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Breastfeeding Information and Management
What is the Baby Friendly Hospital Initiative?Why is breastfeeding so important? Isn’t formula just as good?Risks of formula feeding and costs
What will Baby Friendly mean to me when I am in the hospital?
What else can we do to help our baby get the best start?
What are the other benefits of skin to skin? Are there other times we should be doing skin to skin?
“Your baby’s first sleepover!” Why is rooming in so important?
Breastfeeding and pain relief in labor
What other help is available?
Research continues to demonstrate that breastfeeding has unique benefits to mother and baby and that there are risks to feeding formula. Healthy People 2020, a program from the Office of Disease Prevention and Health Promotion, has established objectives for increasing the number of mothers who successfully breastfeed. The Baby Friendly Hospital Initiative is a worldwide quality improvement project designed to recognize hospitals and birthing centers that provide an optimal level of care to all mothers, regardless of feeding method. Hunterdon Medical Center is currently on the journey to becoming Baby Friendly, along with hundreds of hospitals worldwide.
Becoming Baby Friendly means that hospitals encourage safe feeding through some key practices, which are described on these pages.
If you have, after careful consideration of the risks and benefits, decided to feed formula, or cannot breastfeed for any reason, you will be taught how to do this safely. Baby-Friendly hospitals and birth centers also uphold the WHO International Code of Marketing Breastmilk Substitutes by offering education and educational materials that promote human milk rather than other infant food or drinks, and by refusing to accept or distribute free or subsidized supplies of breastmilk substitutes, nipples and other feeding devices.
Please see these helpful links below:
Simply put, no. Like other mammals, human milk is what is known as ‘species specific’, that is, meant for human babies. Formula companies attempt to duplicate human milk, but this is not possible, because every mother’s milk is different. Formula also contains other substances which do not come from human milk, such as cow’s milk or soy protein, and other additives like sugars, vitamins, and minerals. While babies can grow and be healthy on formula, there is much research that indicates that breastmilk helps babies grow to be healthier overall.
These benefits are best realized when a mom is exclusively breastfeeding, that is, offering her baby nothing but breastmilk (whether it comes directly from her or from a bottle). Some of the benefits don’t occur unless she nurses her baby over a longer time. Because of this, the American Academy of Pediatrics recommends just breastmilk for the first six months. After that time, solid foods can be introduced. Breastfeeding should continue for the first year and beyond if mother and baby wish. Although the first weeks and months might be time consuming, the investment is well worth it. Exclusive breastfeeding is recommended in order for mom and baby to get the full benefits, but any amount or length of breastfeeding will benefit your baby.
- Healthier babies—research shows that formula fed infants have more diabetes, greater incidence of some childhood cancers, more childhood obesity, and more illness and hospitalizations in the first year. This includes asthma, ear infections, respiratory and gastrointestinal infections.
- Healthier moms—formula feeding mothers have more osteoporosis, more ovarian and breast cancers, and a slower return to their prepregnancy weight.
The cost of formula can run as high as $3,600 per year, while breastfeeding is essentially free. Mothers simply need to take in more calories, and no one would complain about that!
The Baby Friendly Hospital Initiative means that we will follow well researched practices that will support you and your baby getting off to the best start in life. These steps have been shown to be the best way to breastfeed successfully. These practices include:
- Putting your baby skin to skin as soon as s/he is born. We will dry your baby, and then put him directly on your bare chest, and cover you both with a blanket. All babies need to adjust to being outside of their mothers, and will go through a series of steps that end in your baby finding the breast all by himself. The first milk, called colostrum, is already in a mother’s breasts when she is pregnant, and is ready for baby at birth. This ‘liquid gold’ as it is called, is unique, and exactly meets your newborn’s needs in the first days.
- Frequent feedings on ‘cue’, that is, when your baby shows signs of being hungry. Babies eat irregularly and frequently, and this is not only meant to help them grow, but also assists in mom’s mature milk coming in.
- Rooming in, that is, keeping your baby with you all the time. This is the best way to get to know your baby: personality, temperament, hunger, and behavioral cues. All procedures, except a circumcision, can be done while your baby is with you in your room.
- Offering nothing but breastmilk, either directly or from a bottle if necessary. Even if we need to supplement, it is best to give the baby your milk rather than formula. Supplementation with formula will only be done if there is a clear reason to do so, as this has been shown to interfere with milk supply and breastfeeding.
- Not offering a pacifier except for procedures which would cause the baby pain. Pacifiers have clearly been shown to interfere with breastfeeding. Instead, your nurse will teach you other ways to soothe your baby.
- Learn as much as you can before your baby arrives, and enlist the support of family members who can help. There are many things that Dad can do to help Mom while she is nursing. We have classes and Board Certified Lactation Consultants who can assist you in the hospital as well as after you go home.
- Plan to limit your visitors. Hospitals are busy places to begin with, and you will only be with us for a few days. We realize everyone wants to see your new baby, but if you can ask them to limit the time they spend, in order to get your rest and feed your baby on cue, it will minimize the stress in those early days. If you need help telling visitors this, let your nurse know, and she will be happy to help.
- Don’t be afraid to feed your baby ‘on cue’, whenever s/he shows he needs to eat. Babies can’t tell time, and eat when they need to. There is no such thing as too much in these early days. Frequent feeding not only helps you both to learn more quickly, but it will increase your milk supply and give your baby exactly what he needs. This does not mean you don’t have enough milk! This frequent feeding does not last forever, and it is so important to early success!
- Babies can be fussier in the evenings and nights, so have a discussion with your nurse about how best to parent during the night time. Limiting visitors during the day, and getting some rest will give you the stamina to keep your baby with you all the time, even during those fussy evening and night times.And talk to your nurse about the many ways to soothe a fussy baby.
Skin to skin is the optimal way to get baby started with breastfeeding, but also can be done at any time during and after your hospital stay. In fact, if you find you have a sleepy baby, putting him skin to skin will often awaken him to feed more frequently. Here are some key benefits to skin to skin:
- Your baby’s temperature will remain more stable all through the hospital stay if you hold her skin to skin for that first hour. Blood sugar levels, and respirations, are also more stable.
- A mother’s chest warms to the exact right temperature that her baby needs to keep him or her warm. And a mom who has twins on either side of her chest will warm each half of her chest differently, according to the needs of that baby! Dad’s chest will warm also, but since his regulation thermostat isn’t quite as fine tuned, he will continue warming and he and his baby might feel too warm! But there is no reason Dad can’t enjoy the wonderful feeling of skin to skin!
- When baby is skin to skin, with hands unwashed right after birth, s/he finds her way to the breast more easily. This is called imprinting.
- With skin to skin, along with breastfeeding, your baby will colonize with the same bacteria as you and your partner. This is thought to help prevent allergies and keep your baby healthier.
- As mom strokes and talks to her baby she soon initiates breastfeeding, increasing her oxytocin levels and decreasing her uterine bleeding. Endorphins are flowing and there is a wonderful feeling of well being when holding your baby close.
- Babies who are placed skin to skin with mom tend to be calmer with less crying. Babies removed from mom may either protest (crying) or go into the state of despair (become quiet because they have shut down).
- Holding your baby skin to skin has been shown to significantly increase milk supply. If your baby needs to be away from you during your hospital stay, put your baby skin to skin as soon as he returns to you. It helps to re-acclimate the baby to you.
- Skin to skin facilitates the flow of information between you and your baby, the language between you two that establishes attachment, regulation and well-being.
- And it’s not just for newborns. Remember skin to skin continues to be a very important contributor to your baby’s long term development. So by all means continue to cuddle as your baby grows!!
“Your baby’s first sleepover!” Why is rooming in so important? Don’t parents need their rest? And don’t they get better sleep by sending the baby to the nursery?
Absolutely, rest is important, and that is why it is good to speak with your nurse about getting the rest you need, and how to do that while keeping your baby with you. And no, studies clearly show that moms and dads actually sleep better with their baby in the room, close by. Perhaps this is because they are secure knowing their baby is right there. Here are some other things to consider about rooming in:
- Your baby has spent nine months in your womb listening to your heartbeat, breathing and voice. After birth, these are the same things that provide a sense of security and comfort to your baby. It is unrealistic to expect that your newborn baby will be more content in a crib or a nursery, separated from you. Babies miss the womb and skin to skin contact with mom is very reassuring.
- Although you may be new at this parenting thing, we believe that the parents are the primary caretakers of normal, healthy newborns. Our nurses are here to assist you and teach you the skills you will need to take your baby home. Rooming-in allows you and your baby to get to know each other and to get in harmony with each other. Parents get a feeling of rightness when they are in sync with their baby, and this will only lead to better confidence in your parenting journey.
- Rooming-in also provides you with the opportunity to learn your baby's feeding cues. Babies awaken and begin these cues in several ways. Often they will look around, lick their lips and put their fingers or fist to their mouth. You may also observe the "rooting reflex" in your baby which is a wide opening of the mouth and turning the head back and forth as if looking for a nipple. When your baby cries, he or she is giving you a very late feeding cue, usually after the other cues have not been responded to. If the baby becomes frantic, you may have missed the window of opportunity for a successful feeding session.
- With 24-hour rooming-in, it has been found that mother's milk appears in greater volume 24 to 48 hours sooner than in mothers who are separated from their infants. Breastfed infants should only have one five-hour interval of sleep in a 24 hour day and this does not usually occur at night during the first several weeks. It has also been documented in research that there are fewer incidences of breastfeeding problems such as sore nipples and engorgement for women who take advantage of 24 hour rooming-in. Often when babies sleep next to their mothers at night, they can continue breastfeeding without either the mother or baby completely awakening. In this way you are actually more rested than when fully awakened by your baby being brought to you crying and difficult to calm for the feeding. Milk-producing hormones are also higher during the evening and night hours, and these feedings are important in the long-term success of breastfeeding.
- It is important for mothers to understand their infant's sleep patterns before going home and it is also important to learn the calming techniques that will help to settle your baby back to sleep. Rooming-in parents are well on the way to achieving two important goals of parenting: to know their baby well and to help their baby feel good.
- You, as parents, are the most concerned and observant caregivers in the world and with the time spent learning from the nursing staff with the baby in your room, you will go home confident and secure in the knowledge that you know your baby very well and are very comfortable with caring for your baby.
Taking a childbirth class is a great way to learn about labor, and the ways you can help your labor to progress as quickly and efficiently as possible. Knowing what labor is like will actually help your labor to move more quickly, because you will be relaxed, which allows your body to work as its most efficiently to birth your baby. Classes will also assist you in dealing with the discomfort during labor. You will learn about medicines as well as relaxation, breathing, touch, movement and other methods that can help you as you birth your baby.
Pain medications are available during labor as well. These are safe, but sometimes can impact the early breastfeeding experience because they can affect you or your baby. It will be important for you to know as much as you can about pain relief methods so that you can make an informed choice that is best for you. Make sure you discuss all of the options with your physician, midwife, and childbirth educator.
How can my partner help?
- Learn about breastfeeding. Take a class with Mom or read a breastfeeding book, such as: ‘Breastfeeding Made Simple’ by Nancy Mohrbacher, or ‘The Womanly Art of Breastfeeding’, by LaLeche League. Read educational materials given to you in the hospital and in classes. Watch the videos while at the hospital. You play an important role in breastfeeding success, and when you are educated, you will be able to provide helpful information and support for Mom. And you can provide correct information so that family members can support her as well.
- Make arrangements for household chores and errands to be taken care of. During the early weeks, both Mom and Baby are learning. You all need this time to get to know one another. The more Mom holds and nurses her baby, the more enjoyable and successful her breastfeeding experience will be. This is the only job a mother should be doing during the first few weeks.
- Limit visitors. More than anything, your partner needs rest and time with the baby now. And this is the time that you all are getting to know each other as a family. If you have visitors, be sure they are supporting your choice to breastfeed. Mom could become upset with critical or overbearing visitors. Also, avoid visitors that Mom would feel the need to cook or clean for.
- Bond with your baby. There are so many ways that partners can actively bond with breastfed babies. Change a diaper, bathe, hold, or rock your baby. Help mom to be comfortable during nursing and help her position your baby at the breast.
- If breastfeeding is not going well, get help for Mom and your baby. Both partners and mothers are welcome to call! Bringing Mom in for a professional consultation may be all that is needed to resolve a breastfeeding issue.
- Be a breastfeeding advocate. Voice your support of your partner’s breastfeeding to others. Let them know that you have every confidence in your partner and baby to master the art of breastfeeding, as the human race has done for centuries. Let your partner know how proud you are that she has given the gift of breastfeeding to your family.
All of our maternity nurses have been educated about how to help new parents feed and care for their baby. Additionally, we have Board Certified Lactation Consultants who will see you and your baby, both in the hospital and after you go home, if necessary. We are also available for telephone consults. You will be given more information on this once you have your baby.
We also have weekly and monthly support groups and classes that assist new parents along the way, and answer all of your concerns.
Here are some helpful links: