Breastfeeding Class – 6:30 - 9
AV Materials: Bras, nursing pads, breast with cover, poster of breast anatomy? Pumps. Bottles. Dolls
Handouts: Outline, Is it safe, others
From Home: Video, Myths & Truths
Write on board: my email. 386-6000 Swedish. 386-MOMS Infant Care and Breastfeeding Hotline, 215-3338 Class Registration. www.breastfeeding.com, www.lalecheleague.org
Intro myself, housekeeping, adult learners, give brief overview of the class. ~10:35
Goals of the class:
Some moms strong feelings, some undecided, some want to but have concerns.
Today: you’ll get info about how to breastfeed, learn about benefits, boost your confidence in the process by knowing how to tell if your baby is getting enough to eat, and I’ll give resources
Intros: Name, Due Date, Have you definitely decided to BF, or still thinking about it? What concerns do you hope get addressed today? (Ask partners if they have anything to add)~10:45
Benefits of Breastfeeding: Myths and Truths Game ~11:00
Preparation for Breastfeeding:~11:10
Has anyone told you to do anything to prepare nipples for breastfeeding? Not necessary
Here’s what you can do: Eat well; baby gaining ˝ pound a week.
Buy nursing bra: month before due date, get help sizing, open with one hand. PASS AROUND
Touch on nursing clothes: Optional, here’s what you should think about. Consignment. No tight shirts. Yes to prints and plaids and layers.
Nursing pads / Breast pads. (When you might leak, some people don’t, some lots)
Get help for after baby’s born.
Get educated, find out about resources. Point out class reg, tell about 11 am class and phone hotline.
Breast Changes in Pregnancy / Anatomy and Physiology 11:22
Ask them: What’s happened to your breasts during pregnancy?
Nipples darken, target. Montgomery glands become more prominent. Blood flow to breasts increase: may see veins. Fatty tissue develop to cushion and protect milk ducts. Each breast grows average of 2 lbs. New bra?
Pregnancy: >estrogen = sensitive nipples, milk ducts lengthen. > progesterone = alveoli develop.
3rd trimester, colostrum. Has anyone seen yet? Just wipe off with warm water
15-20 milk ducts per breast… not just one opening!
Inverted nipples? With finger and thumb at noon and 6:00 on areola, gently press down toward wall of chest. (Don’t squeeze thumb and finger together, or the nipple may invert further.) Nipple should pop out. If it turns inward…
When baby is born, placenta delivered, progesterone and estrogen levels plummet, and prolactin, another hormone, tells your body to begin producing milk.
Your milk does not begin to come in until 3-5 days after birth. In meantime, colostrum.
Early Feeding
Nursing lots helps _mature_ milk come in, gives baby lots of colostrum benefits
Start nursing baby within one hour of birth.
Once mature milk comes in: foremilk, hindmilk. Oxytocin letdown. (Nachos, dinner)
Supply and demand: breasts don’t necessarily feel full. 70% of milk produced while suckling
Position and Latch ~11:35
Have everyone pick up babies: show common mistakes: baby in lap, baby head turned to side
Look, magically, you’re doing cradle hold. Teach details. Dads pillows.
Latch: No tongue clicking, tongue under nipple, hear swallowing, lips flange, sucking motion by baby’s ear, nose by breast, chin indents breast.
Teach football hold. Touch on breastfeeding after cesarean
Teach side-lying. While they practice, touch on night-time feeding. Address safe co-sleeping.
Video 11:35 – 11:45
11:45 – 12:00 Break time (Back before 12:00 if possible!!)
Maternal Nutrition ~12:05
Have you heard there are things you can’t eat? Touch on allergies, sensitivities, etc.
Pass around handout: Is it safe. Briefly touch on.
Calories: increase by 500 calories per day. Water: LOTS. (Nursing stations, dads bring.)
Prenatal Vitamins
Frequency and Duration of Feedings ~12:20
Feed 8 – 12 times in 24 hours. Around the clock! At least every 3 hours in day start to start, every 4 at night
Touch on “sleeping through the night.”
Nurse at least 10 minutes per breast.
Some babies want to nurse much more than every 3 hours! May want to nurse more than 10 mins
Time is from start time to start time, just like contractions. Will eat less and quicker as get older.
Swedish: Feed on Demand. Touch on scheduling. No such thing as “spoiled baby.”
Hunger Cues: Rooting, tongue thrusts, sucking, wiggling. Cry is late! Easier to respond sooner.
Fullness Cues: Pulling away, much more pause than suck, sleeping. But if less than 3 minutes…
Feed till full on one side. Then burp, try other side
Burping. Spitting up.
Switching Sides
“Signs” Baby is getting enough. Write on board. 12:25
Start just after birth. Colostrum till day 5.
How you know milk comes in: More wet diapers/Bms. More swallowing. “Flooding”
Feeding 8-12 times per day, at least ten minutes per feeding!
Wet / soiled diapers: at least 1 diaper per day for every day old. After 7 days 5-10 per day.
Disposables: how can you tell? Girls: assume peeing. Can chart to keep track.
Gaining weight. After initial loss, 1 oz per day. Weigh in at one week, two weeks.
Assume you have enough! 24 hour cure
Hurdles. (Write on board) ~12:35
Engorgement: Normal! Sometimes in first week, can be anytime. Need to release some milk: warm washcloths, shower, hand express. Then nurse as long as baby will take it. Massage.
Sore Nipples: keep dry, express and rub in. Fresh air and sunshine. Keep nursing!
Thrush: White patches that don’t rub away. See dr.
Clogged Ducts, Mastitis. Massage, warm compresses, natural tx. antibiotics (milk not infected)
Lack of support, tiredness, fears, pressure to share feeding responsibilities, etc.
Pumping and Bottles ~12:50
Introducing the Bottle: wait until at 3-4 weeks (it’s easy, baby will get lazy) Do by 3 months or so. If you haven’t started one yet by 5 months or so, try a sipper cup
What type of bottle: doesn’t matter. They will nurse differently than on breast
If medically possible, don’t pump for first few weeks, want to focus on baby bonding
Show pumps. Discuss options. Whittlestone. Where to get (www.kidalog.com) Can rent! ~12:50
How to Bottlefeed: ~12:55
Tip bottle up. 2-4 oz 8-10 times a day. 2-3 ounces for every pound of baby.
Once they’ve eaten off a bottle, can’t be re-stored for later use as bacteria builds
Serve milk or formula at room temp to body temp
How to heat: not microwave!
Whenever baby eats from bottle, you should pump! Keeps us milk production.
Storage: ~1:00
4 Best Foods for Baby
Pump, put in bag. Label. Don’t put more than 2 ounces in bag for newborn, 4 at most. Twist tie
CDC: room temp for 10 hours
Fridge for 8 days. Set up a system, use oldest milk first
Freeze for 3 months, if fridge cold enough to keep ice cream hard. (Turn up) Middle of freezer
Thawing: in fridge overnight. Or in warm water bath (replace water when cool)
Combining formula and breastfeeding.
Doesn’t have to be all or nothing.
How long to breastfeed: ~1:05
AAP says exclusive for 6 months. (No water, juice or food needed)
Supplement with solid foods for 6-12 months.
Then as long as mutually desired. Talk about what it’s like to nurse a toddler.
If time: Sexuality. (Leaking and contraception). BF in public. Position practice, latch discussion.
Evals. 1:05 – 1:15
Review Questions: When should you first bf? When should you first pump? Teach me how to do cradle hold. How do I know latch is good. What is colostrum? Why engorgement?