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l.f Conner- you're my sunshine
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The Village Maternity Services
P.O. Box 972906
Miami, FL 33197
www.villagematernityservices.com
write: [email protected]
ring:(305) 482-1649
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Table of Contents
PREFACE 7RISK OF NOT BREASTFEEDING 9THE BASICS 11SKIN TO SKIN 13FEEDING ON DEMAND 15LATCH 18ADDITIONAL TIPS 19APPENDIX 20BIRTH PLAN WORKSHEET 21
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Prefaceon taking the first steps necessary
towards creating a positive breastfeeding
experience for you and your baby. Ive
heard many lactation professionals say, breastfeeding is not only a science, but an
art. This is so profoundly true. My breastfeeding journey isn't unlike that of many
other women. I had some good days, some triumphs, disappointments and
regrets. In retrospect, I realize I didn't do my due diligence as an expecting
mother. I knew I WANTED to breastfeed and that was it. I thought it was
something that would come automatically. After all, isn't breastfeeding natural?
Boy was I in for a surprise. Although I breastfed my son until he was about 9
months; I weaned after returning to work and starting nursing school; I was
unable to produce enough milk to exclusively breastfeed. When faced with some
of the challenges that may come with breastfeeding, I didnt know where to go
for help. I became frustrated! Possessing the knowledge I have now would have
Breastfeeding is not only a science, but an art!
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made a world of difference for my son and myself. You see, London, my son,
suffers from asthma, a myriad of allergies, and eczema. It pains me to know that
my chose to not exclusively breastfeed may have been the contributing factor.
That is why I am so happy to be able to take the information I have gathered as
healthcare professional and mother and share with you.
Breastfeeding is making headlines around the world. Although I am excited to see
this push, we must also support each others decisions. Women in our society
have so many obstacles and face a myriad of booby traps. Think about it for a
moment:
If you were returning to work, would you be able to pump every 2-3 hours,in a stress free, clean room (cannot be a bathroom)?
At the hospital, did your nurses encourage formula? Did you leave the hospital with a gift bag filled with formula?
Did you leave the hospital confident in your ability to breastfeed?
Do you give women who breastfeed in public strange looks?Do you have a support system?
We should support each others decisions. We dont know what difficulties
someone is facing until we walk in their shoes. My lactation instructor Gini Baker,
would always say You did the best you could, with what you knew. Lets adopt
this philosophy for ourselves and others. Be a positive vessel for change.
Furthermore, I hope what you find within these pages gets you one step closer to
reaching your definition of breastfeeding success. Thank you for allowing me to
be a part of your village.
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RISK OF NOT BREASTFEEDINGIf you are like most women, then you are well aware of the BENEFITS associated
with breastfeeding. Here are just a few:
Not to mention, there is absolutely nothing in the world, that anyone can
manufacture, that can ever be as easily digestible and homogenous to your babys
digestive system as human breastmilk. But did you know that by not
breastfeeding you and your baby are at a higher risk of developing certain
diseases?
Risks for your baby
Ear infections Gastroenteritis Pneumonia Atopic Dermatitis Childhood cancer
Risk for you
Menopausal breast cancerOvarian cancerPostpartum depression
Benefits ofbreastfeeding
Decreaserisk ofSIDS
Decrease riskof childhood
obesity
Preventing
allergies
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On a larger scale, Author of The Politics of Breastfeeding, Gabrielle Palmercredits
women for producing "the most ecological food product in the world ."
Breastmilk is a natural, renewable resource! According to the U.S. Department of
Agriculture, $3.6 BILLION would be saved if we increased the number of
breastfeeding women 10%. So see, the benefits of breastfeeding dont stop at
your front door. Breastfeeding can have a major positive economic effect
nationwide.
Key points:
Breastfeeding is good for baby, mommy, and our economy American Academy of Pediatrics recommends breastfeeding for 1 year
(only breastmilk for the first 6 months)
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The BasicsOne of the biggest mistakes I made during my nursing process was that I did not
understand the means by which my body would produce milk. This along with
skin-to-skin and latch, which we will discuss later, are the building blocks for
successful breastfeeding. Our bodies are uniquely designed to produce the
amount of milk necessary to feed our baby. Clickhereto watch a video that helps
illustrate this point.
At about 14 weeks into your pregnancy, your body will begin making colostrum.
Once you give birth, you dont need to wait for you milk to come in. Nature
makes sure its already there. In the first few days of breastfeeding, your baby
may want to suck a lot. This is important. Let your baby suck on demand.
Whenever he wants; even if it is only for 5 minutes. During this time, your baby is
getting use to the motions of sucking, swallowing, and breathing. Establishing
good techniques now will help when your milk increases in volume. During this
time you are bonding and releasing feel good hormones that aide in breastmilk
production.
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Oxytocin
Milk
productiion& letdown
Suckingstimulus
Brain
Key points
Milk production begins 14 weeks into pregnancy Milk does not come in at birth. It is already there. It will, however,
increase in volume later
Sucking is a stimulus that signals your body to produce more milk
\
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SKIN TO SKINThere may be reasons a womans body is not producing enough milk to feed a
growing baby.
Tongue-ties Breast augmentation Severe maternal stress Milk Stasis Engorgement
Some complication may arise weeks and months after initiating breastfeeding.
This book by no means, serves to state that your breastfeeding experience will be
as easy as 1-2-3. However, the first few days are pivotal in getting your body on
the right track. These steps outlined in these chapters will get you on your way.
Skin-to-skin, also called kangaroo care, is a crucial first step in creating a bond
between you and your baby that will promote the release of oxytocin and
promote let-down. Skin to skin regulates the babys temperature, blood sugar,
breathing, heart rate, and calms a fussy baby. Immediately following birth, place
baby on your bare chest between y our breast. Baby will lay there for a while and
begin to familiarize himself with the new surroundings. It may take some time (1-
2 hours), but a newborn can actually find, crawl to, latch, and breastfeed on their
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own! All around the world, women are experiencing the breast crawl
phenomenon. Heres alink. If would like to do skin-to-skin immediately after
birth, discuss your wishes with your healthcare provider. A good way to begin
this conversation is by developing a birth plan. A birth plan outlines your wishes
for your birth experience. Please visit ourwebsitefor a list of printable
worksheets.
Key points:
Skin-to-skin helps baby acclimate themselves with their new world Promotes release of feel good lactation hormones Skin-to-skin immediately after birth and as often as possible Create and discuss your birth plan with healthcare provider
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FEEDING ON DEMANDIts important to understand that newborns feed frequently. It maybe every 1-2
hours, or in 45 minute time spans. Understand early hunger cues and it will be
easier to feed baby.
Early hunger cues:
Smacking or licking lips Opening and closing mouth Sucking on tongue, lips, hands,
etc
Rooting (turning head to theside searching for nipple)
Late hunger cues:
Moving head frantically fromside to side
Fussing and breathing fastCrying
Since the proteins in breastmilk are small, it is a lot easier to digest. A breastfed
baby will feed more often than a formula fed baby. Also,a newborns stomach is
very small. At this time you will be producing about 30 mL of colostrum per day;
more than enough to feed your baby. 3-5 days after birth, your milk will increase
in volume. Since your baby has retained fluid at birth water is not necessary.
Even after baby has lost the extra fluid, your breastmilk is designed to hydrate
your baby. Your foremilk is thinner and will quench his thirst. The hindmilk is
denser and calorie rich providing baby all the nutrients he needs for the first 6
months of life.
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Also, for the first 6 weeks
resist the urge to use bottles
or pacifiers. This is especially
important for mothers that
want to exclusively breastfeed.
By using a pacifier, you are
satisfying your babies sucking
need and decreasing the
stimulation to your nipples
needed to increase milk
volume. The use of bottles will
create a preference; not
confusion. Babies are not confused. Its much easier to get milk out of a bottle.
He has to work harder to massage milk from the breast and may begin toprefer
the bottle over your breast. At about 6 weeks, a good breastfeeding regimen
should be established, and introducing any of these items at this point should not
interfere with breastfeeding.
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Key points:
Breastfed babies feed oftenBreastmilk is the only thing your baby needs in the first 6 months of lifeDont substitute baby to breast for anything else (pacifiers or bottles)for
the first 6 weeks of life.
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Latch
Since you are breast feeding, and not nipple feeding, you want to ensure baby has
a deep latch on your breast. Baby needs to take in the nipple and large portion of
the areola; especially on the bottom. The bottom jaw does the majority of the
work when it comes to sucking. You want to present the breast and rub your
nipple against the babystop lip. He will instinctively put his head back and open
his mouth to feed. You will then bring the baby to the breast; chin first; while his
mouth is wide open. Always bring the baby to the breast, never your breast to the
baby. You will know he has a good latch because his lips will be pursed out like a
fish. An improper latch that is not deep is the main reason women experience
soar and cracked nipples; some tenderness in normal. Youve never had this
amount of stimulation and pressure applied to your nipples. However, the
nipples shouldnt crack and feeding shouldnt be painful. If he isnt latched
properly, insert a clean pinky into his mouth, and pull outward on his check
breaking the seal. Attempt to re-latch.
Key point: Breastfeed. Dont nipple feed Lips should appear pursed out like a fish during feeding Break the seal and re-latch if breastfeeding is painful or latch isnt deep
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I hope you find this information useful as you begin your breastfeeding journey. If
you encounter difficulty, seek the assistance of a lactation educator/counselor or
a lactation consultant. La Leche League offers free support groups in many
communities. Together, we can raise happier healthier babies.
ADDITIONAL TIPS
Dont wait. Ask for help right away if you experience difficulty. Problemsare easier to fixthe sooner they are addressed
Dont watch the clock. Let your baby set the paceConsider a co-sleeper or rooming inDevelop your support team
Consider a to-do-list for friends and family that want to help out. Youshould be resting during this time, not entertaining guest
Have family & friends signup to deliver mealsDrink plenty of fluids
If you cant sleep when baby sleeps, at least try to get rest. Put your feetup. Read a magazine.. REST
The world can wait, so can the dishes and the laundryGive yourself time
Dont measure your success against anyone elseEnjoy your baby
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APPENDIXColostrum This is the first milk. It is usually yellow in color compared to
mature milk. Also known as the foremilk. Newborns have veryimmature digestive systems, and colostrum delivers its
nutrients in a very concentrated low-volume form. It has a mild
laxative effect, encouraging the passing of the baby's first
stool, which is called meconium. This clears excess bilirubin, a
waste-product of dead red blood cells, which is produced in
large quantities at birth due to blood volume reduction, from
the infant's body and helps prevent jaundice.
Foremilk milk (typically lower in fat) available at the beginning of afeeding
Hindmilk hindmilk is milk at the end of a feeding, which has a higher fat
content than the foremilk at that feeding
Letdown This let down reflex usually happens after your baby has been
sucking the breast for about two minutes. Some women feel
this let-down reflex as a tingling or a warmth. Other womendont feel their let down at all. Even if you dont feel your let
down, you will see a change in babys swallowing patterns and
hear your baby swallowing
Oxytocin Causes the cells around the alveoli to contract and eject your
milk down the milk ducts
Diaper chart
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Birth Plan Worksheet
Basic Information
Name: __________________________________________
Partners Name: ___________________________________
Doctor/Midwifes Name(s): __________________________
Other Birth Attendants (doula, friends, etc.): ________________________________________________
_____________________________________________________________________________________
Children and Helpers, if attending: ________________________________________________________
_____________________________________________________________________________________
Babys pediatrician, if known: _________________________________
Delivery location: ______________________________________Estimated Due Date: ___________________________________
Pre-Birth Preferences
Induction:
___ I prefer to be induced on _____________ (date)
___ I will discuss induction after _____________ (date)
___ I prefer not to be induced unless it becomes medically necessary
___I am having a scheduled c-section on _____________ (date)
Arriving at the Birth Location
___ I will be birthing at home
___ I prefer to arrive as soon as contractions begin or my water breaks
___ I prefer to arrive once my labor is well established
___ I prefer to arrive only once I am advanced in labor; I want to labor at home as long as possible
Paperwork
___ We will pre-register
___ We will do the paperwork at our earliest convenience; please do not separate me from my support
person
___ We will do the paperwork immediately; please make an y separation as brief as possible
Comfort Measures
I would like to use the following comfort measures:___Pain medication (see below)
___Massage
___Birthing ball
___Birthing tub
___Music
___Essential oils
___Other: _____________________________
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Pain Medication
___Please dont offer it; I will ask if I want it
___Please offer me pain medication immediately upon arrival (explain my options)
___Please offer me pain medication only if I seem to need it
IV
___I do not want an IV or Hep lock at all
___I am okay with a Hep lock, but do not want an IV
___I would like an IV
Water
___I would like my water broken upon arriving at the hospital, to speed things along
___I would like my water broken only if my labor is slow and I am exhausted
___I would like my water broken only if my babys arrival is imminent and it hasnt broken on its own
___I would not like my water broken under any circumstances
Food/Drink___Please offer me ice chips or popsicles and nothing else
___Please offer me drinks but not food
___Please offer me food and drink as I need it
___Please do not offer me anything; I will ask or have an IV
Labor Augmentation
___If it becomes necessary, I would like to try natural methods first, including:
___Nipple stimulation
___Walking
___Herbs
___Other___Please offer me Pitocin
___I would like to try to avoid augmentation if at all possible; my baby will come when s/he is ready
Fetal Monitoring
___I prefer an external continuous monitor
___I prefer a continuous internal monitor
___Please use an external monitor for a few minutes per hour to check on my baby
___Please use a Doppler to check on my baby occasionally
___Please do not use any devices to monitor my baby; use a fetoscope or palpations only
Labor Positions
I would like to labor:
___While walking
___Lying down
___Sitting on a birthing ball
___In the tub/shower
___Let me decide at the time
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Environment
___Please keep the lights dimmed
___Please keep noise levels low
___Please play music. I would like a particular collection: _________________
___Please do this: _______________________________________
Internal Exams
___Please examine me as soon as I arrive and hourly after to check my progress
___Please examine me only if I ask
___Please keep examinations to a minimum
Pushing Preferences
___I would like to push on my back
___I would like to push on my hands and knees
___I would like to push on my side
___I would like to push on a birthing stool
___I would like to push _____________________
___Let me the decide at the time
Episiotomy
___Please cut an episiotomy if my baby is large and having difficulty
___Please do not cut an episiotomy; I would rather risk a tear
___Please allow me to try different pushing positions to avoid a tear
___Please use perineal support, massage and hot compresses to help avoid a tear
Vacuum/Forceps
If I need an assisted delivery, I would prefer:
___Vacuum
___Forceps___I trust my doctor to decide whats best
C-section
___Please help me to avoid a c-section unless an emergency arises
___Please offer me a c-section in my labor is not progressing after ___ hours
___I would prefer a c-section
___Other: ___________________________
Emergency Procedures
___Please explain to me what my options are so I can choose
___Please use your own discretion and choose what is best for me
Moment of Birth
___Please place my baby immediately onto my chest and leave him/her there
___Please allow me to hold my baby briefly before taking him/her to be cleaned and weighed
___Please take my baby to be cleaned/weighed immediately
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Cord Cutting
___Please cut my babys cord immediately
___Please allow my husband/partner to cut the cord
___Please have a doctor cut the cord
___Please wait until the cord stops pulsing before cutting
___Please wait at least an hour to cut my babys cord
___Please do not cut my babys cord (lotus birth)
Initial Bonding
___Please leave us alone for an hour after birth to bond
___Please clean and dress my baby, complete our medical exams, and then allow us bonding time
___Please do this: _______________________________________________
Newborn procedures:
We give consent for:
___Eye ointment
___Hep B vaccine___Vitamin K shot
___PKU test
___Hearing test
We do NOT give consent for (please bring us any waivers we need to sign):
___Eye ointment
___Hep B vaccine
___Vitamin K shot
___PKU test
___Hearing test
Feeding
___My baby is exclusively breastfed, please do not offer:
___Formula
___Sugar water
___Pacifiers
___My baby is formula fed, please help us choose a formula
Rooming In
___I wish for my baby to remain in my room 24/7
___Please take my baby to the nursery only at my request
___Please take my baby to the nursery at night so I can sleep (bringing him/her for feedings)
___Please take my baby to the nursery except when s/he needs fed
Visitors:
___I am open to any visitors during visiting hours
___Please allow only the following people: __________________________________________
___Please do NOT allow the following people: _______________________________________
___Please, no visitors during these times: ___________________________________________
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Medications Post-Birth
___Please offer me OTC-strength medications to cope with pain (acetaminophen, ibuprofen)
___Please offer me stronger medications to cope with pain (as prescribed)
___Please offer me arnica or another natural pain reliever
___Please do not offer me pain medication
___Please offer me a stool softener
___Please do NOT offer me a stool softener
Babys Exam
___Please perform my babys exam in my room
___Please perform my babys exam in the nursery with myself or my partnerpresent
___Please perform my babys exam in the nursery, we do not need to be present
Hospital/Birthing Center Stay:
___We prefer to leave 6 hours after birth
___We prefer to leave 24 hours after birth
___We prefer to stay 48 hours after birth___Please give your recommendation on our length of stay
Complications
___If my baby requires a hospital transfer, please allow my partner to accompany him/her
___If my baby requires a hospital transfer, please allow us to go together once I am released
___Please allow another family member to accompany my baby: ________________________
Other:
_____________________________________________________________________________________
_____________________________________________________________________________________
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