GETTING STARTED DOYLESTOWN HOSPITAL, DOYLESTOWN PA Keep your baby with you day and night to learn and respond to your baby’s feeding behavior

Watch your baby & not the clock!! STIMULATING YOUR BABY FOR FEEDINGS □ Burp your baby before, between and after feedings □ Place your baby skin to skin on mother or father

□ Express onto your baby’s lips

□ Massage and compress your during feeding TENDERNESS BREAST CARE □ Apply small amount of lanolin to your nipple after the feeding. □ Express colostrum or and massage into your nipple Keep the exposed to the air as much as possible after feeding to keep nipple skin healthy – air dry before □ Wear breast shells inside your bra between feeds to provide replacing clothing air circulation FEEDING GUIDELINES □ If nipple skin is cracked, apply saline soaks for 15-20 minutes □ Watch your baby for signs of hunger – rapid eye in a nursing pad before applying lanolin. movement (REM), wriggling, bringing hands to the face, ENGORGEMENT sucking sounds or motions. □ Massage and apply moist warm compresses, for a few □ Feed on your baby’s cue or every 1-3 hours – minimum minutes of 8 feeds per 24 hours □ Apply ice packs or cool compresses after the feed to relieve □ **Place no restrictions on frequency or duration discomfort and inflammation. □ Try to nurse at least 20-30 minutes on the first breast; □ Use a for a few minutes to form the nipple then offer the second breast □ If your baby did not remove enough milk to relieve fullness, □ Your baby may cluster feed every 1-2 hours with longer pump only for comfort sleep periods, this is normal especially on nights 2&3 after birth NUTRITION □ □ Colostrum transitions to mature milk on day 3-4; full Follow a healthy diet; prenatal guidelines do not apply to production is established at 3 weeks breastfeeding. □ □ Breastfeed exclusively for 6 months with no water or May consume moderate amounts of caffeine in the morning – other supplements; continue to breastfeed to 12 months watch your baby for signs of sensitivity or as long as mom and baby desire. □ Limit Albacore Tuna to 6 ounces in 1 week POSITIONING AND □ Wait 2-3 hours after each alcoholic drink or until you no □ Practice all positions: football, cross cradle, side lying longer feel the effects of the alcohol before breastfeeding and cradle and laidback. WHY WE SUGGEST YOU AVOID BOTTLES AND PACIFIERS □ Form a breast sandwich to help baby latch. Finger and □ Wait 3 weeks to introduce a bottle, and 4 weeks for a pacifier thumb located where baby’s nose & chin are. until breastfeeding is established □ Wait for a wide open mouth and then bring your baby to □ Frequent breastfeeding stimulates milk production your breast quickly □ Pacifiers and bottles decrease time at the breast and may □ Watch for more of the baby’s mouth toward the bottom lead to low milk production of the , chin touching the breast, and lips flared □ Pacifiers and bottles teach a baby how to suck differently and Signs of Effective Feeds may lead to sore □ Pattern of suck, swallow, breathe during feeds EXPRESSING AND SAVING MILK □ Audible swallowing with high volume of milk □ Store in glass bottles, BPA-free hard plastic bottles or □ Baby is satisfied and content after feeds specially designed storage bags. □ Breastmilk storage guidelines: □ Starting on Day 5: 6 wet and 3 soiled diapers per day  Room temperature at 77°F or 25°C Up to4-6 hours □ Baby gains 5-7 ounces (142-198 grams) per week after  Refrigerator (fresh expressed) at 39°F or Up to 4-6 days full milk production is established. 4°C  Insulated cooler with frozen gel packs Up to 24 hours (transported milk) at 59°F or 15°C  Completely thawed & placed in Up to 24 hours The more you nurse, the more milk you make. refrigerator at 39°F or 4°C

 Freezer compartment of 2-door □ Warm only to body temperature (37°C/98.6°F) Up to 3-6 months refrigerator (not in door) at 23°F or -5°C □ Warm only the amount that will be fed to the baby and discard  Deep freezer at -4°F or -20°C Up to 6-12 months any milk that was warmed and not used

□ Thaw either in refrigerator overnight, in a pan of □ Do not microwave Breastmilk lukewarm water, or directly under faucet in stream of warm water RESOURCES

WE RECOMMEND YOU HAVE A GOOD BOOK ON BREASTFEEDING

 Breastfeeding: A Parent’s Guide, Amy Spangler, RN, IBCLC — Available at Doylestown Hospital  The Nursing Mother’s Companion, Kathleen Huggins, RN, IBCLC

 So That’s What They’re For! Breastfeeding Basics, Janet Tamaro

 The Womanly Art Of Breastfeeding,

 Nursing Mother, Working Mother, Gale Pryor

SUPPORT GROUPS WITH VOLUNTEER COUNSELORS TO HELP YOU (No Charge) 215-572-8044 – Nursing Mothers Advisory Council – Hotline and to locate a local counselor 1-877-452-5324– La Leche League Help Line 610-584-4013 – North Penn Nursing Mothers

PRIVATE PRACTICE CONSULTANTS (Outpatient Consults for a fee)

215-534-3439 -- Cindy Jarret, RNC, IBCLC, Best for Babies- Doylestown, PA 215-837-6664 -- Jean Krauss, RN, BSN, RLC, Best for Babies- Doylestown, PA 215-385-4657 – Hope Allyson Dwiggins, IBCLC, RLC – Horsham, PA 215-346-6177 – Amy Goldberg, RN, CCE, CIMI, IBCLC, RLC Warrington, PA 610-584-6111 – Judy Crouthamel, RNC, BSN, IBCLC – Skippack, PA 19474 215-491-0502 – Cathy LaTorre, RDN, IBCLC – Warrington, PA 18976 267-231-9442 – Susan Slear, RN, IBCLC, CCE – Langhorne, PA 19047 215-679-4028 – Phyllis Young, RNC, IBCLC – Pennsburg, PA 18073 215-886-2433 – Breastfeeding Resource Center – 1355 Old York Rd Ste 101&102 Abington, PA 19001

BREASTFEEDING SUPPLIES

215-345-2200 – Doylestown Hospital Breastfeeding Supplies – Extension 4637 (Medela) 215-886-2433 – Breastfeeding Resource Center – 1355 Old York Rd Ste 101&102 Abington, PA (Medela, Ameda)

Doylestown Hospital Website - www.dh.org Provides breast feeding information along with feeding and diaper records to download

HELPFUL WEBSITES www.ilca.org - Find a www.nursingmoms.net / www.laleche.org / www.workandpump.com

FORM # 637-014 pink stock 1.2016

www.kellymom.com / www.Breastfeedingusa.org

FORM # 637-014 pink stock 1.2016