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South Canterbury Breastfeeding Handbook

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SOUTH CANTERBURY BREASTFEEDING HANDBOOK South Canterbury Breastfeeding Handbook 1 Version 5 Updated May 2019 South Canterbury Breastfeeding Handbook 2 Best Practice for Maternity Units 5 Attachment / Bonding 6 Definitions 7 The Importance of Skin-To-Skin Contact 8 The Importance of Rooming In 8 Sleeping Safely At Home 9 Baby-Led / Cue Based Breastfeeding 9 Early Feeding Cues 10 Baby’s Stomach Size 11 The Composition of Breast Milk 12 When Your Milk ‘Comes In’ 13 Baby’s Output 14 How Does Using A Dummy / Pacifier Or A Bottle Affect 15 Breastfeeding Latching Your Baby On Well 16 Breastfeeding Positions 18 Breastfeeding Tips If You Have A Caesarean Birth 20 Expressing and Storing Breast Milk 21 Returning to work 24 Solutions For Common Breastfeeding Challenges 25 Tiredness 25 Sleepy Baby 25 Painful Shallow Latch and Nipple Pain 25 Unsettled Hungry Baby 25 South Canterbury Breastfeeding Handbook 3 (continued) Engorgement 26 Mastitis 26 Low Milk Supply 26 Supplementation 27 Reflux 27 Teething 27 Inverted Nipples 27 Alcohol and Other Drugs 28 Covid-19 Breastfeeding advice for Women & Babies 29 Red Flags 30 Preparing Yourself for Breastfeeding Before Your Baby is Born 31 How Your Family and Friends Can Support You 32 Introducing Solids 33 Where to go for Breastfeeding Support in South Canterbury 34 La Leche League 35 “BreastfeedingWorks!” 36 Plunket - Well Child Provider 40 Arowhenua Whanau Services 41 Breastfeeding Friendly Places Around South Canterbury 42 My Breastfeeding Diary 43 South Canterbury Breastfeeding Handbook 4 New Zealand is working towards restoring breastfeeding as the cultural norm. A Baby Friendly Hospital protects supports and promotes breastfeeding by following these 10 Steps: 1. They have a written breastfeeding policy that is routinely communicated to all health care staff 2. Train all health care staff in skills necessary to implement this policy 3. Inform all pregnant women about the benefits and management of breastfeeding 4. Help mothers initiate breastfeeding within an hour of birth 5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants 6. Give newborn infants no food or drink other than breast milk unless medically indicated 7. Practice rooming-in – allow mothers and infants to remain together – 24 hours a day 8. Encourage breastfeeding on demand 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic (A joint WHO/UNICEF Statement 1989) The World Health Organisation strongly recommends exclusive breastfeeding for the first six months of life. At six months other foods should be introduced but breast- feeding is recommended to continue for up to two years or beyond. Jean Todd Maternity Unit has been accreditated for BFHI since 2004. South Canterbury Breastfeeding Handbook 5 “You’ve probably heard plenty about the nutrition and immunities in human milk. But if you talk to most experienced breastfeeding mothers, they’re more likely to focus on the way breastfeeding helps you and your baby feel connected and attached to each other, weaving an emotional cord to replace the umbilical cord” Womanly Art of Breastfeeding 8th Edition. All the hormones that course through a mother’s body during and after the birth of a baby are there to help the mother and baby establish their relationship and bond. The levels of these hormones are higher in exclusively breastfeeding mothers. As a mother breastfeeds her baby she also tends to gaze at him or her and touch them lovingly which also helps to build this strong attachment, which will help the baby throughout his or her life. Continued breastfeeding causes these hormone levels to remain high and help the mother to be more caring and tuned in to her baby. They also reduce stress hormones in both mother and baby and help baby to better deal with stress even as an adult. Other hormones create the feelings of pleasure that we get when touching our babies (and others we love). Breastfeeding creates many opportunities for mothers to touch their babies and feel this joy which also enhances bonding. Father who lives with his partner and their baby also has changes in his hormones that help him to bond with both his partner and baby which enhances their relationship. When babies cry, instinctively a mother wants to respond to her baby and hold it close. This responsiveness helps the baby’s brain pathways to be wired up to know that the world is trustworthy and they can feel secure. Breastfeeding also help these pathways to be strengthened, because of the frequent touch and pleasure in the whole experience. If a mother experiences post-natal depression, breastfeeding helps mother and baby develop this bond faster and stronger than it might otherwise have been if they were not breastfeeding. Sometimes, if there are breastfeeding difficulties at first, it can take time for breastfeeding to become enjoyable but it is worth persevering to get to this point. South Canterbury Breastfeeding Handbook 6 Exclusive breastfeeding is when the infant has never had water, formula or other liquids or solid foods. Only breast milk, from the breast or expressed, and prescribed medicines have been given from birth. Full breastfeeding is when the infant has taken breast milk only, and no other liquids or solids except a minimal amount of water or prescribed medicines, in the past 48 hours. Partial breastfeeding is when the infant has taken some breast milk and some infant formula or other liquids or solids in the past 48 hours. Artificial feeding is when the infant has had no breast milk but has had alternative liquid such as infant formula, with or without solid food, in the past 48 hours. Importance of breast milk: • All your baby needs to eat and drink for the first six months • Meets all nutritional requirements • Helps protect your baby against colds, tummy-bugs, infections and allergies • Helps your baby feel safe and secure • Is always available, the right temperature, thirst quenching and free from contamination • The longer you breastfeed, the better it is for you and your baby (Ministry of Health) Risks of using Infant Formula: • It is NOT the nutritional equivalent of breast milk • It is expensive • Requires time for preparation and cleaning and sterilising equipment • Increases your risk of bone thinning, osteoporosis, breast cancer and ovarian cancer • Does not help you lose pregnancy weight like breastfeeding can because breastfeeding increases energy output (like exercise) • Does not give your baby any protection from infection or help your baby’s immune system to develop. South Canterbury Breastfeeding Handbook 7 Immediately after the birth your baby will be placed skin-to-skin with you. Skin-to-skin contact is important because: • It assists with bonding and helps stabilise baby’s heart rhythm, breathing and temperature • It encourages breastfeeding, a latch usually occurs within 60 minutes, as long as there is no influence from drugs given during labour • For babies who may take longer to ‘latch on’ continued skin to skin for as long as possible can help these babies to get started. • Releases colostrum ready for the baby • Babies cry less (being separated from their mother increases the baby’s stress). It is useful to continue having skin-to-skin contact if your baby is having feeding difficulties or is unsettled. If you are not able to have skin-to-skin contact with your baby, the baby’s father or another family member can do this instead. Having a baby stay in the mother’s room after the birth, (“rooming-in”) is important for breastfeeding because: • Rooming-in supports women to respond to early feeding cues • It helps mothers get to know their baby’s cues, providing a great start to your relationship • It helps to initiate breastfeeding • It decreases the risk of breast engorgement • Being separated is stressful for the mother and the baby • It encourages bonding • It improves the infant’s sleep South Canterbury Breastfeeding Handbook 8 The Ministry of Health recommends baby sleeps in their own bed (cot or bassinet) in the same room as their parent or caregiver. Babies who sleep in the same room as parents for the first six months are at lower risk of SUDI (Sudden Unexpected Death in Infancy). You might find it easiest to keep baby’s cot next to you so that you can reach him or her when needed. Baby needs to be face up, face clear and not able to fall or become wedged between surfaces. Make sure your baby is healthy and strong. If you choose to sleep in bed with your baby, put them in their own baby bed beside you—for example, a pepi-pod or wahakura. This will help keep your baby safe while they are asleep. Information about using a pepi-pod or wahakura is available online at www.whakawhetu.co.nz and www.pepi-pod.co.nz Baby-led breastfeeding (feeding on demand) means allowing your baby to feed whenever he or she wants. Be prepared to breastfeed often because frequent unrestricted breastfeeding helps to establish a good milk supply. • Timing feeds does not help you establish a good milk supply. Let baby lead the way. Your baby should feed at least 8-12 times per day although some babies feed more frequently, until lactation is established. • It usually takes six to eight weeks for you and baby to establish breastfeeding. • Your baby will go through growth spurts and will want to feed more often than usual. This is temporary and if you respond to this by breastfeeding more, your milk supply will increase.
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