1. Breastfeeding Basics Prenatal IV

2. Introductions: About your instructor – 1.Name 2.Role at KP (IBCLC/BFS) 3.Contact info (phone and email) About YOU – 1.What is your first name? 2.What would you like to learn today?

3. Objectives In this class you will learn about: How breastfeeding protects Mom & baby Breast anatomy and milk transfer Skin-to-skin contact Breastfeeding latch-on and holds Hand expression and pumping Solutions to common breastfeeding challenges & returning to work

4. Infant health and breastfeeding What have you heard?

5. Infant health and breastfeeding Milk is species specific

6. Let’s compare… NutrientsHuman milkCow milk formula proteins promote brain development promote muscle growth carbohydrates (sugars)enhance digestion increase incidence of constipation & intestinal infections fatty acids (Omega 3 and 6) from Mom from fermented micro- algae & soil fungus* immunities specific to human illnesses specific to cow illnesses *added to cow milk-based formula

7. Infant health and breastfeeding What am I having?

8. Infant health and breastfeeding Intestinal infections Allergic disorders Ear infections Urinary tract infections Bacterial meningitis Respiratory illnesses (such as pneumonia) Sudden Infant Death Syndrome (SIDS) Tooth decay Formula-fed babies are at risk for:

9. Adult health and breastfeeding Adults who were breastfed as babies have a lower risk of: Coronary artery disease Inflammatory bowel disease Obesity Diabetes (Type 1 & Type 2) Cancers – including leukemia

10. Multiple Choice Formula-fed babies are at increased risk for which infections? a.respiratory b.intestinal c.ear d.all of the above

11. Maternal health & breastfeeding What have you heard?

12. Maternal health & breastfeeding Women who breastfeed have: Less bleeding after delivery More rapid return to pre-pregnant weight and figure Less risk of post-partum depression Less risk of breast cancer Less risk of ovarian cancer

13. Breasts and breastfeeding What have you heard?

14. Breast anatomy 101 © Medela AG,Switzerland, 2006

15. Breast Anatomy 101 © Medela AG, Switzerland, 2006

16. Breast Anatomy 101 The size of your breasts has NO effect on the amount of milk you produce.

17. How milk is produced Before you deliver As you deliver After you deliver http://www.breastfeeding.com/helpme/hel pme_video_anatomy_of_lactating_breast. html http://www.breastfeeding.com/helpme/hel pme_video_anatomy_of_lactating_breast. html

18. Skin-to-skin contact Immediately after delivery ask your nurse to: 1. Dry baby off and put a knit cap on baby’s head 2. Place naked baby, tummy down, on your bare chest 3. Cover both of you with a warm blanket 4. Allow both to remain undisturbed for about an hour 5. Baby may show an interest in breastfeeding and latch on without help http://breastcrawl.org/video.shtmlhttp://breastcrawl.org/video.shtml

19. Latching on The process of latching on http://www.breastfeeding.com/helpme/helpme_vid eo_latch_on.html http://www.breastfeeding.com/helpme/helpme_vid eo_latch_on.html Shallow latch vs deep latch Asymmetric latch Breast balloon exercise

20. Milk transfer Nibbling http://www.drjacknewman.com/vi deo/nibbling-1.wmv http://www.drjacknewman.com/vi deo/nibbling-1.wmv Really good drinking http://www.drjacknewman.com/vi deo/really%20good%20drinking- 1.wmv http://www.drjacknewman.com/vi deo/really%20good%20drinking- 1.wmv

21. Fill in the blank & True/False 1.Women who breastfeed have less risk of post-partum d_________. 2.The dark area around the nipple is called the a_____. 3.Larger breasts mean more milk. __True __ False

22. Common breastfeeding positions Cradle hold Cross-cradle hold

23. Common breastfeeding positions Football hold Side-lying position

24. Infant feeding cues: Increased alertness or activity Mouthing or “rooting” Tongue movements Hand to mouth Clenching fists, bending arms Fussiness Crying – late sign

25. Support from partners… How to help Mom Help her into a comfortable position Arrange pillows for support Provide water or juice Praise her for nursing How to help Baby Hold baby skin-to-skin when not nursing Burp, diaper, and swaddle Take baby for walks …is proven to increase breastfeeding success

26. Breastfeeding and milk supply What have you heard?

27. Breastfeeding and milk supply Supply and Demand Principle:  The more the breast is drained, the more milk is made  The less the breast is emptied, the slower the milk production

28. Breastfeeding and milk supply Risks of supplementing with formula bottles: Interferes with baby learning to properly latch onto the breast Decreases the frequency of breastfeeding, breast stimulation, and milk withdrawal

29. How to tell your baby is eating enough “Milk-drunk” Wet diapers Soiled diapers Gaining weight

30. Sleepy babies Wake baby during “light sleep” Undress down to diaper Check latch and milk transfer Do breast compression Switch sides Rub back or pat feet

31. Fill in the blank & True/False 1.C_____ is a late sign of hunger. 2.One important reason women give for deciding & continuing to breastfeed is support from her p______. 3.The more the breast is drained, the more milk is made. __True or __False

32. Nutrition and Medication What have you heard?

33. Nutrition and Medication No special diet Caffeine - ok in moderation Alcohol - ok on occasion and in moderation Most medications ok: check with Newborn Club staff or pediatrician

34. Common concerns What have you heard?

35. Common concerns: flat or inverted nipples

36. Common concerns: previous breast surgery Breast augmentation (implants) – usually able to successfully breastfeed Breast reduction – may have challenges producing enough milk if nerves or milk ducts were cut

37. Common concerns: sore nipples To avoid or treat sore nipples: Check baby’s latch Vary breastfeeding positions Break suction Air dry nipples Don’t use soap on nipples Rub in breastmilk or lanolin Video: Latching onVideo: Latching on

38. Common concerns: engorgement Symptoms: Both breasts feel hot, swollen, painful, red, and shiny Low grade fever Usually occurs 3-5 days after birth

39. Common concerns: engorgement Treatment: Frequent feeding Warm compress to breasts Soften areola with hand expression Cool compress after nursing Ibuprofen (if not allergic) http://www.breastfeeding.com/helpme/helpme_video_en gorged_breasts.html http://www.breastfeeding.com/helpme/helpme_video_en gorged_breasts.html

40. Hand expression Steps for hand expression: 1. Wash hands 2. Apply warm, moist heat to breasts 3. Gently massage both breasts 4. Thumb and finger placement 5. Push back toward chest 6. Press thumb and forefinger together 7. Press - Compress - Relax http://newborns.stanford.edu/Breastfeeding/HandExpression.html http://newborns.stanford.edu/Breastfeeding/HandExpression.html

41. Pumping Manual pump Single electric pump Double electric pump Hospital grade double electric pump

42. Multiple choice & True/False 1. Engorgement usually lasts a.a few days b.a few weeks c.a few months 2. Breastfeeding should not be painful. __True or __False

43. Returning to Work What have you heard?

44. Returning to work Arrange for a time and place at work for pumping and storage Start pumping 2 weeks ahead of time Introduce your baby to a bottle about 2 weeks ahead of time Expect to pump 2-3 times each workday

45. Breast milk Storage Guide Deep Freeze Self- contained Freezer Refrigerator Cooler with 3 frozen ice packs Room Temperature Fresh breast milk 6+ months @ 0 o F 3-4 months 5-8 days @32-39 o F 24 hours @ 59 o F 4-10 hours @ 66-72 o F Thawed breast milk Do Not Refreeze Do Not Refreeze 24 hoursDo not store * For healthy, full-term babies

46. Thank you!