1. Nursing the Baby Nurse as soon as possible after birth Comfortable position & support breast Tummy to tummy hold Wait until mouth opens wide (stimulate) Nipple plus 1 inch of areola No artificial nipple until 3 weeks/ later Proper latch on critical

2. Nursing the Baby (cont.) Use both breasts Check positioning, nipple care, thrush Supplemental feeding not recommended 12 month (min. 6 mths. - AAP) recommended though usually culturally determined

3. Nursing the Baby (cont.) Problems –Engorgement (gentle massage/ heat pad/ pump out some milk) –Mastitis (cold and flu-like symptoms; breast pain; fever; hot red area - does not affect milk quantity or quality, therefore continue to feed) –Inverted nipples (manual or shield manipulation) –clogged ducts (massage)

4. Nursing the Baby (cont.) Problems (cont.) –poor production (hypothyroidism, excessive antihistamine use, combination oral contraceptives, excessive caffeine, illness, poor diet, retained placental fragment, fatigue –poor let down (stress, anxiety, some drugs, hypertension, smoking)

5. Nursing the Baby (cont.) Expressing milk –hand expression, manual pump, electric pump –48 hours in refrigerator; 2 weeks in freezer compart. inside refrigerator; 3-4 months separate door freezer; 6 months in deep freeze (hard plasticor glass containers or special milk freezer bags)

6. Nursing the Baby (cont.) Assistance Programs –La Leche League International –WIC, EFNEP, CEP (pagers for mothers to call at all times with questions)

7. Nursing the Baby (cont.) Is baby getting enough? –Urination 6-8 times/day –4+ BM’s by 4th day of life (sometimes 1 every feeding –adequate weight gain, color & skin tone –at least 10 min. of good sucking and swallowing during feeding –feeds 8 to 12 times/ 24 hrs (2.5 oz per lb body weight e.g. 12 lb baby + 30 oz) –firm (before) to soft (after) breast tissue