OBSTETRICS/MATERNITY:
Breastfeeding and Breast Care
After delivery, the Saint John’s Health Center’s highly trained lactation certified nurses or lactation consultants are available to provide new mothers with breastfeeding support. She will be assisted in learning about baby's feeding cues, proper positioning and latch-on techniques, issues arising from prematurity, breastfeeding after breast augmentation or reduction, and breastfeeding in the workplace. This encouragement is reinforced through post-hospitalization visits and consultation.
When the Milk Comes In and EngorgementIf the baby has been nursing well and on demand since delivery, a woman’s milk may come in around the second to fourth day (initially the breasts contain colustrum--a thick, creamy, yellowish milk that helps protect the newborn from infection).
Sometimes when a woman’s milk comes in, there can be accompanying swelling of the breast tissue called engorgement. If this occurs, continue with frequent nursings--at least eight to twelve times in 24 hours--which will helps regulate milk supply to the baby’s needs. Also, mothers may use warm packs to the breast followed by cold packs after nursing. Warm showers also help.
Mothers may have to express some milk before feeding in order to soften the areola and allow the baby to latch on. Engorgement is temporary and usually lasts 48 to 72 hours. Bottle-feeding mothers click
here.
Breastfeeding Tips:
- Position the baby correctly on the breast to prevent sore nipples. New mothers should have a Saint John’s nurse observe her breastfeeding to help with positioning and latching.
- Babies should nurse on the areola or dark-colored area of the breast and not the nipple itself.
- Women should try frequent, demand feedings. Newborns should nurse eight to twelve times in 24 hours.
- Each feeding may last 15 minutes to an hour, so women should be sure they are positioned comfortably. Sitting in a recliner, with their feet up and using pillows to help support the baby close to the breast can make breastfeeding more enjoyable.
- Women should start on the breast they finished with. If nipples are sore, start on the less sore side first.
- Try to offer each breast at each feeding. Switching between breasts helps stimulate milk supply evenly.
- Burp the baby after each breast and rotate the positions used.
- Before removing the baby from the breast, always break the suction by gently inserting a finger into the corner of the baby’s mouth
Latching On
Proper latch-on occurs when the baby takes hold of the nipple/areola, drawing the nipple toward the back of the mouth. This is approximately 1.5” behind the tip of the nipple. Stroking a newborn’s cheek will often make the baby turn their head and open their mouth (known as the rooting reflex).
Breast Care
Breastfeeding mothers should cleanse their breasts once a day with warm water. Avoid the use of soap on breasts because soap can wash off the natural skin oils and dry the skin. Before breastfeeding, wash hands.
After nursing, allow breasts to air-dry by leaving the flaps of the nursing bra open for 15-20 minutes. Once the skin is dry, apply a thin layer of lanolin breast cream to the nipple and areola. There is no need to wash off the lanolin prior to the next feed. Lanolin is a natural moisturizer derived from wool. If a woman is sensitive to wool, she is encouraged to use her own breast milk as a moisturizer. Be sure to wear a supportive nursing bra and avoid the use of plastic-lined nursing pads.
DietWomen should continue taking their prenatal vitamins while nursing and as long as indicated by their physician. It is important to eat a well balanced diet, high in fiber, and to continue to drink plenty of fluids--including eight to twelve glasses of water a day. Breastfeeding mothers need approximately 2,500 calories a day.
To ask questions or make follow-up appointments with a Saint John’s lactation consultant, call 310-829-8944. New mothers can also attend Saint John’s Breastfeeding Support Group.