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Nebraska Medicine Patient Breastfeeding Class

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by

Jill Seberger

on 10 November 2016

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Transcript of Nebraska Medicine Patient Breastfeeding Class

Welcome to Breastfeeding Class!
Yes... Your baby is getting enough.
HOW IS MILK MADE?
delivery of placenta
removing milk
breast feed the baby!
or pump

SUPPLY AND DEMAND
the more you nurse, the more milk your body makes

CLUSTER FEEDING

FOLLOW UP PEDIATRICIAN APPOINTMENT

FEEDING GOALS

DIAPER GOALS
Alright... What else?
Pacifiers
Engorgement
Different breasts and nipples
Supplies



Fun Videos for Breaks
Teach me how to breastfeed
Okay...
the first feeding is done.
Now what?
Baby behavior
Feeding Cues
Latching
So... how do I do this?
What to expect after delivery
The first hour
Skin to skin

Critical First Hour
According to the American Academy of Pediatrics (AAP), a healthy newborn should be placed
skin to skin
directly after birth and stay there until AFTER the first feeding is accomplished.
How do we make this happen?
limit visitors
warn Grandma ahead of time
partner protect these important moments
use your nurse
this usually takes 60-90 minutes
...give it time!

Baby naked or in just a diaper
Bare chest
HELPFUL HINTS
wear hospital gown backwards or robe
bra that detaches in front
As much as possible day and night
Why?
So what is Skin to Skin?
Join the
Boob-olution!
The New Normal
Introductions
Names
When are you due?
Boy? Girl? Twins??
What burning questions do you have? What have you heard? What are you afraid of?
Housekeeping
Please...

Interrupt to ask questions throughout the night!

Use the bathroom when you need to!

We will try to remember most of you are pregnant and offer breaks accordingly.
You're here... Why? Why breastfeed?
What are some of your reasons?
Breastfeeding Benefits
FORMULA FED BABIES:
more respiratory infections, ear infections, and stomach problems
greater risk of SIDS
greater risk of asthma, obesity, diabetes, heart disease, certain cancers

BREASTFED BABIES HAVE
higher intelligence scores
more emotional security and enhanced bonding



They recommend:
0-6 months: Only breastfeeding/breast milk
About 6 months: Continue breastfeeding along with complimentary foods for two years of age or beyond.
This can be done in the OR with c-sections also...
discuss with your MD ahead of time.
HELPFUL HINTS
ditch the baby clothes
Benefits of Skin to Skin
Dads too!
brain development
stabilized heart rate and blood sugar
+ breast milk stabilizes blood sugar better than formula
cry less
stimulates mom's hormones to make milk
latch better
Questions
Break time
BABY BEHAVIOR
FIRST 24 HOURS
Sleepy baby!
Parents, take naps!

How do you wake a sleepy baby to eat?
skin to skin

DAY 2
More awake!

What do you do?
1. skin to skin
2. ditch the mittens
3. room in
4. feed on demand
Feed on demand? What is that?
Feed babe when he shows feeding cues
Early
clenching fists at center of body
smacking or licking lips
opening and closing mouth
sucking on lips, tongue, hands or fingers
{when you see these: position babe at breast or watch breast crawl}
rooting
stretching
trying to position for nursing
fidgeting, squirming
cooing, sighing sounds
starting to fuss and/or breathe fast
{when you see these: place babe skin to skin to calm}
moving head frantically from side to side
crying
feeding cues
{when you see these: place babe skin to skin}
Active
feeding cues
Late
feeding cues
After babe calms, try again
Babies get over stimulated easily
...noise, lights, visitors...
What do YOU do to calm a baby?
{consistency is key. boundaries. repetitive motion. calm visuals. give it time to work}
great job for dad
Colostrum: the first milk
Mature milk: increases about day 3
What questions do you have? What problems are you worried about?
Okay, I think she wants to eat, how do we latch?
football hold
Let's practice!
cross cradle hold
cradle hold
sidelying
twins
HELPFUL HINTS
Mom feels comfortable
Baby feels secure
Tummy to tummy
Ear, shoulder, hip lined up
CORRECT LATCH
Start nose to nipple
Mouth full of breast tissue
A good latch helps baby get more milk and mom have less pain.
Hand expression
The skinny on Pacifiers...
1. Breast
2. Baby's hand
3. Your clean finger
4. Pacifier
If possible, avoid offering a pacifier or bottle for the first 4 weeks. - Recommended by the American Academy of Pediatrics
Paci use puts you at risk for:
lower supply
pain
difficulty latching
HELPFUL HINTS
Thanks for coming!
Congrats and don't hesitate to call us!
Over stimulation
When the first hour is interrupted, restart at the beginning.
provide lubrication to the skin
discourage bacteria growth
secrete smell like amniotic fluid to guide babe to the breast.
throughout the breast, not behind nipple
My baby is fussy but won't latch...
Please grab a red folder and a baby doll.
-Jill, Jen, Stacia, Nicole, Sara, Lacey & Alana
MOMS WHO FORMULA FEED
more blood loss following birth
greater risk of postpartum depression
greater risk of breast and ovarian cancer
PLUS
fit into your jeans sooner!
convenient
cheap

Breastfeeding Benefits
Our goal...
to get breastfeeding off to a good start to give you the greatest chance of success.
...Other bumps in the road can be overcome as they appear.
Takeaways

1. Resources
ask for help
evidence based
2. Skin to skin
for prevention and treatment of any issues
45 states (including Nebraska) have laws that allow mothers to breastfeed in any private or public place.
When babe is latched:
chin and nose touch breast
mouth wide open
mouth covers all of nipple and most of areola
lips flange out
listen for swallowing
breast compressions
Why is a good latch important?
Latch impacts:
transfer of milk
comfort for Mom
Okay, I think
she wants to
eat. Now how
do we latch?
How often do we do this?
Watch baby, not the clock
Nurse until babe shows signs of being full
self detaches
falls to sleep
breast may feel less full
"milk coma"
If you continue to feed on demand, you may have an easier time maintaining your supply.
Newborns nurse frequently, not on a schedule
Later, babe will adapt a more predictable routine
First 3 weeks (at least): babe gets to eat whenever she wants
Dude, where's the food?
Feeding Goals:
Day 1

Day 2, 3, 4...
6-8 feedings in 24 hours

8-12 feedings in 24 hours
Diaper Goals:
Day 1
Day 2
Day 3
Day 4
Day 5
Days 6, 7, 8, 9....
1 wet, 1 dirty
2 wet, 2 dirty
3 wet, 3 dirty
It's day 4. You've been home from the hospital for 24 hours and babe has had 2 wet diapers.

What do you do?
Call us!
Or call someone trained in lactation.
Use your resource list
If you have an object in front of you, can you tell us how it is related to the benefits of breastfeeding?
Breast Milk
treat eye infections
speed the healing of skin problems
stabilize blood sugar better than formula
develop an immune system nearly as sturdy as mom's
help clear meconium
What thoughts do you have on the video?
Quiz:
Grandma is holding baby, who starts to squirm and puts her hands in her mouth.
What do you do?
What can you do to help ensure you produce enough milk?

Nursing in Public
Diet
Helpful Resources
You have everything you NEED: YOU, BREASTS, and BABY
Other Stuff:
Soft Carrier
Nursing Pads
Nursing clothes
Nursing bras
Breast Pump
Nursing Footstool

Research shows babies who are worn for much of the day fuss less.
What I want to teach you vs. what you want to know.
Pumping!
Let's look at your handouts.
3-4 weeks after delivery
IF breastfeeding is
well established
start pumping to build a supply
for return to work or other times away from babe
There are to pumping too soon
risks
When someone doubts how your baby breastfeeds, remember this:

Breastfeeding is only partly about nutrition.
developmental
brain development
relationship development
disease fighting
illness fighting
antibodies
bonding
decreases SIDS risk
comforting
teaches baby to calm
frequent feedings maintain supply
frequent feedings reduce obesity
teaches baby to love
teaches baby to relate to others
develops trust
relieves pain
What questions do you have left?
Why Avoid Formula?
Week 1: Baby's stomach and gut is most susceptible - increase in asthma and allergy risk
Other risks:
low milk supply for mom
difficulty latching
nipple pain
Formula increases health risks at any time, but especially in the first week of life
Feeding your baby only breast milk has been found to be the single most important thing you can do for your child's health.
You CAN do this!
Put the baby skin to skin with mom!
There is no one right or perfect way to feed your baby.
laid-back
Diet
Do I have to maintain a perfect diet while breastfeeding?
Short answer: NO!

Eat when hungry, drink when thirsty!

There are no foods you should avoid simply because you are breastfeeding :)
Alcohol
Current research reveals that occasional use of alcohol (1-2 drinks) is not harmful for the nursing baby

AAP: recommends ingestion of alcohol should be limited to about 2 oz liquor, 2 beers, 8 oz wine and to nurse 2 hours (or longer) after drinking to minimize concentration

Alcohol filters through breastmilk at the same rate it filters through blood
More resources:
www.kellymom.com
www.globalhealthmedia.org/videos
www.infant risk.com
(806)352-2519

Lactmed phone app
MommyMeds app
Does not increase milk production
Please don't be afraid! You'll do great!
Who are we?
Introductions
Who are you?
Jill
Jen
Stacia
Nicole
Sara
Lacey
Alana
Nebraska Medicine Lactation Consultants
Increased health for mom and babies
by itself, can:
The list goes on and on...
The longer the breastfeeding journey, the more benefits.
The American Academy of Pediatrics (AAP) and World Health Organization (WHO) agree:
Getting Started
No bra, no shirt
Mom or Dad's
A dad wanted to know...
Safe Sleep and Safe Positioning
Infant's face can be seen
Head in sniffing position
Nose and mouth aren't covered

When you are tired and may fall asleep, place yourself in a safe position while breastfeeding.
On a firm mattress
Avoid couches and puffy chairs
Ask family and whoever is around helping you to keep an eye on you and baby and your safe positioning.

Infants should sleep in a bassinet in their parents room for the first year of life.
Nothing else should be in the bassinet or crib except baby
no stuffed animals, siblings...
Resources for safe sleep: AAP Recommendations, James P McKenna's sleep lab research and book, "Sleeping with Your Baby"
Sesame Street
Full transcript