hours) 24 rst fh2 or) hours) 24 fth re provider ______(If it comes out, it must have gone in!) gone have it must out, (Ifit comes ague Leader ______Leader ague tear- toolkit tear- sheet diapers that have contents at least as big as the the as big as least at contents have that diapers ed Lactation Consultant ______Consultant Lactation ed at least at Expect X X X

this many “okay” many this diapers nger. No need to count wet wet count to need No nger. 451 3 3 3 2 1 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 453 n • • • • • • • • • • • but at astretch, hours three than sleeps longer newborn If your he might take sips from a spoon. Feed in whatever him way works for you. He might latch and nurse in his sleep in a laid- back breastfeeding position, or try: to Things minutes. twenty in again Try wake. to hard be he’ll go, it let you when rock a like drops it and arm his lift to he’sIf yousheet. try and tear next sleeping onthe listed day. each poopyleast good diapers four at has and own onhis hewakes until day each for nursings at leastten aim weight. his and diapers poopy his on eye an Keep is. he who just probably that’s It will be easier to wake him to feed you if be toeasier cues seewake him some of Itfeeding the will If he’s and well he sleeps hours notmoreat three gaining a than stretch, him to swallow before adding more. before adding toswallow him for his waiting in mouth— bit, a milk just or colostrum little a Put cloth. adamp facewith his Wipe and vertical tohim. you as talk back, nearly to horizontal nearly from your him at lift feet and hands, elbows, your in head forearms, your along him Hold side. other way onthe his way the on one sidefrom all to all gently him downroll and Lay him feet. Rub his name. his call and him Stroke or completely. on chest. your him Put partially Undress him drapes.the It’s pull lights, the Dim easier if he doesn’t have to squint. Log) Days Diaper Early (see the on track are diapers His when heHe feeds feeds well Your you baby physicalwith contact stays in You medications no birth had WakingSleepy a Newborn tear- toolkit tear- sheet

453 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 455 n • • • • • • • • Offer even if she’s not asking, anytime you like. Offer evenshe’s anytime if not asking, to slow down production. Don’t wait for your breasts to feel A full. breast full has already started for her demands. waiting of instead requests her answer you if easier is Breastfeeding tofeed her. her down before trying Calm of hunger. sign a is Crying latching. time harder a have she’ll she’sOnce crying, to cry. starts herAs her body builds, hunger and mouth tense. She breathes fast or easily. and younow,breastgently offer your If nurse probablyto take she’ll or squeaking. chest, whimpering your toward obviousones— rooting more adds she Then mouth movements.face, ﬂ eyelids lids, eye- nursing beneath subtle cues— moving with eyes starts baby A uttering before they even open, hands coming toward coming hands open, even they before uttering tear- toolkit tear- sheet FeedingCues

455 late 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 457 Lale_9780345518446_3p_all_r6.indd 458 n • • fi the of end the By confi patience, rst week—help, dence • • • • fi nger- bottle or feed shield, nipple use pump, or increases—hand-express volume milk As • • • • expression hand regular hours—begin 6 about By • • to 6 Birth hours— skin contact • • do what he is designed todo! do what he isdesigned a fl If to we jump through teach can a tiger going. supply your Keep well. breastfeed to weeks take sometimes Babies E pes t es 81 tms e 2 hus tprn of s baby as off tapering hours, to nurse. 24 begins per times 8–10 least at Express Continue skin- to- much as possible. as skin/holding volume, milk increased With fi baby to help the latch. Consider shield a nipple afterward. express hand ing, fi Pump at least 8–10 in at 24 times hours least (including once at night) possible. as much skin- holding as contact, to- laid- and Continue skin back, the feeding as baby. important as is breasts your from milk Removing of when either and you athours wakes night. spoon, a spoon- every into baby2–3 feed colostrum express Hand on. tolatch him toencourage on nipple your of drops milk Express baby the in keeping Continue skin- to- you. contact with skin hours. medicated— was If birth hand- by end ofexpress colostrum fi baby the Keep skin- to- tobreastfeed. him encourage gently and skin support. breastfeeding or other Leader your touch with in Stay help. will two a or couple Adding ahead. two of sessions pumping extra for a day or You to be a feeding store fridge and may the want to express in extra nishing with nishing hand expression. Massage before and/or pump- during 458 Feedingthe Non- LatchingBaby:

the womanly art of breastfeeding of art womanly the OnePossible Approach tear- toolkit tear- sheet nger- nger- may work. or bottle a feeding aming hoop, we help can aming a baby

457 rst two rst two 6/2/10 3:02:49PM 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 459 n • • • • • .html. ducts. other from milk move to position different a to hand Shift like. you whenever e vdo t newborns.stanford.edu/Breastfeeding/HandExpression at video See bowl. or large funnel pump into Express Milk: collect drops on plastic spoon, Colostrum: into tip baby’s mouth or col- Add immediately. massage Don’t Repeat times. several anything expect Release pressure, relax hand relax Release pressure, skin but not sliding ﬁ Compress chestPress backtoward on opposite sides of areola Fingers your Wake breasts your up— move massage, them shake, lect with dropper. with lect Press. Press. ngers toward each other, drawing slightly toward nipple nipple toward slightly drawing other, each toward ngers tear- toolkit tear- sheet HandExpression Compress. Compress.

459 Release. 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 461 n ______We’re getting to know our baby, and we may be pretty busy right now. right busy We’re toknowourbaby, andmay we bepretty getting Lale_9780345518446_3p_all_r6.indd 461 n knock Please knock ______We’re getting to know our baby, and we may be pretty busy right now. right busy We’re toknowourbaby, andmay we bepretty getting knock Please knock tear- toolkit tear- sheet we hope you’llwe understand. OurBaby Is Here! quietly. If don’t we the door, answer tear- toolkit tear- sheet we hope you’llwe understand. OurBaby Is Here! was born on was born quietly. If don’t we the door, answer weighing was born on was born weighing

461

461 6/2/10 3:02:49PM 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 463 n Lale_9780345518446_3p_all_r6.indd 463 Meals: Meals: Groceries: Chores: Chores: Errands: n Life is very busy for us right now, and it would mean a lot if you could if you a lot could mean it now, would and for us right busy is very Life Chores: Chores: Errands: Meals: Groceries: Life is very busy for us right now, and it would mean a lot if you could if you a lot could mean it now, would and for us right busy is very Life choose one item from this list to help uswith: tohelp choose thislist oneitemfrom We’dLove Your Help! choose one item from this list to help uswith: tohelp choose thislist oneitemfrom tear- toolkit tear- sheet We’dLove Your Help! tear- toolkit tear- sheet

463

463 6/2/10 3:02:49PM 6/2/10 3:02:49PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 465 Lale_9780345518446_3p_all_r6.indd 465 Lale_9780345518446_3p_all_r6.indd 465 n n n What works for you? works What • for you? works What • • • • • • for you? works What • • • • • • • • • • • • • • • • • who’ve mothers from on those beenthere: variations are age- • talk some old and are baby Here walk, soothers. • carry, Contact, • • • • who’ve mothers from on those beenthere: variations are age- talk some old and are baby Here walk, • soothers. carry, Contact, • • who’ve mothers from on those beenthere: variations are age- talk some old and are baby Here walk, soothers. carry, Contact, to your baby.to your almost nursing always ends up being the solution; is nursing soothing baby the Nursing you walk. while sling the in discreetly soothes the baby and you get some The babyexercise! can even nurse outdoors,your A babywith walk Often if weather a permits, in sling. baby.to your you hold her. while ball or birthing exercise ball on an Bouncing almost nursing always ends up being the solution; is nursing soothing people/sights other and spell. ride the may break Acar Shopping! baby the Nursing of Change scenery— outdoors. angle, different a room, different a you walk. while sling the in discreetly noise. or white washer as or avacuum static, water, radio Running soothes the baby and you get some The babyexercise! can even nurse music. fi you once especially outdoors,your A baby vigorously,with walk Often if weather a permits, in sling. together Dancing baby.to your you hold her. while ball or birthing exercise ball on an Bouncing walk. your in bump alittle Put swaying. than rather jounce A little almost nursing always ends up being the solution; is nursing soothing people/sights other and spell. ride the may break Acar Shopping! isn’t distress. total in baby the Nursing who baby a For ofready). Change bath the get you scenery— while outdoors.baby angle, different a the room, console different a can you walk. while sling the in discreetly noise. or white washer as or avacuum static, who water, radio there someoneRunning have you if (best lights low with bath shared A soothes the baby and you get some The babyexercise! can even nurse music. baby the isn’t motions,if up. wound totally soothing and lights Low fi you once especially outdoors,your A babywith walk Often if weather a permits, in sling. vigorously, together Dancing Baby Hold Magic you hold her. while ball or birthing exercise ball on an Bouncing walk. your in bump alittle Put swaying. than rather jounce A little people/sights other and spell. ride the may break Acar Shopping! isn’t distress. total in who baby ofa For Change ready). bath the scenery— get you outdoors. angle, different a room, while baby different a the console can noise. or white washer as or avacuum static, water, radio who Running there someone have you if (best lights low with bath shared A music. baby the isn’t motions,if up. wound totally soothing and lights Low fi you once especially vigorously, together Dancing Baby Hold Magic walk. your in bump alittle Put swaying. than rather jounce A little isn’t distress. total in who baby a For ready). bath the get you while baby the console can who there someone have you if (best lights low with bath shared A baby the isn’t motions,if up. wound totally soothing and lights Low Baby Hold Magic tear- toolkit tear- sheet toolkit tear- sheet toolkit tear- sheet again again again FussyBaby Ideas FussyBaby Ideas FussyBaby Ideas . Hunger isn’t always the initial problem, but problem, initial the isn’talways Hunger . but problem, initial the isn’talways Hunger . but problem, initial the isn’talways Hunger .

465 465 465 n hs favorite his nd favorite his nd favorite his nd 6/2/10 3:02:50 PM 6/2/10 3:02:50 PM 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 467 Lale_9780345518446_3p_all_r6.indd 468 n lems and health risks for baby. your risks health lems and Instead: prob- breastfeeding cause to it’sbutlikely more helpful, seem may bottle” • • • • • • • • • • • and you are the ﬁ you the and are bigger, getting keeps world his now,but right baby’sworld your of center the are Mama and Nursing Mama. Not Is Who Person Safe The You are When your baby is frazzled, you may be just the difference that he needs. that you difference may just be baby your the frazzled, is When good. be can different that YouYou him differently. baby your teach hold • • • • Your ﬁ Your Some things you can do: you can Some things different. are smell and hands, voice, shape, Your Different. are You Jiggle and sway. and Jiggle Babies tend to like side- to- side motion. thigh. right hold and his yours), of side either on arm (one shoulder left his over arm left your bring front, your baby’sagainst back your with Hold: Baby Magic the Use safely 12). Chapter (see him Sleep with whenever mother he needs her. his to Take him Take together. a bath house. the around about things Talk tohim on chest. your him Take with anap soon. very them love now,he’ll changes diaper hates he if diaper—even his Change voice. your love hearing baby—he’ll toyour Read people. out about; babies social Go and are for go awalk. and carrier or other Wear baby asling your in Care for her so that she can care for for child. care she your Care her can so that tostart). places good are ilca.org and (llli.org it needs she if help good get her Help her fed. Keep criticism. from partner your Protect The mother breastfeeds, and the baby doesn’t thebaby and him. youtofeed need breastfeeds, mother The rst job is to is job rst 468 Your two separate roles work together to form a strong, Your astrong, toform work separate together roles two rst he person adds.

secure safety netfortheWorld’s safety secure Baby. Best the womanly art of breastfeeding of art womanly the WhatAbout Partners? tear- toolkit tear- sheet support support So what youdo? can So breastfeeding, not breastfeeding, Anything else! Anything

467 compete compete with it. A “relief “relief A it. with 6/2/10 3:02:50PM 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 469 n them. Your practical help and support are a golden investment in your your in together. lives your in and investment future, grandchild’s golden a are support and help practical Your them. love to grandparents their need still babies And motherhood. and feeding ﬁ they as them with patient be to people laundry. need of They load a in throw or meals prepare to around members family guessBut what hasn’t changed? babies. own your or more. years two years—even toddler these into diet their to added foods solid with breastfeeding tinue con- and so, solid or exclusively— or months foods— formula six nofor breastfed be babies that recommend Organization, WorldHealth the and comfortably. soon breastfeeding be should mother help, the some isn’t expert With right. quite something that fre- quite you Fortunately, can’t feed often. too beginning. the usually in quently, especially That’s schedule. a on not cues, hunger to response in It’s environment. for even the future. good the in and now both mother’shealth, the for developmentand and health ababy: Here’s what’s aboutbreastfeeding new New mothers still need lots of help, lots of support, and lots of loving loving of lots and support, of lots help,of lots need still mothers New had you when learned you what from different be may this of Much Pediatrics of Academy American the including experts, medical Most sign a are they breastfeeding; of part expected an aren’t nipples Sore baby fed is best worksthe when breastfeeding that found has Research baby’s forthe important is breastfeeding that shown has research New YourGrandchild Is Breastfed? tear- toolkit tear- sheet

469 gure out both breast- both out gure 6/2/10 3:02:50PM

Breastfeeding: It’s Just Good Sense

You knew breastfeeding was better. That’s why you started. Here’s why it’s worth getting problems solved.

Breastfeeding Is always clean Is a relationship Promotes normal health in infancy Is immediate, simple, nearly free and beyond Provides a normal start in life Smells fi ne going in and coming Promotes normal jaw development out Is the normal follow- up to birth for Is the normal start for the World’s the mother Best Baby Provides mothering hormones Lets the baby control his own Formula- feeding appetite Is a feeding method Saves money for the family Needs equipment, preparation, money, extra medical care Human Milk Is artifi cial and has risks Has many hundreds of known and Increases need for orthodontia unknown ingredients, including Is linked to certain women’s cancers interferon and white blood cells, Provides no mothering hormones antibacterial and antiviral agents, Can lead to overfeeding and intestinal soothers, growth obesity hormones, and everything else a Makes money for industry baby is known to need Changes to meet the baby’s Formula changing needs has far, far fewer ingredients, Is non- allergenic but includes tropical oils, Is the human infant’s only normal no anti- infectives, intestinal food irritants, poorly absorbed Promotes normal brain nutrients, known and unknown development microdefi ciencies

Lale_9780345518446_3p_all_r6.indd 471 6/2/10 3:02:50 PM Lale_9780345518446_3p_all_r6.indd 472 Is linked tolower IQ scores Is linked Isn’t to handle what babies built are common of either two Contanis manufacturing with only Changes soybeans or milk allergens—cow common are which errors, preparation and 472 This is too important to both of you to risk losing it. tobothofyourisk istooimportant This

If you’re not enjoying breastfeeding, gethelp! If you’re breastfeeding, notenjoying the womanly art of breastfeeding of art womanly the Is vastly inferior to your milk to your inferior Is vastly bad pretty Smells many in toincreases Is linked frequently and Is easily vision deﬁ vision breast cancer, pneumonia, SIDS, including diseases, and illnesses contaminated cits, obesity,cits, diabetes 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 473 n Wait long enough and it will change, and the questions and answers will be be fl excellent an is dog A will answers and questions battles. your Pick the and change, will it and enough long Wait of state motherhood. ideal an achieve never You will to you. listen who someone will Find heneeds. you what tell He will intuition. his and baby. him toyour Respect Listen to yourself. Listen just wrong. are books the Sometimes normal. what’s really so you babies know other to see It’s important reality. against argues wordthat apoison is Should stinks. motherhood Sometimes immunities. extra builds house A dirty People but say they things, aren’t to be alwaysjudgmental when trying they say them. answers. noright are There babies. magazine don’t lookNewborns like Just because it’s fun doesn’t it’s it’sJust mean because not important. fun be. is what let and expectations of go your Let You do. you do what can only can fi the feel you bizarre totally how at surprised Don’t be look and a take deep breath, back, Step your shoulders outside when throw you can, as people other doesn’t bother crying The house. ofthe out get so, or week a After it’s mother. for the It’s child, a playgroup. notJoin for the offer help, say people yes. When ideal The adult- to- fi the one to about three is babyratio you you’rewhether know until to ever use going Hold things off buying them— like an of changes, kinds diaper uses— all public for have surface a blankets Receiving do you ask?” “Why with to questions Respond different. really weird. really seconds. up for afew at least adventure. a store wonderful seem like can it grocery even and does, the much as you think one baby, manage. and you’ll one mother is new of consumerism the in up caught get Don’t parenthood. table. changing or crib a catching seat, acar in wrap spit-extra up. Words of Wisdom from Real Mothers at a La Leche League Meeting League La a Leche at Mothers Real from Wisdom of Words WhatMothers Needto Know Before oor cleaner. oor tear- toolkit tear- sheet They’reMothers

473 rst week. It’s normal to feel feel to It’snormal week. rst rst week. But if all you have all But if week. rst 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 475 n Adapted from “Song for a Fifth Child,” by Ruth Hulbert Hamilton Hulbert by Ruth Child,” for a Fifth “Song from Adapted The cleaning and scrubbing and cleaning The I’ve to my learned sorrow. So quiet down, cobwebs. quiet So tear- toolkit tear- sheet Can wait ’til tomorrow, ’til wait Can And babiesAnd don’t keep. BabiesDon’t Keep I’m my baby, nursing For babies up, grow Dust, go to sleep. go Dust,

475 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 477 Lale_9780345518446_3p_all_r6.indd 478 n • • • • • • • notweaning. breastfeeding, continued month. a to up for intestines baby’s the disrupts and diseases, and illnesses adult and childhood many of risk the increases formula of bottle single A be. would formula as risky as rarely is medication? a take to wean to need you Do Mothers’ Milk • • • o mr ifrain cek hms aes book Hale’s Thomas check information, more For bloodstream. and putbabyher digest, breastfeeding into to in her swallow milk, rg opne tn t rcmed enn t aod litigation avoid weaning. research rarely supports to weaning recommend to tend companies Drug ﬁ reduction risk Further Talk aboutoff permanently. risks! faucet a not is Breastfeeding time. baby— weaning Temporary or fussiness. diarrhea doubt in When children. babies to or small directly may given be that drug a for wean to told mistakenly are mothers Some concern. are not a concern for full- term babies. The older the baby, the less the Age matters. Some that drugs might be a concern for premature infants dilute very still it’s high, is drug given a for level blood mother’s a if Even weaning. even temporary choicespart- than better far time—all Breast Milk (ukmicentral.nhs.uk/drugpreg/qrg_p1.htm) Breast Service Health National UK The Dr. Hale’s website (neonatal.ttuhsc.edu/lact) Database (toxnet.nlm.nih.gov/cgi- bin/sis/htmlgen?LACT) of Health’s Institutes National U.S. the LactMed, ve “ “ ve half- ﬁ lives,” or: is a huge physical and emotional stress emotional and physical huge a is 478 Medicationsand Breastfeeding

, check the baby’s blood or just watch for changes like like changes for watch just or baby’sblood the check , the womanly art of breastfeeding of art womanly the tear- toolkit tear- sheet —and pumping, and bottle- feeding an unhappy unhappy an bottle- and feeding pumping, —and nding a safer drug or treatment, even nursing nursing even treatment, or drug safer a nding Nursing before taking the dose, waiting waiting dose, the taking before Nursing : . Turning it off abruptly can mean turning it turning mean can abruptly offit Turning . Here are some Here are of reasons: the “Playing it safe” almost always means means always almost safe” it “Playing uc Rfrne ud fr rg in Drugs for Guide Reference Quick

The drug drug The not! certainly Almost during an already stressful stressful already an during 477 Drugs and Lactation Lactation and Drugs Medications and and Medications The actual actual The .

for his 6/2/10 3:02:50PM 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 479 n dpiebesfeigrsuc fourfriends.com/abrw llli.org Academy of Pediatrics American resource breastfeeding Adoptive International League Leche La Depression in new mothers new in Depression (Diane kellymom.com breastfeeding Sense Common information Breastfeeding— general nipple and breast after Breastfeeding Plus- clothing and bra nursing size ( issues Oral tongue- caries, dental tie, supply issues milk Low MD, Jack Newman, co- ofauthor Lactation (International ILCA The United States Breastfeeding Breastfeeding States United The ( Hale Thomas Sleeping safely— (Notre together and Research- hospital based protocols— Breastfeeding Policy Statement Policy Breastfeeding Wiessinger) surgery resources etc.) Answers of Book Breastfeeding Ultimate The Association) Consultant Committee Milk Lab) Sleep Dame Mother- Baby Behavioral Medicine Academy of Breastfeeding ) A FewA Online Breastfeeding Resources Medications and Mothers’ Mothers’ and Medications tear- toolkit tear- sheet forMothers lowmilksupply.org aappolicy.aappublications.org/cgi/ normalfed.com bfar.org vireday.com/plus/PlusMat_Nursing brianpalmerdds.com drjacknewman.com ilca.org granitescientﬁ usbreastfeeding.org neonatal.ttuhsc.edu/lact nd.edu/~jmckenn1/lab bfmed.org content/full/pediatrics;115/2/496 .html

479 c.com 6/2/10 3:02:50PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 481 Lale_9780345518446_3p_all_r6.indd 482 n • • • • ideas Breast • • • ideas Soaking • • • • ideas Manual • • ideas Nursing • • • ideas Other • • • • Diet ideas Lay cabbage leaves of cabbage overLay area engorgement. any washer cycle. on spin against lean or toothbrush, electric razor, electric massager, personal Use of breast. the treatment physiotherapistSee for ultrasound underwire. an or stop a bra, wearing Stop wearing Epsom salts teaspoons (2 a in cup of water) warm perfour day. times on breast a pad. Vinegar a bra. over inside nipple your on a cotton ball oil Olive and manipulation. massage gentle with along nipple, the behind pressure Apply days. several for day, a times several antibiotic topical Apply needed. if tweezers and open overneedle, lift gently skin bleb; Using use sterilized sterile bleb.the release to nipple of surface rub gently soaking, or showering After out. Use hand expression and to gentle nipple work manipulation the bleb breast dangling. with nurse and knees, and elbows on him over Lean ceiling. the toward Lay your baby on his back on a folded head blanket, off the edge, face as soft as possible. breast affected the keeping possible, as often as Nurse Call an LLL Leader or breastfeeding helper. Why go it go alone? helper. Why or breastfeeding Leader LLL an Call simplex. Herpes Anemia? Stress? an doctorAsk your about taking anti- inﬂ C. Dand vitamins system like boosters immune Increase ated products. decaffein- and antiperspirants, caffeine, fats), fats saturated chocolate, (especially peanuts, sugar, products, dairy all or some Avoid stores). vitamin and drug, health, at (available daily tablespoonsof lecithin Take two ﬂ Increase 482 uids.

Dealingwith Plugs and Blebs the womanly art of breastfeeding of art womanly the tear- toolkit tear- sheet

ammatory medicine. ammatory 481 6/2/10 3:02:51PM 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 483 n ments fi for tion It antibiotics. may soother treat-not you be infection, try an could down (“holiday mastitis”). down (“holiday pressure from (or a pumping), bra and orrun- overtired babybeing carrier, nursing infrequent or ineffective ducts, plugged in, germs let that nipples • • • • • but include: may not be.Signs infection, infl an means Mastitis mastitis protocol at bfmed.org/Resources/Protocols.aspx. mastitis about antibiotics. Think What can you do? you can What o mr sgetos se h Aaey f ratedn Medicine’s Breastfeeding of Academy the see suggestions, more For better? No 24. another for repeat Youcan hours? 24 after worse No it? get you did How approves. Over- the- anti- counter infl feels better. whichever pad, or heating a of cold on infl the ora cloth) sources in other Cold (such wrapped packs as frozen peas or sleeping. resting down, possible as bedor lying in much time or ing, hand- as spending and (b) tomoving expressing keep the milk Empty Breast, Lots of Rest. That means (a) frequently nursing, pump- you fl have the though as aching, and/or fever generalized and/orSometimes chills breast one may look streaks or red that have reddish both) on (rarely area painful) (sometimes sensitive hot, or warm A Mastitis,and What You CanDo if You GetIt rst. You may want to talk to your doctor about a prescrip- abouta doctor your to talk Youto want may u. Often nobody knows. Maybe cracked or damaged damaged or cracked Maybe knows. nobody Often ammation in your breast. It’s sometimes due to an an to due sometimes It’s breast. your in ammation amed area, twenty minutes on, twenty minutes off, minutes on, twenty minutes twenty amed area, tear- toolkit tear- sheet amtr mdcto ta yu doctor your that medication ammatory

483 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 485 n 13. 12. 11. 10. 9. 8. 7. 6. 5. 4. 3. 2. 1. . . . these Do sound familiar? thriving Is yourbaby but nursingisastruggle? extra fat, milk travels fast through her intestines, doesn’t her intestines, down fully, break fast through travels milk fat, extra ﬁ grows She cheesecake. much gets never and soupof lot whole a through plows baby the mean can that more, or hours two to nursings our space to try we if side,”or other the takes she sure make “to the soupall at one If sitting. we the nursing switch through breasts partway through get not may she milk, much too have we If feeding. the through “cheesecake” to “soup” from gradually a changing be lower- to milk, fat cheesecake.” up that builds in our tends The milk breasts feedings between hs cn en bb wos etn “o mc su, o enough not soup, much “too getting who’s baby a mean can Those If it’s been less than two hours, I look for some cause for fussiness fussiness for cause somefor look I hours, two than less it’s been If I try to make a point of nursing on both breasts each time. each breasts on both of point a nursing make to try I My baby often seems intestines. tohave uncomfortable when she nurses. My baby grimaces for not only food, nurse for comfort. My baby will event. athletic an is at asleep nursing my breast; My baby falls rarely increased. fussiness as dropping ﬁ at fast grew or rapidly, gaining is baby My stools. greenish blood. may have alittle Some diapers or frothy always—has sometimes—or baby My My baby iscolicky, or gassy, or spits upfrequently. My baby of lots poopy has wet and diapers. tugging, crying, arching. off, pulling breast, my with milk “wrestles” baby my My when spray they and/or releases. full, feel always breasts My splutters when she and My nurses. baby chokes gulps and other than hunger. than other Gaining,Gulping, Grimacing? tear- toolkit tear- sheet

485 rst with weight gain gain weight with rst ne. But without the the without But ne. 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 486 green stools. green frothy and discomfort, gas, causing intestine, large her in ferment can and • • things: two by cheesecake is, where doing the ofbottom barrel,” the You may ﬁ Not much or her feel drown. fun. she must swallow baby’smaking mouth, days. If not, check with an LLL Leader or visit llli.org for more ideas. llli.org or visit Leader LLL an Ifnot,checkdays. with body. your Trust trust her, and sometimes. sides both taking start or often, more nurse is do to has she all it, increase to wants supply.she If milk good of signs are these nursing, after and ing lots of looks wetand ting comfortable and relaxed poopyand dur- diapers, get- still baby is your If choking. or breasts moreleaking heavy,No milk.” feedings. delaying sides, and switching of point a problem—making the started have may that ideas two past get And then there’s the ﬁ there’sthe then And You to should see begin a a few happier babywithin and easier feedings your “lost you’ve that worry may you down, settles supply your As These sound butrules, like they’re just to reminders help temporary you comfort, then go back to the side you’re trying tosoften. side you’re backtothe go then comfort, trying what you If want. you’re is which production, back cuts side other the on The fullness over clock. the than more instinct your Use other. the using before side couple a for hours may side be itall one takes. Some need Using to spend four to time. six hours on next one again it use afterward, soft and isn’t nice side that If there. her leave side, one she’son happyIf there. still is fat milk higher the mean intervals Shorter minutes. few a just after even interest, shows she whenever nurse to Offer nd your baby is happier and more if settled you let her “get to the 486

the womanly art of breastfeeding of art womanly the re hose effect. All that milk can squirt into your your into squirt can milk that All hoseeffect. re overfull, nurse or express just too enough overfull, for 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 487 n ______12345678910 11____ Midnight 1234567 8 910 Noon 11 ______12345678910 11____ Midnight 1234567 8 910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ______12345678910 11____ Midnight 12345678910 Noon 11 ____ Date D ul-pm aot 5 iue a ﬁ at minutes 15 about Double- pump For best volume, be sure to follow each pumping session with some with session pumping each follow to sure be volume, best For If you have a non- nursing baby, 10 expressions per day is excellent. excellent. is day per expressions a 10 non- baby, have you nursing If at least once night. a Pump hand expression! hand After the ﬁ the After weeks. early the in below8 fall notto Try for8. aim mothers Many breasts. rst two weeks, 6 is a bare minimum. weeks, 6isabare rst two Circle Each Hour in Which You’ve Each Hour Which in Circle Pumped tear- toolkit tear- sheet PumpingChart rst; adjust as you learn your your learn you as adjust rst;

487 ol Total Goal 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 489 n doors separate with refrigerator of compartment Freezer ergrtr39° Refrigerator hr eprtr ieComments bag cooler Insulated Time Temperature temperature Room Where of refrigerator of compartment Freezer epfezr–4° freezer Deep StoringMilk for Your Healthy Full- TermInfant 0° to 26° (19° (–15° to 4° (–15° 5° to5° 39° to 78° 66° 5° F F (–15° F F (–18° (–20° (4° tear- toolkit tear- sheet C C F C ) 3–8 days Collect in a very clean way clean very a in Collect days 3–8 ) ) 2 weeks Store milk away from sides sides away from milk Store 2weeks )

C F C C ) 3–6 months 3–6 )

) ) ) 6–12 months 6–12 ) 24 hours Keep ice packs in constant constant in packs ice Keep hours 24 4–8 hours Containers should be be should Containers hours 4–8

489 down over time. down break milk the in fats the of some but safe, usually is ranges these than longer for stored Milk constant. most is temperature freezer, where ofthe back towardthe and limit opening cooler bag. cooler opening limit containers; milk with contact may keep milk cooler. milk keep may towel adamp with container the covering possible; as cool keptas and covered body of the refrigerator. of the body main ofthe back the in milk Store spoilage. to minimize 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 491 n • • • • • • • • • • routinely doesn’troutinely fi he If overfeeding. of risk the reduces This closed. lips his keep just he’ll Finally again. offer and remove, so, or sucks ten another offer it, takes he If more. wants he if see to again bottle the offer diately ready, too. be to him want she’ll and nurse, to ready be She’ll amount. small a just him give or him, distract to try soon, coming is mother his If next feeding. the until refrigerator left If there’sover, don’tmilk it keep throw justout! It fi will he is you think When whento. he wants breaks take pause and him Let own. topause on his soon learn away. He will drains milk the so forward slightly bottle and baby tilt gulps, or tense gets he If just comenose. outbut his it will air, some sucking him hear Youmay control. more much have he’ll and automatically, him into pour won’t milk The mouth. his in it’s when horizontal nearly is bottle the that so upright, fairly him Keep part. skinny nipple, bottle the of part fat the on close lips his so self, him- in it draw him Let mouth. opening his into horizontally bottle fi hold your his lips at against Hold as the start, youalmost bottle vertically would control. him togive upright babyHold fairly the snugly. him Keep babyFeed not the cues, when on he aschedule shows hunger it. precautions with special take to need you feelDon’t sturdy. and safe is milk Human Bottle- FeedingBreastfeda Baby: Ideasfor Day Care and Others nger to say “Shh.” When he reaches with his lips, tip the the tip lips, his with reaches he When say to “Shh.” nger tear- toolkit tear- sheet nish the bottle, put it. less in bottle, the nish nearly full, twist and remove the bottle. Imme- removebottle. and the twist full,

491 just the the just not ne in the ne the in . 6/2/10 3:02:51PM

© 2010 La Leche League International, The Womanly Art of Breastfeeding, Chapter 20. Lale_9780345518446_3p_all_r6.indd 493 n • • • • milk your Thawing • • • • • • • • • • milk Storing your • • • milk your Expressing refreeze, orrefreeze, discard. use, Then hours. twenty-four to up for refrigerated be can Thawed cold milk. Some babies happy are to drink stove, on the don’t directly use amicrowave. Don’t milk heat the faucet. warm under or water warm of bowl a or refrigerator in milk frozen Thaw ﬁ Use oldest the milk frozen may save bags space. Horizontal to avoid burn. freezer bags, in milk storing double-If container sealed storeor in them bag mostis steady. temperature where sides, from away freezer the of back the in Store for needed. frozen be as uselater can Unneeded milk waste. tominimize ml) (60 2ounces only with container each Fill freeze. to plan you if top the at space leave so freezes, it as expands Milk cold to cold. by adding one container in pumpings several Combine before feeding. cream redistribute to shake) (don’t swirl separates, milk If next fewhours. the in right if after expressing it your milk won’tor Refrigerate chill be used or bottle bag on the name and date Put tom of container. the bot- the on PP and/orletters symbol the recycling 5 number forthe works. To container or look clean use glass Any avoid toxins, known milk. your Wash or before handling hands expressing your SafeHandling and Storage of Your Milk tear- toolkit tear- sheet rst to keep it from getting tooold. rst tokeep it getting from

before ﬁbefore lling 493 . 6/2/10 3:02:51PM