Breastfeeding is an important part of your baby’s development and growth. Even though it can be challenging at times, you are to be congratulated on providing the best and most natural nutrition for your baby. Below are some helpful tips for your family as you begin your incredible and rewarding journey together.
- Breast Milk: The Perfect Food For Infants
When your baby comes into the world, an amazing thing happens. You suddenly discover that you not only want the best for your child, you will do everything possible to keep your baby healthy and happy. Choosing to breastfeed is one way to help give your baby the best opportunity for nutritional intake – and an important way to enhance his or her growth and development. Although it can be an emotional decision, and many moms choose to bottle-feed their children with successful results, there are clear advantages to breastfeeding.
There's a good reason why breast milk is often described as "the perfect food for infants" and why breastfeeding is recognized as the best way to feed and nurture your baby. Why? Your breast milk is uniquely designed to meet the specific nutritional needs of your baby. While the main components of human milk are relatively similar, each woman’s breast milk is slightly different and can vary with the time of the day, the time of year, baby's eating pattern, baby’s health and growth, and mom's diet and nutritional health.
Human milk versus cow milk: Which is better?
Research indicates that breast milk contains unique nutrients that are important to baby. Here is how human breast milk compares to cow milk when it comes to baby’s nutrition:
- Although there is less protein in human breast milk than cow milk, the amino acids found in breast milk are critical to baby’s brain growth and eye development.
- Breast milk contains more lactose, a form of sugar, than cow milk and helps to aid brain development.
- Unlike cow milk, breast milk features special enzymes that helps baby in the digestion process. One of these enzymes breaks down the fat component of breast milk so that baby efficiently absorbs the milk.
- Breast milk minerals have special carriers that allow for easy absorption into baby’s digestive system. The vitamins in breast milk enhance this mineral absorption and provide the proper balance of nutrients necessary for baby’s growth and health.
Why human breast milk is the healthy choice.
Unique components found in breast milk are thought to enhance baby’s immune system, promoting immediate and life-long health benefits. In addition, studies have shown that fully breastfed infants have a lower risk of developing diarrhea, coughs, and vomiting than infants who are not breastfed. Breastfeeding also offers a healthy benefit you might not expect. Recent research indicates that breastfeeding may be a preventative measure against adolescent obesity. The study found that infants that were fed breast milk for the first six months were 22% less likely to be overweight nine to 14 years later.
There are many proven benefits to breastfeeding your baby. Breast milk features the key nutrients your baby needs, in the right amount, all in an easily digestible form. It's the best way to give your baby the specific nutrients he or she needs for physical and mental development – and a great way to give yourself peace of mind in knowing that you are making a smart choice for your baby that offers healthy benefits now and in the future.
- Yes, You Can Work – And Avoid Lactation Exasperation
You've experienced the joy (and trauma) of childbirth, learned the best methods for breastfeeding your precious little one, discovered a whole new world of "riveting" TV programming at 3:00 a.m., and actually secured a few hours of sleep thanks to, well, sheer exhaustion. Just as you finally feel like you are catching your second wind, you glance at the calendar and realize – with a large lump in your throat – that your maternity leave is about to expire. (Gulp!)
Before you forget that it’s the middle of the night and call your mom for moral support and encouragement, stop, put down the phone, and know that you are not alone. In fact, over half of all U.S. women who work outside the home have children under the age of three. And while you may have heard the statistics that women working outside the home are only half as likely to continue breastfeeding as those women remaining at home, you can still provide your baby with the nourishing breast milk he or she deserves. While it does take some organization and preparation, you can succeed in breastfeeding and working outside the home. Here are some tips:
Promoting milk supply – the law of supply and demand.
The best way to keep your milk supply at peak levels is to breastfeed your baby as often as he or she demands it – and that’s as often as possible. Allowing your baby unlimited access to your breast when you are together during non-work hours helps to maintain your milk supply because your baby provides better breast stimulation than breast pumps can. In addition, try feeding your baby right before you go to work and as soon as you arrive home to decrease the amount of milk you need to pump.
Choose those who handle breast milk with care.
As you evaluate caregivers, determine their attitude about feedings and be sure they are knowledgeable about storing breast milk. Often, moms are not able to pump enough milk during work hours because baby is being overfed by the care provider or milk is being wasted. When babies are overfed, there are typically not ready to nurse with mom when she arrives home from work, missing out on a valuable opportunity. Be sure your caregiver knows that breast milk should only be used for feeding baby when he or she is hungry – not when baby is fussy. Also consider using low-flow nipples because rapid-flow nipples may cause baby to overfeed or prefer the bottle.
Know your rights in the workplace.
Before returning to work, understand your company’s breastfeeding policies. Once you know the regulations, make sure you will have a comfortable, private place to pump within the office. Also, you have rights as a breastfeeding mother in the workplace. If anyone within your organization attempts to limit or forbid you from pumping, review your state’s laws at lalecheleague.org. It might also be helpful to discuss your situation with other breastfeeding mothers within your office so they can share their experiences with you. Finally, take good care of yourself and be sure to keep a bottle of water with you all day and have nutritious high-protein snacks easily accessible at work. Staying hydrated and having adequate amounts of nutrients in your system will help you make lots of healthy milk for your baby.
Returning to work when breastfeeding can make the office seem like a lonely and isolated place. With a little planning and preparation, you can help to make your return to the employment world a positive one. Remember that you are not alone (there are hundreds of thousands of other mothers doing what you are doing every day) and take solace in the fact that you are giving your baby a precious gift – the natural and nutritious benefits of breast milk.
- Milk Supply – Myths v. Truths
Myth #1: If I wait to express my breastmilk for a longer period of time, I will get more milk.
TRUTH: For many moms, waiting longer than three hours to express your milk can actually result in a decrease in milk supply. When your breasts are full, it sends a message to your brain that no more milk needs to be produced. In order to maintain or increase your milk supply, you need to express often and consistently to give your brain the feedback that when your breasts are empty, it's time to make more milk.
Myth #2: Once I go back to work my milk supply will naturally go down.
TRUTH: Returning to work and being away from your baby can be stressful for moms. When mom and baby are together, milk supply is increased in response to baby adding a feeding here or there. When moms are separated from babies consistently and expressing their milk, they may not increase the amount of pumping as the baby’s needs increase. Moms who want to increase their milk supply should nurse or express often. In order to increase your milk supply, add five minutes after breastfeeding sessions for a few days. If at work add a very brief pumping or two for a few days. Although you may not get much or any milk, this process will signal your body to produce more milk. In three to five days, if you express for a few minutes after daytime feedings (approximately five-seven times a day, depending on the age of your baby) you should see an increase in your milk supply.
Myth #3: I have no way of knowing if my milk supply has truly increased.
TRUTH: A velocity test can help you determine how much milk baby is getting. Follow these steps to perform a velocity test to determine how much breastmilk your baby is receiving at a feeding. First: weigh your baby in grams before a feeding. Baby can be clothed and the weight in grams is important, as this measurement is more accurate then pounds. Breastfeed the baby on both breasts until baby is satisfied. Weigh baby at the end of the feeding in grams. Subtract the ending grams from the beginning grams, divide by 28.4 and this will tell you how many ounces of breastmilk your baby just consumed.
- Before breastfeeding weight in grams: _______
- After breastfeeding weight in grams: ________
- Divide by 28.4
- Total # of ounces of breastmilk consumed at feeding: ____________ oz.
Myth #4: My baby nurses "all the time". I must not have enough breastmilk.
TRUTH: A baby goes through many growth spurts. A baby who suddenly begins nursing all the time is ordering up more milk for later. Also, the baby may just be thirsty and need a little drink, rather than a full feeding. Encourage this behavior in your baby as he/she knows how much breastmilk is needed for proper growth and development.
Myth #5: I am nursing all the time and still don’t have enough milk for my baby. There is nothing I can do.
TRUTH: There are many actions you can take if your milk supply is low. Do get assistance from your local Lactation Consultant. She may recommend herbs such as fenugreek, blessed thistle, or shatavari that are reported to be helpful for increasing your milk supply. Dr. Brown's recommends you see a Lactation Consultant for a full evaluation of your milk supply and milk transfer prior to starting any treatment.
- Dads Help Too
Your role as dad is very important in your new breastfeeding family. While it may seem that mom and baby have all the work to do, you don't have to feel left out. Even if at first it seems strange being a part of the breastfeeding experience, your help with support, encouragement, and bonding are crucial to the success of your family's breastfeeding plans. Here are some quick tips on ways you can help and where you fit in:
9 Ways Dad Can Help Too
- Go to appointments - You are most likely doing this already with doctor visits, but you can also be supportive by going with mom to her appointments with her lactation consultant. Watch and learn as much as you can because when you get home, you will be the trusted companion who will need to provide help and assistance during those middle of the night feedings when no one else is around. Listen and ask questions. Your mere presence will show your support but you will also find that you are able to learn the basics and be a valuable coach in the process.
- Help with the latch - If your baby is having difficulty latching properly, you can help mom with this. In addition to the challenges of having to hold her baby, offer her breast, and cradle properly, it can be awkward for mom to be able to check for proper latch. From your perspective, you will have the best view of whether or not baby is latching correctly. If baby is not latching properly, use what you have learned at the LC. Adjust baby's chin by pushing gently with one finger. (Try this on yourself and you will see how it pushes your tongue out.) Only with baby's tongue sticking out and mouth open wide, can baby achieve a good latch. Of course, there are many other techniques you and mom will learn from your LC. Work together to make sure mom and baby achieve a comfortable breastfeeding experience.
- Burp your baby - After baby is finished feeding, you can give mom a break and take over. Because babies can end up swallowing air during feeding, your baby may need to be burped. While your baby's chin is resting on your shoulder, gently pat baby's back. You did place a towel over your shoulder first, right? Good.
- Calm baby and mom - There may be times that everyone is crying, except you…yet. When the baby is fussy (but not hungry) and mom is upset too, this is your chance to step in. As dad, you will have a great ability to calm your baby. When baby is feeling scared, lonely, cold, or just generally agitated, your comfort and touch will help calm your baby down. Your smell and touch is obviously different from mom and your baby will recognize this and be able to relax.
- Learn to swaddle - What does this have to do with breastfeeding, you say? Lots. In the first few weeks, you baby may feel much more content when swaddled. The womb was a comfy place and the world can be big and scary not to mention cold. By learning the proper techniques for swaddling your baby, you will be the hero of the hour as the baby goes back to sleep and then so can you and mom.
- Suck action practice - Your baby is naturally born with the sucking reflex. When holding your baby, allow baby to use your finger to practice this calming technique. Your baby may already use her own thumb or fist for this. Don't worry, it doesn't necessarily mean she is hungry.
- Bath time - Bath time for your baby is an excellent time to bond. After your baby's cord falls off, you can begin giving your baby a bath or even taking baby into the shower with you. Babies love this. (Be careful though, they get slippery.)
- Feeding expressed breast milk - If mom will be going back to work or will need to be away from baby for any length of time, you may want to consider introducing a bottle of expressed breast milk before this situation arises. It is important to practice this before your baby is 4-6 weeks old or you run the risk of baby not accepting a bottle at all. Have mom pump breast milk and then leave the area. With you and baby alone, introduce the breast milk bottle. Be patient here. Your baby needs to eat at her own pace.
- Play and Reading - Of course you don't need to be reminded to play with your baby, but it is good to remember how important this time is as a part of the bonding experience. Talk to her and tell her all about her surroundings. Take your baby on a tour of her world. Read to your baby. Babies are ever interested in your voice and their surroundings. Enjoy these moments. Your baby certainly will.
By following these tips – and many more that you will discover – you will be an integral part of your family's breastfeeding and nurturing plan. Assure mom that she does not have to do this all alone. You should feel a sense of gratification at having a real role in taking care of your family. Congratulations!
- Breastmilk Storage Guidelines
Storage Duration of Fresh Breastmilk
(For Use with Healthy Full Term Infants)
Location Temperature Duration Countertop, table Room temperature
(up to 77°F or 25°C)
6-8 hours Containers should be covered and kept as cool as possible;
covering the container with a cool towel may keep milk cooler.
Insulated cooler bag 5-39°F or -15-4°C 24 hours Keep ice packs in contact with milk containers at all times,
limit opening cooler bag.
Refrigerator 39°F or 4°C 5 days Store milk in the back of the main body of the refrigerator. Freezer compartment of a refrigerator 5°F or -15°C 2 weeks Freezer compartment of a refrigerator with separate doors -0°F or -18°C 3-6 months Chest or upright deep freezer -4°F or -20°C 6-12 months Store milk toward the back of the freezer, where the temperature is most constant. Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degredation resulting in lower quality.
Reference: Academy of Breastfeeding Medicine. (2004) Clinical Protocol Number #8: Human Milk Storage Information
for Home Use for Healthy Full Term Infants. Princeton Junction, New Jersey: Academy of Breastfeeding Medicine.
- How much breastmilk does my baby need?
The American Academy of Pediatrics recommends that during the first six months your baby should only have breastmilk and should eat 8 to 12 times each day. If you have decided to exclusively express your milk rather than feed baby at the breast, there are some things you should remember. You will need to express your milk the same number of times that your baby would breastfeed.
Your baby needs about 55 calories for each pound of body weight. Your milk has approximately 22 calories per ounce. This means that if your baby is 8 pounds, about 440 calories is needed for the baby to grow properly (about 20 ounces of expressed breastmilk) each day. If your baby eats 10 times each day this means that he will eat about 2 ounces at each feeding.
Feeding Cues – How do I know if my baby is hungry?
Babies don't always eat the same amount so sometimes they will eat more than 2 ounces and sometimes they will eat less. Babies know when they are hungry or full. Feed your baby every time she is hungry or thirsty.
Babies will not typically overeat during the first year of life unless pressured to do so. Remember to watch your baby's feeding cues. These cues can difficult to see at first. When babies begin to feel hungry they may move, lick or smack their lips. They might open their mouth or suck on their lip. You may see the baby’s eyes moving under their eyelids if they are sleeping. If these cues are not recognized and babies become hungrier they may begin moving their legs and arms quickly. They may start fussing or crying. Babies also have cues to tell you they are satisfied. Moving away from the nipple, smiling, or disinterest in eating may indicate they are finished.
Remember, babies need small frequent meals but no two babies are alike. Sometimes babies will eat more—like right before a growth spurt—and sometimes babies will eat less. Rest assured, babies know how much to eat and will let you know when they are hungry.
In the Table below are some guidelines. These are not hard and fast rules because every baby is different.
Expressing Milk for My Baby – The First 6 Months
Size of Baby
Five 275 1 14 12 to 14 Six 330 1.25 16 14 to 16 Seven 385 1.5 18 17 to 19 Eight 440 1.9 19 18 to 20 Nine 495 2.25 22.5 20 to 25 Ten 550 2.5 25 22 to 26 Eleven 605 2.75 27.5 24 to 30 Twelve 660 3 30 26 to 34 Thirteen 715 3.25 32.5 30 to 36 Fourteen 770 3.5 35 32 to 38 Fifteen 825 4.5 37.5 34 to 40 Sixteen 880 5 40 36 to 42 Seventeen 935 5.3 42.5 38 to 44 Eighteen 990 5.6 45 40 to 46 Nineteen 1045 6 47.5 42 to 48 Twenty 1100 6.25 50 44 to 50
Expressing 12 times a day Expressing 10 times a day Expressing 8 times a day
1. Heird, WC. Nutritional Requirements During Infancy Modern Nutrition in Health and Disease. Ninth Edition 1999. Willimas and Wilkins. pages 839-855.
2. Morin, KH. Update on what and how much infants and toddlers eat. AM J Matern Child Nurs 2006;31(4):269.
©Dr. Jimi Francis 2011.